Glaucoma – Articles 2

© 2012

Ginkgo biloba: an adjuvant therapy for progressive normal and high tension glaucoma

            (Cybulska-Heinrich, Mozaffarieh et al. 2012) Download

Gingko biloba has been used for hundreds of years to treat various disorders such as asthma, vertigo, fatigue and, tinnitus or circulatory problems. Two of the main extracts are EGb761 and LI 1370. Most pharmacological, toxicological and clinical studies have focused on the neuroprotective value of these two main extracts. Neuroprotection is a rapidly expanding area of research. This area is of particular interest due to the fact that it represents a new avenue of therapy for a frustrating disease that may progress despite optimal treatment. One such disease is glaucoma.Glaucoma leads to the loss of retinal ganglion cells and their axons but also to tissue remodelling which involves both the optic nerve head and the retina. In the retina the astrocytes get activated. In addition, the optic nerve gets thinner and the cells of the lateral geniculate ganglion disappear partially. On average, ocular blood flow (OBF) is reduced in glaucoma patients in various tissues of the eye. Increased intraocular pressure (IOP) is a major risk factor for glaucomatous damage. Nevertheless, there is little doubt that other risk factors besides IOP are involved. One such risk factor is a primary vascular dysregulation (PVD) occurring in patients with a disturbed autoregulation, another risk factor is oxidative stress.

Short-term effects of Ginkgo biloba extract on peripapillary retinal blood flow in normal tension glaucoma

            (Park, Kwon et al. 2011) Download

PURPOSE: Based on the vascular theory of glaucoma pathogenesis, we wanted to evaluate the effect of Ginkgo biloba extract (GBE) on peripapillary blood flow in patients with normal tension glaucoma (NTG). METHODS: Thirty patients with NTG were randomly placed in the GBE-treated or control groups. The GBE-treated group received 80 mg GBE orally, twice a day for four weeks, and the control group received a placebo twice a day for four weeks. Complete ocular examinations including visual field, Heidelberg retina flowmeter, and systemic examinations were performed on the first study day and on the day treatment was completed. RESULTS: After GBE treatment, the mean blood flow, volume, and velocity increased at almost all points, and there was a statistically significant increase in blood flow at almost all points, in comparison to the placebo. Blood volume significantly increased only in the superior nasal and superior temporal neuroretinal rim areas. GBE also significantly increased blood velocity in areas of the inferior temporal neuroretinal rim and superior temporal peripapillary area. CONCLUSIONS: GBE administration appears to have desirable effect on ocular blood flow in NTG patients.

Ginkgo biloba extract and bilberry anthocyanins improve visual function in patients with normal tension glaucoma

            (Shim, Kim et al. 2012) Download

Ginkgo biloba extract (GBE) and anthocyanins are considered beneficial for various vascular diseases. This study was performed to evaluate the effect of GBE and anthocyanins on visual function in patients with normal tension glaucoma (NTG) based on the vascular theory of mechanisms of glaucomatous optic nerve damage. Retrospective analysis was carried out by a chart review of 332 subjects (209 men and 123 women) who were treated with anthocyanins (n=132), GBE (n=103), or no medication (control, n=97). Humphrey Visual Field (HVF) test, logarithm of the minimal angle of resolution best-corrected visual acuity (logMAR BCVA), intraocular pressure, blood pressure, and fasting blood glucose were determined before and after treatment. Complete ocular and systemic examinations were performed. The mean follow-up duration was 23.82+/-9.84 (range, 12-59) months; the mean anthocyanin treatment duration was 24.32+/-10.43 (range, 6-53) months, and the mean GBE treatment duration was 23.81+/-10.36 months (range, 6-59) months. After anthocyanin treatment, the mean BCVA for all eyes improved from 0.16 (+/-0.34) to 0.11 (+/-0.18) logMAR units (P=.008), and HVF mean deviation improved from -6.44 (+/-7.05) to -5.34 (+/-6.42) (P=.001). After GBE treatment, HVF mean deviation improved from -5.25 (+/-6.13) to -4.31 (+/-5.60) (P=.002). A generalized linear model demonstrated that the final BCVA was not affected by demographic differences among the groups. These results suggest that anthocyanins and GBE may be helpful in improving visual function in some individuals with NTG.


References

Cybulska-Heinrich, A. K., M. Mozaffarieh, et al. (2012). "Ginkgo biloba: an adjuvant therapy for progressive normal and high tension glaucoma." Mol Vis 18: 390-402.

Park, J. W., H. J. Kwon, et al. (2011). "Short-term effects of Ginkgo biloba extract on peripapillary retinal blood flow in normal tension glaucoma." Korean J Ophthalmol 25(5): 323-8.

Shim, S. H., J. M. Kim, et al. (2012). "Ginkgo biloba extract and bilberry anthocyanins improve visual function in patients with normal tension glaucoma." J Med Food 15(9): 818-23.