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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.”