Dietary supplementation and glaucoma

The Science behind the Tip

Dietary supplements belong to the broad group of complementary and alternative medicine (CAM). A recent survey in Canada has found that 1 in 9 glaucoma patients was using CAM. Most of them were using herbal medicines (34.5%), dietary modifications (22.7%) or dietary supplements (18.8%) (1). Based on the fact that some glaucoma patients continue to progress at low IOPs, a wide space is left for hypotheses, preclinical experiments, clinical trials and speculations! There is a rationale to consider that dietary supplementation could help in glaucoma. For instance oxidative stress is well established in glaucoma and combat that stress makes sense (2). Another example is the ability of the omega 3 polyunsaturated fatty acids (PUFAs) to decrease IOP in rats (3).

Unfortunately there is not robust interventional dietary supplementation study demonstrating the positive effect of such a treatment in glaucoma patients. Conversely there is evidence that some of these compounds may arm, such as an increase intake of magnesium which was found associated with a higher incidence of glaucoma (4).

Several observational studies have pointed out a reduced risk for glaucoma for higher fruits and vegetables intake (5) or higher omega 3 PUFAs consumption in selected populations (6). However additional prospective studies are mandatory before glaucoma specialists can recommend any valid dietary supplementation.

Contributor: Alain Bron, Dijon, France

References

1. Wan MJ, Daniel S, Kassam F, et al. Survey of complementary and alternative medicine use in glaucoma patients. J Glaucoma 2012;21 (2):79-82.

2. Pasquale LR, Kang JH. Lifestyle, nutrition, and glaucoma. J Glaucoma 2009;18 (6):423-428.

3. Nguyen CT, Bui BV, Sinclair AJ, Vingrys AJ. Dietary omega 3 fatty acids decrease intraocular pressure with age by increasing aqueous outflow. Invest Ophthalmol Vis Sci 2007;48 (2):756-762.

4. Ramdas WD, Wolfs RC, Kiefte-de Jong JC, et al. Nutrient intake and risk of open-angle glaucoma: the Rotterdam Study. Eur J Epidemiol 2012;27 (5):385-393.

5. Giaconi JA, Yu F, Stone KL, et al. The association of consumption of fruits/vegetables with decreased risk of glaucoma among older African-American women in the study of osteoporotic fractures. Am J Ophthalmol 2012;154 (4):635-644.

6. Renard JP, Rouland JF, Bron A, et al. Nutritional, lifestyle and environmental factors in ocular hypertension and primary open-angle glaucoma: an exploratory case-control study. Acta Ophthalmol 2012;91 (6):505-213.

Tip Reviewer: Roger Hitchings
Tip Editors: John Salmon and Gordana Sunaric Mégevand