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Monday, July 14, 2025

Antioxidant-rich Diet Can Help Prevent Glaucoma

 


A study from China analyzed U.S. survey data to examine the link between diet-based antioxidant levels and glaucoma risk. Using a measure called the Dietary Oxidative Balance Score (DOBS), which reflects the balance of antioxidants and pro-oxidants in a person's diet, researchers found that higher DOBS—indicating more antioxidants—was associated with a lower risk of glaucoma. Specifically, each point increase in DOBS reduced the risk by 4%, with the highest antioxidant group showing the lowest glaucoma rates.

While the findings suggest a protective role of antioxidants, the study had limitations. It relied on self-reported glaucoma diagnoses, only included adults, and couldn’t prove a direct cause-and-effect link. The authors emphasized the importance of maintaining oxidative balance and called for more research into how nutrition affects glaucoma development and treatment.


Blood Pressure variability Associated with Macular Degeneration

 

Local oxidative stress and choroidal ischemia are some of the main mechanisms of AMD’s pathophysiology, as it’s been shown to induce vasoconstriction of the choriocapillaris, which can lead to ischemia and thinning of the choroid and AMD onset.

In a recent study, researchers aimed to assess associations between long-term BPV and the risk of age-related macular degeneration (AMD) and found that a 5mm Hg increase in diastolic BPV was associated with a 54% higher risk of advanced AMD, suggesting that one of the mechanisms is choroidal ischemia and inflammation leading to choroidal thinning and ultimately to AMD onset. 

In their paper, the researchers speculated that blood pressure variability affects choroidal thickness. 

“It has been observed that, in the presence of continuous fluctuations in systemic BP, the choriocapillaris sympathetic system is overstimulated by, among others, local oxidative stress. This has been shown to induce vasoconstriction of the choriocapillaris, which can lead to ischemia and thinning of the choroid,” the authors explained in their article.

One study observed a thinning of the choroid in hypertensive patients compared to a control group, particularly in the subfoveal region. The authors also showed that the longer the duration of hypertension, the thinner the choroidal layer. Another previous study consistently reported a decrease in choroidal thickness associated with vascular risk factors.

“Choroidal ischemia and related local ‘microangiopathy’ has been put forward as one of the main mechanisms—along with inflammation—leading to choroidal thinning and ultimately to AMD onset,” they wrote.

Understanding whether long-term BPV is an independent risk factor for AMD may provide new insights for clinical and public health recommendations aimed at preserving ocular health in aging populations, the authors wrote.

“These findings underscore the need for further research to confirm this association, explore the underlying mechanisms and potential interventions that could mitigate this risk,” the researchers concluded.

Wednesday, July 9, 2025

BOTULINUM TOXIN FOR EPIPHORA

 

Patients who received Botox injections saw a mean reduction in Schirmer score of 8.8mm at three months. Note, however, that Botox has the ability to diffuse up to 45mm from injection site, crossing anatomical barriers like the orbital septum, and this local diffusion and subsequent chemodenervation is likely contributing to adverse effects like ptosis that can manifest.

Lacrimal gland injections can be a good option for patients who experience excessive tearing. In this study it was found that Schirmer test scores decreased at three months as well as having decreased at six months. Adverse event overall incidence was 22%, with the most common being ptosis and diplopia. 

Other than the objective measurement of Schirmer scores, subjective patient-reported outcomes also displayed significant improvement, reflective of high patient-reported satisfaction.

Therapeutically, the effect of Botox is achieved via inhibition of acetylcholine at the neuromuscular junction within the lacrimal gland.

In general they believe botulinum toxin injection “stands as a promising option for select patients, offering a balance of efficacy, reversibility and low invasiveness in managing chronic epiphora.”

Thursday, June 12, 2025

Adding IPL to LLLT Improves Symptom Frequency and Severity in Meibomian Gland Disease and Dry Eye.

 

Eyes with MGD-associated dry eye disease responded well in this study to low-level light therapy alone or in combination with IPL. Both approaches showed significant improvements in symptom frequency and severity three months after treatment; however, only eyes receiving the combined therapy revealed reduced flavin fluorescence, suggesting that the addition of IPL helps boost cellular energy levels.


Two emerging treatments for dry eye disease (DED) associated with meibomian gland dysfunction (MGD) are intense pulsed light therapy (IPL)—thought to lead to the breakdown of aberrant or telangiectatic blood vessels and decrease inflammation—and low-level light therapy (LLLT)—a more recent development intended to aid tissue repair and neural recovery. When performed alone, the latter procedure has been shown to alleviate clinical signs and symptoms better than IPL, prompting the authors of a new study to investigate whether LLLT is more effective for MGD-related DED on its own or in combination with IPL. Their findings revealed that while both approaches improved symptom frequency and severity, combined therapy held an advantage in boosting cellular energy levels.

The results revealed significant improvements in symptomatology across both treatment modalities. 

Furthermore, meibum expressibility saw improvements in both groups after treatment.  The study did not report any adverse effects throughout its duration, a testament to the safety and tolerability of both treatment modalities.

The researchers note that “LLLT alone could be considered in clinical settings as an adjunctive therapy for MGD if IPL is contraindicated for improving meibum expressibility and symptom frequency.”

Wednesday, June 4, 2025

Higher Copper Intake Associated with Reduced Risk of Late AMD


Copper depletion can trigger apoptosis of RPE and retinal cells, contributing to mechanisms of AMD.


Copper, found in foods typical of the Mediterranean diet, plays a critical role in various biological processes, including antioxidant defense and extracellular matrix biosynthesis. In a recent study, researchers investigated the relationship between the intake of copper, as well as iron, zinc, selenium in diet and late AMD, and found that out of all of these elements, increased copper consumption is associated with a reduced risk of late AMD, especially in those between the ages of 70 and 85.

The Age-Related Eye Disease Study (AREDS) 1 and AREDS 2 study demonstrated similar results, indicating that copper consumption was linked to reduced late-stage AMD risk.

The authors suggest that more research into the mechanism linking copper and late AMD development is warranted.

Thursday, May 29, 2025

Tryptyr - New Dry Eye Medication from Alcon


Alcon says its newest dry eye drug can show improved tear production as early as day 1 of therapy, overcoming a key complaint about some interventions that require a ramp-up period.

Tryptyr (pronounced trip-tir), released by Alcon activates trigeminal nerve signaling, leading to increased basal tear production. The recommended dosing of Tryptyr is twice per day. 

Roughly half of subjects receiving the test drug met the primary outcome of at least a 10mm increase in Schirmer score at day 14, up to a fourfold increase over controls treated with the vehicle only, 

The Alcon press release also states that some subjects treated with Tryptyr demonstrated statistically significant natural tear production as early as day 1. The company anticipates a US launch in the third quarter of 2025. Tryptyr will be supplied in preservative-free, single-use vials.

Thursday, May 22, 2025