Alpha Agonists in Glaucoma Patients may Increase the Risk of Alzheimer's Disease.

 From Review of Optometry:

Researchers in Taiwan designed a nationwide large study to investigate the association between

Alzheimer's Disease (AD) and different classes of topical glaucoma medications. They determined that using topical alpha-2 adrenergic agonists should be undertaken judiciously, especially in middle-aged and older populations. Their findings also indicated glaucoma may increase the risk of AD regardless of glaucoma subtype.

“Our observations indicating that alpha-2 adrenergic agonists potentially confer an increased risk of developing AD when compared to beta-blockers 

Irrespective of the type of glaucoma, individuals with glaucoma had a significantly higher risk of AD compared with those without glaucoma.

“Eyecare practitioners and neurologists need to be aware of the potentially higher risk of AD development associated with alpha-2 adrenergic agonists compared with beta-blockers among glaucoma patients,” they concluded in their paper for the journal.

HIGH HDL MAY BE A RISK FACTOR FOR DEMENTIA AND GLAUCOMA

 “Good cholesterol” has been praised for its association with reduced cardiovascular disease risk, but new evidence suggests that elevated levels of this high-density lipoprotein cholesterol (HDL-C) may be harmful to the central nervous system. Serum lipid studies have reported associations between HDL-C and increased risk of dementia, and other associations with IOP and glaucoma have also been reported.

the study revealed an association between HDL-C levels and neurodegenerative diseases, suggesting that elevated HDL-C may serve as a novel risk factor for conditions such as dementia."

- Review of Optometry

Central Treatment Zone, CRT, and Myopia Control

 According to this report, CRT lenses with a smaller treatment zone are better for myopic control.  

PSORIASIS AND MACULAR DEGENERATION

 This report in Review of Optometry demonstrates a relationship between psoriasis and neovascularization in age-related macular degeneration.  

ONCE WEEKLY 1% ATROPHY

 According to this study,  1% Atropine administered once per week may be adequate to slow myopia progression.  It suggests that some patients may not respond as well, and that this can be determined within the first 2 months of initiation of treatment.  

LOWER BLOOD PRESSURE INCREASES GLAUCOMA PROGRESSION IN SOME PATIENTS

This report discussed this study: 

"Researchers wanted to examine the relationship between systemic arterial blood pressure and the rate of change in standard automated perimetry (SAP) in glaucomatous eyes and glaucoma suspects. 

"Each 10mm HG lower in 24-hour average mean arterial pressure and systolic BP were linked with -0.17dB/year and -0.14dB/year faster rates of mean deviation loss. Mean deviation loss was also associated with lower mean systolic BP during follow-up.

"Glaucomatous eyes with progression at low IOP levels may benefit from 24-hour blood pressure monitoring."

VITAMIN D AND DRY EYES

Patients suffering from dry eye may find relief with vitamin D supplementation, according to a review and meta-analysis published recently in Contact Lens and Anterior Eye. Researchers from China explained in their paper that vitamin D “deficiency exacerbates the ocular inflammatory response in patients with chronic dry eye.  They added that deficient levels of this vitamin may also affect nerve fibers, resulting in worse symptoms of ocular pain or foreign body sensation.

Upon analysis, the researchers found that vitamin D supplementation significantly improved tear production by Schirmer testing and tear film stability by tear break-up time and reduced lid hyperemia, and OSDI scores. 

PSHYCHOLOGICAL STRESS AND GLAUCOMA

A new study appearing in Ophthalmology Glaucoma had researchers measuring intraocular pressure (IOP) behavior in primary open-angle glaucoma (POAG) patients after induce psychological stress —a simulated job interview followed by mental arithmetic—and controls. 

The researchers found that 61.1% of patients undergoing the stress test experienced an IOP increase greater than 4mm Hg.

Because of this marked difference, the investigators “believe that repetitive stress stimuli in POAG may compromise IOP control and potentially increase the risk of disease progression.” 

On the other side of this trial, some investigations have measured IOP after anti-stress therapies. One of these studies evaluated effects of mindfulness-based stress reduction on IOP and stress biomarkers in a randomized trial. After being assigned either to mindfulness meditation group or control group, results indicated mean IOP reductions from 18.8mm Hg to 12mm Hg in the right eye and 19.0mm Hg to 13.1mm Hg in the left eye of the meditation group. 

Taken together, as the authors explain, these correlations “in conjunction with our results, emphasize the correlation between IOP and stress: not only psychological stress can elevate IOP, but anti-stress therapies may improve IOP control.”

Calcium Channel Blockers for Hypertension may Increase Glaucoma Risk

 According to this study:

"an adverse association between Calcium Channel Blocker (CCB) use and glaucoma was observed, with CCB users having, on average, 39% higher odds of glaucoma. Calcium channel blocker use was also associated with thinner mGCIPL and mRNFL thicknesses, providing a structural basis that supports the association with glaucoma. The lack of association of CCB use with IOP suggests that an IOP-independent mechanism of glaucomatous neurodegeneration may be involved. Although a causal relationship has not been established, CCB replacement or withdrawal may be considered should glaucoma progress despite optimal care."

Melatonin and Risk of Macular Degeneration

In this studystudy:

"Researchers found that melatonin reduced the risk of age-related macular degeneration by more than half."

This is exciting news, but the study needs to be confirmed with more controlled studies.  

Exercise and Cataracts

According to this study:

"moderate to vigorous physical activity with higher frequency and longer duration will causally reduce the risk of senile cataracts"

AMD AND GCC LOSS

This study demonstrates that GCC thickness is reduced in AMD eyes, with the greatest reduction observed in late AMD eyes, particularly those with geographic atrophy. “Future therapeutic strategies for AMD may need to consider these inner retinal alterations and their potential impact on response to therapy,” the researchers concluded.

COVID VACCINE AND INCREASED INCIDENCE OF UVEITIS

 According to this study, " there was an elevated risk of uveitis following COVID-19 vaccination, with the vaccine type and period mediating this risk. For individuals with a history of uveitis, clinicians should consider the potential risk of uveitis recurrence in vaccination strategies and clinical monitoring."