Nutrition and the Eye

Question 1

Current therapy for glaucoma focused on?

Answer 1

Lowering the intraocular pressure/ medications that do this

Question 2

Other considerations of therapy for glaucoma?

Answer 2

o Circulatory issues, idependent role or cofactor
o Neuro protection issues
o Adjunct therapies

Question 3

How does alcohol effect glaucoma?

Answer 3

• alcohol decreases IOP
  o effect not significant enough for theurapuetic measures
  o large comsumption of beer is similar to water provocative tests

Question 4

How does caffine affect glaucoma?

Answer 4

o Over 2-3 mmhg increase within 2-3 hours
o Has antioxidants ( drinking it in moderation can be beneficial)
o Increases metabolic rate
o Secondary benefits to blood flow

Question 5

Marijuana effect on glaucoma? Active ingredient?

Answer 5

o Lowers IOP 3-4 mmhg
o Only effective for short period of time; would have to consume it every 3 hours
o Taking more has no benefit / increased dosage does not lead to greater efficiency
o Active ingredient is delta-9-tetrahydrocannabinoid
o Cannabinoid

Question 6

Fat intake effect on glaucoma?

Answer 6

o Very little research
o Dietary fat may modulate the availability of intraocular prostagandins
o Total fat intake not associated with glaucoma
o high ratio of n-3 to n-6 polyunsaturated fat appears to increase the risk of POAG, particularly high-tension POAG. *
o high ratio not good
o in summary, can’t advice pts to take more or less of types of fat

Question 7

How does ginko biloba affect glaucoma?

Answer 7

o	Reduction of platelet aggregation
o	increasing vasodilation 
o	Reducing blood viscosity 
o	quenching of free radicals
o	In humans it increased end diastolic flow velocity in the ophthalmic artery of healthy volunteers

Question 8

Ginko B. affect visual fields?

Answer 8

• One study showed improvement VFS in patients with normal tension glaucoma who receieved 120 mg of ginko a day (4 weeks)

Question 9

What increases in vfs due to ginko?

Answer 9

• Increased blood flow in all points
• Increased blood volume in superior nasal and sup temporal areas
• Increased blood velocity in inf-temporal and sup-temporal areas
• Blood flow parameters are measured using the Heidelberg retina flowmeter

Question 10

Human Lens

Answer 10

o Grows throughout life
o Better organelles than rest of body
o Lower oxygen- prevent oxidative damage
o Relatively dehydrated structure
o Aqueous humor has 14x amount of vitamin C than blood
o Yet if one lives long enough, they will develop cataract

Question 11

Carotenoids effect on cataracts

Answer 11

o High dietary intake of lutien and zeaxanthin yielded 22% reduction in risk for cataract surgery

Question 12

Vitamin C effect on cataracts?

Answer 12

o Vitamin C: supplements 10 years or greater were 45% less likely to require cataract surgery

Question 13

Multivitamins and Cataract

Answer 13

Blue Mountains Eye Study found that long-term use of daily multivitamins protected against the development of nuclear and cortical cataracts

Question 14

Beaver Dam Eye Study

Answer 14

Study found no relationship between the incidence of nuclear sclerotic cataract and increased dietary intake of vitamin C, vitamin E, alpha-carotene or beta-carotene; unless other risk factors were present

Question 15

AREDS 9

Answer 15

high intake of vitamin C, E, and beta carotene had no effect on incidence of either cataract development or extraction during an approximate six-year period

Question 16

AREDS 32

Answer 16

Centrum multivitamins are associated with decreased risk of nuclear cataract

Question 17

Cataract Formation Factors

Answer 17

age
diet
environmental (radiation)
medical conditions such as diabetes
use of systemic/ topical medications

Question 18

AMD statistics

Answer 18

• major cause of blindness; more than 50%
• 1.2 million U.S. residents are living with neovascular AMD and 970,000 have geographic atrophy (Numbers expected to rise by 50% in 2024)

Question 19

Major risk factors of AMD

Answer 19

Age
Family history
smoking

Question 20

When does AMD damage first occur?

Answer 20

childhood

preventative measures at 40 but too late

Question 21

Pathogenesis of AMD

Answer 21

exact path. uknown
high oxygen= high oxidativee damage
blue light

Question 22

Natural Protection against AMD

Answer 22

antioxidants present in eye (vitamin C, aeaxanthin, meso-zeaxanthin, leutin)
pupils get smaller
yellowing of lens cuts out blue ligt

Question 23

Omega 3 and AMD

Answer 23

o AREDS 2
o Prior studies, diet high in omega 3 fat, greater chance of AMD
o AREDS 23
• —a reduced likelihood of progression to central geographic atrophy in individuals with bilateral drusen at baseline

Question 24

Vitamin C effect on AMD

Answer 24

no effect

Question 25

Carotenoids effect on AMD

Answer 25

some show benefit; some don’t ; o capable of quenching the reactive oxidative species, thus protecting the retinal pigment epithelium from oxidative damage
o Macular carotenoids absorbs blue light

Question 26

2 carotenoids found in retina?

Answer 26

leutin and Zeaxanthin(greater amount

Question 27

Relationship between carotene and smokers?

Answer 27

• high dosage of beta carotene or in combination with vitamin E are associated with sig. risk of developing lung cancer

Question 28

AREDS 2 and carotene

Answer 28

But added lutein 10 mg and zeaxanthin 2 mg found

—18% reduction of preogession to advanced AMD

Question 29

Zinc and AMD

Answer 29

• zinc may help AMD
• high dosage 80 mg/ day increases chance of hospitalizations for genitourinary causes
• high in aqueous humore can cause cataracts
• Participants with moderate AMD in the antioxidant combination plus zinc group were 25% less likely to experience AMD progression than participants in the placebo group
  o Beta carotene
  o Vitamin-C
  o Vitamin-E
  o Zinc