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."

EARLIER AGE OF ONSET OF MYOPIA THE GREATEST PREDICTOR OF HIGH MYOPIA

 According to this Chinese study, 

Patients who developed myopia before 12 years old had a higher risk of developing high myopia than those who developed myopia later.  Age of myopia onset may be the single best predictor for high myopia.  

RETINAL FINDING ASSOCIATED WITH HEART ATTACKS

 This study in The American Journal of Ophthalmology states that there is an association between retina ischemic perivascular lesions (RIPLs, "ripples") and myocardial infarction in patients with coronary artery disease.  

317 patients with coronary artery disease had OCT (optical coherence tomography) performed.  59.3% of the patients in that group who had a history of myocardial infarction demonstrated the presence of RIPLs on their OCT, while only 35% of those who did not have a myocardial infarction demonstrated RIPLs. 

RIPLs show focal areas of atrophy of the inner nuclear layer of the retina along with resultant expansion of the other nuclear area, causing a "ripple" appearance on cross-sectional OCT. . 

Prior studies have demonstrated an association of RIPLs with certain cardiovascular disease, including diabetes, hypertension, coronary artery disease, atrial fibrillation, and carotid artery stenosis. 

This study suggests that OCT screening in patients with coronary artery disease could determine if patients have a higher risk of myocardial infarction. They suggest that patients with RIPLs on OCT should be referred for cardiovascular consultation. 

POPULAR CLASS OF A DIABETIC DRUG DECREASES GLAUCOMA RISK

 In this study,  type 2 diabetic patients taking Glucagon-like Peptide-1 Receptor Agonist (GLP-1RAs) have an initial 19% reduced glaucoma risk, increasing to a 29% reduction after 3 years.   

Examples of GLP-1RAs include Exanatide (Byetta), Semaglutide (Ozempic), Liraglutide (Victoza, Saxenda), and Lixisenatide (Adlyxin).  

MYOPIA CONTROL SPECTACLES SHOW DECREASED EFFECTIVENESS IN PATIENTS WITH CONVERGENCE EXCESS

 

According to this study, "myopic subjects with convergence excess had faster elongation (resulting in faster progression of myopia) than normal myopic children in DIMS wearers (those who wore the myopic control spectacles). 

The article suggests that this occurs because convergence excess causes an accommodative lag that creates greater peripheral retinal defocus, thus counteracting the effect of the myopia control lenses.  

DEEP BREATHING AND GLAUCOMA

 According to this study: 

After 6 weeks of adding the 360 breathing technique (deep breathing six cycles per minute for 5 minutes, three times per day) to pharmacological glaucoma treatment, patients on average had a reduction of their intraocular pressure by roughly 2.5mmHg.  The study concludes:

"365 breathing technique can reduce IOP, serum cortisol and improve autonomic dysfunction in glaucoma patients."

ACETYLCHOLINESTERASE INHIBITORS AND MACULAR DEGENERATION

 According to this study: acetylcholinesterase inhibitors, commonly used in the treatment of Alzheimer's Disease, decreases the risk of macular degeneration by 6%.  

ASSOCIATION BETWEEN LOWER BIRTH WEIGHT AND VERTICAL CUP TO DISC RATIO

 This review of a German study indicated that children born with lower birthweight, regardless of term, have a higher rate of increased vertical cup to disc ratio as adults, and possibly lower retinal nerve reserve.