WALKING STEPS AND GLAUCOMA

 

A daily average of more than 10,000 paces was shown to have a long-term impact on ocular blood flow that may confer a protective effect against glaucoma.

A minimum of 10,000 steps per day has been associated with numerous health benefits, including a reduction in blood pressure, an enhancement in exercise capacity and a decrease in sympathetic nerve activity among individuals with hypertension. 

A recent study published in Journal of Glaucoma revealed that increasing patients’ daily exercise, particularly to more than 10,000 steps per day, may be a pragmatic approach to improving optic disc blood flow in glaucoma patients.

“Our study implies that daily physical activity may have a long-term impact on ocular blood flow” the study researchers wrote in their paper. 

Click here for the journal source.

CHRONIC STRESS AND MACULAR DEGENERATION

 

A new study in American Journal of Ophthalmology demonstrated a connection between chronic stress and age-related macular degeneration (AMD). 

The data revealed that AMD patients exhibited significantly higher chronic stress scores as far back as a decade before their diagnosis when compared to controls without AMD. For each unit increase in chronic stress score, the odds of having AMD increased by a factor of 1.11, highlighting a direct correlation between chronic stress and the increased likelihood of developing AMD. 

While this study reinforces that smoking cessation is the most important lifestyle modification to lower AMD risk, the researchers point out the connection between smoking and  chronic stress.

Smoking has been directly associated with higher stress scores. Nicotine exposure may lead to activation of stress systems, and chronic stress may lead to adoption of poor health behaviors like smoking.

Future work could expand on current efforts to understand the role of chronic stress in ocular health and disease outcomes, such as AMD progression.

Semaglutide May Be Useful in Reducing Dry Macular Degeneration and Glaucoma

 A recent study published in Ophthalmology demonstrated GLP-1 receptor agonists were associated with reduced hazard of nonexudative AMD. Notably, GLP-1 receptor agonists also significantly reduced the risk of exudative AMD and POAG compared to insulin after three years.

“The consistency of these findings across multiple comparisons suggests a potential benefit of GLP-1RAs in mitigating the risk of nonexudative AMD,” the researchers wrote in their paper. “Demonstrating a reduction in risk of POAG without a significant impact on the rate of ocular hypertension could indicate the protective effect is separate from lowering intraocular pressure.”

SEMAGLUTIDE and GLAUCOMA

This report in American Journal of Ophthalmology concluded:

This systematic meta-analysis found that GLP-1 RA use is associated with reduced glaucoma development in retrospective studies. Future, well-designed, long-term studies focusing on GLP-1 RAs and SGLT-2 inhibitors are needed to validate these findings and evaluate their effects on glaucoma progression and vision loss. The overall interpretation should be cautious.

OZEMPIC AND NAION

 According to this report Ozempic may be associated with increased NAION within the first year of use.  Further studies need to be done to determine causality. 

ANTERIOR SEGMENT ATLAS

 This article in Review of Optometry has an excellent review with photographs of the most common anterior segment conditions.  

ESR and CRP use in Eyecare

 From Review of Optometry:

"There are many ocular diseases in which inflammation is a key factor, potentially leading to abnormalities in these ancillary tests. The two most common and relevant clinical scenarios are temporal arteritis and uveitis. Elevations in ESR and CRP levels, for example, are often diagnostic for temporal arteritis or polymyalgia rheumatica in conjunction with the clinical picture.12

Uveitis, pictured here, is one ocular condition with marked inflammation, which would be indicated upon ESR or CRP testing. Photo: Kyle D. Dohm, OD. Click image to enlarge.

"Uveitis is a manifestation of numerous underlying systemic conditions, many of which would result in elevated ESR and/or CRP values. While uveitis in and of itself is inflammation, regardless of cause, studies have shown that first attacks of uveitis do not often lead to abnormal laboratory values. However, elevated levels of ESR and CRP suggest a systemic process causing uveitis. Further investigation has also attributed elevations in ESR to be due to autoimmune or collagen vascular disease etiologies, whereas abnormal CRP was more associated with trauma and infectious causes.3,13

"When taken together, both ESR and CRP laboratory tests can be helpful in the clinical setting. Understanding the nuances of each test and why they are measured will give the clinician the highest yield in the diagnosis and monitoring of diseases with inflammatory components."

Hypertension and Glaucoma Progression

 In this study:

Lower baseline 24-hour ambulatory blood pressure measurements, as well as low systolic blood pressure during follow-up, were associated significantly with faster rates of glaucomatous visual field loss progression and may be used as a predictor of risk of glaucomatous progression.

.05% Atropine and Myopia Progression

 In this study:

"Over 5 years, the continued 0.05% atropine treatment demonstrated good efficacy for myopia control. Most children needed to restart treatment after atropine cessation at year 3. Restarted treatment with 0.05% atropine achieved similar efficacy as continued treatment. Children should be considered for re-treatment if myopia progresses after treatment cessation."

.05% performed better than .025% and .01%. 

IPL AND DRY EYE

 This study concludes:

"Although IPL probably results in a clinically relevant reduction in symptoms of dry eyes when compared to placebo, in practice IPL would typically be used as an add-on to standard treatment. It is therefore essential with further studies investigating whether this use would give a clinically relevant reduction in symptoms, and what the potential harm of IPL is when treating MGD."

Vyzulta and Retinal Vessel Density

 According to this study: 

Treatment with Vyzulta reduced IOP by an average of 29.9% and 31.8% in patients with POAG and PXG, respectively, and improved retinal vessel density. Therefore, Vyzulta likely increases macular microcirculation, possibly via nitric oxide, independent of its IOP-reducing effect.

LANDMARK EYE STUDIES

 Review of Optometry creates a summary of  80+ landmark eye studies.  This is a great place to review those studies. 

E-CIGARETTES (VAPING) AND UVEITIS

 A new study in Ophthalmology found that there was an elevated risk of uveitis among patients who vape. 

The results showed that e-cigarette users demonstrated a heightened risk of developing uveitis when compared to non-users. 

Traditional cigarette use was also found to increase uveitis risk, but not as significantly as e-cigarette use.