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Minerva Oftalmologica 2019 September-December;61(3-4):66-70

DOI: 10.23736/S0026-4903.19.01832-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: Italian

Diet and glaucoma

Maria ALTOMARE COCCO 1 , Patrizia ROBERTO 1, Igino CIRULLI 2

1 Department of Ophthalmology, Hospital of Foggia, Foggia, Italy; 2 Department of Surgery, Hospital of Foggia, Foggia, Italy



Glaucoma is now considered a chronic neurodegenerative disease characterized by visual field defects associated with specific optic nerve damage due to the loss of retinal ganglion cells. The increase in intraocular pressure (IOP) is considered the main risk factor for the onset of glaucoma. Clinical studies that have found that glaucomatous patients not treated with a therapy for IOP reduction showed a progression of glaucomatous damage (54% of patients in 10 years in the St. Lucia Study, and 62% of patients in 6 years in Early Manifest Glaucoma Trial), while IOP reduction may be effective in slowing the progression of optic nerve damage with relative visual field loss. If the glaucomatous pathology were due exclusively to an increase in IOP, through medical therapies, a halt in the progression of glaucomatous damage could have been achieved. On the contrary, it has been shown that a high percentage (45%) of glaucomatous patients present with damage progression despite the reduction in IOP. In the glaucomatous patient, due to a number of causes (hyperbaric damage to the body of retinal ganglion cells, oxidative stress, mitochondrial dysfunction, neurotrophin deprivation, etc.) there is an acceleration of the apoptic process (programmed death mechanism) of the retinal ganglion cells with consequent loss of their axons that go to form the fibers of the optic nerve. At this stage of the disease, the patient does not perceive any visual symptoms and this represents the greatest danger of glaucoma, as it is a “subtle” disease, which is established slowly and progressively without patients being aware of what is happening in their visual system: a loss of at least 20% of ganglion cells and fibers is necessary for the earliest visual field defects to emerge. As previously stated, among the various mechanisms proposed which induce the acceleration of apoptic processes with consequent death of retinal ganglion cells, oxidative stress is particularly important. Numerous experimental studies have been carried out which have proposed the use of antioxidant and antiapoptotic substances: coenzyme Q10, the “free radical scavenger,” ginkgo biloba as a molecule with neuroprotective potential, and citicoline in the reduction of oxidative stress.


KEY WORDS: Glaucoma; Diet; Nitric oxide; Cytidine diphosphate choline; Coenzyme Q10; Neurodegenerative diseases

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