A two‐year follow‐up of oral antioxidant supplementation in primary open‐angle glaucoma: an open‐label, randomized, controlled trial

García-Medina, J.J.; García-Medina, Manuel; Garrido-Fernández, Pablo; Galván-Espinosa, José; Garcia-Maturana, Carlos; Zanón‐Moreno, Vicente; Pinazo-Durán, María Dolores

doi:10.1111/aos.12629

Cited by 62 publications

(44 citation statements)

References 41 publications

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“…As such, we excluded 21 potentially relevant trials with a follow-up ranging from two hours to three years. Five of these studies reported results for visual outcomes at follow-up times of two years or greater (Araie 2010; Drance 1998; Garcia-Medina 2015; Koseki 1999; Sawada 1996). …”

Section: Discussionmentioning

confidence: 99%

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Neuroprotection for treatment of glaucoma in adults

Sena

Lindsley

2017

Cochrane Database of Systematic Reviews

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Background Glaucoma is a heterogeneous group of conditions involving progressive damage to the optic nerve, deterioration of retinal ganglion cells, and ultimately visual field loss. It is a leading cause of blindness worldwide. Open angle glaucoma (OAG), the most common form of glaucoma, is a chronic condition that may or may not present with increased intraocular pressure (IOP). Neuroprotection for glaucoma refers to any intervention intended to prevent optic nerve damage or cell death. Objectives The objective of this review was to systematically examine the evidence regarding the effectiveness of neuroprotective agents for slowing the progression of OAG in adults compared with no neuroprotective agent, placebo, or other glaucoma treatment. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 7), Ovid MEDLINE, Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE Daily (January 1946 to August 2016), Embase (January 1980 to August 2016), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to August 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 16 August 2016. Selection criteria We included randomised controlled trials (RCTs) in which topical or oral treatments were used for neuroprotection in adults with OAG. Minimum follow-up time was four years. Data collection and analysis Two review authors independently reviewed titles and abstracts from the literature searches. We obtained full-text copies of potentially relevant studies and re-evaluated for inclusion. Two review authors independently extracted data related to study characteristics, risk of bias, and outcomes. We identified one trial for this review, thus we performed no meta-analysis. Two studies comparing memantine to placebo are currently awaiting classification until study investigators provide additional study details. We documented reasons for excluding studies from the review. Main results We included one multicenter RCT of adults with low-pressure glaucoma (Low-pressure Glaucoma Treatment Study, LoGTS) conducted in the USA. The primary outcome was progression of visual field loss after four years of treatment with either brimonidine or timolol. Of the 190 adults enrolled in the study, the investigators excluded 12 (6.3%) after randomization; 77 participants (40.5%) did not complete four years of follow-up. The rate of attrition was unbalanced between groups with more participants dropping out of the brimonidine group (55%) than the timolol group (29%). Of those remaining in the study at four years, participants assigned to brimonidine showed less progression of visual field loss than participants assigned to tim...

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Section: Discussionmentioning

confidence: 99%

“…The fifth excluded study with visual outcomes at follow-up times of two years or greater was Garcia-Medina 2015. Participants with primary open angle glaucoma were randomly assigned to one of three groups: oral antioxidant supplementation with omega-3 fatty acids; oral antioxidant supplementation without omega-3 fatty acids; and control.…”

Section: Discussionmentioning

confidence: 99%

Neuroprotection for treatment of glaucoma in adults

Sena

Lindsley

2017

Cochrane Database of Systematic Reviews

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“…Even if glaucoma is a multifactorial disease [7,10], systemic oxidative stress may play an important role in the pathophysiology of POAG and PEG. Despite growing research on antioxidant therapy to prevent glaucoma, in both in vitro [64] and in vivo studies with animals [65] and humans [66], antioxidative supplementation has shown contradictory [66,67,68]. However, there were promising results of supplementation in endothelial function [69], some specific clinical conditions [70] and overall mortality [71].…”

Section: Discussionmentioning

confidence: 99%

Oxidative and Anti-Oxidative Stress Markers in Chronic Glaucoma: A Systematic Review and Meta-Analysis

d'Azy¹,

Pereira²,

et al. 2016

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Chronic glaucoma is a multifactorial disease among which oxidative stress may play a major pathophysiological role. We conducted a systematic review and meta-analysis to evaluate the levels of oxidative and antioxidative stress markers in chronic glaucoma compared with a control group. The PubMed, Cochrane Library, Embase and Science Direct databases were searched for studies reporting oxidative and antioxidative stress markers in chronic glaucoma and in healthy controls using the following keywords: “oxidative stress” or “oxidant stress” or “nitrative stress” or “oxidative damage” or “nitrative damage” or “antioxidative stress” or “antioxidant stress” or “antinitrative stress” and “glaucoma”. We stratified our meta-analysis on the type of biomarkers, the type of glaucoma, and the origin of the sample (serum or aqueous humor). We included 22 case-control studies with a total of 2913 patients: 1614 with glaucoma and 1319 healthy controls. We included 12 studies in the meta-analysis on oxidative stress markers and 19 on antioxidative stress markers. We demonstrated an overall increase in oxidative stress markers in glaucoma (effect size = 1.64; 95%CI 1.20–2.09), ranging from an effect size of 1.29 in serum (95%CI 0.84–1.74) to 2.62 in aqueous humor (95%CI 1.60–3.65). Despite a decrease in antioxidative stress marker in serum (effect size = –0.41; 95%CI –0.72 to –0.11), some increased in aqueous humor (superoxide dismutase, effect size = 3.53; 95%CI 1.20–5.85 and glutathione peroxidase, effect size = 6.60; 95%CI 3.88–9.31). The differences in the serum levels of oxidative stress markers between glaucoma patients and controls were significantly higher in primary open angle glaucoma vs primary angle closed glaucoma (effect size = 12.7; 95%CI 8.78–16.6, P < 0.001), and higher in pseudo-exfoliative glaucoma vs primary angle closed glaucoma (effect size = 12.2; 95%CI 8.96–15.5, P < 0.001). In conclusion, oxidative stress increased in glaucoma, both in serum and aqueous humor. Malonyldialdehyde seemed the best biomarkers of oxidative stress in serum. The increase of some antioxidant markers could be a protective response of the eye against oxidative stress.

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“…As such we excluded 21 potentially relevant trials, ranging from two hours to three years follow-up. Five of these studies reported results for visual outcomes at follow up times two years or greater (Araie 2010; Drance 1998; Garcia-Medina 2011; Koseki 1999; Sawada 1996). …”

Section: Discussionmentioning

confidence: 99%

“…The fifth excluded study with visual outcomes at follow-up times two years or greater was Garcia-Medina 2011. Participants with POAG were randomly assigned to one of three groups: oral antioxidant supplementation with omega-3 fatty acids; oral antioxidant supplementation without omega-3 fatty acids; and control.…”

Section: Discussionmentioning

confidence: 99%

Neuroprotection for treatment of glaucoma in adults

Sena

Lindsley

2013

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Background Glaucoma is a heterogeneous group of conditions involving progressive damage to the optic nerve, deterioration of retinal ganglion cells and ultimately visual field loss. It is a leading cause of blindness worldwide. Open angle glaucoma (OAG), the commonest form of glaucoma, is a chronic condition that may or may not present with increased intraocular pressure (IOP). Neuroprotection for glaucoma refers to any intervention intended to prevent optic nerve damage or cell death. Objectives The objective of this review was to systematically examine the evidence regarding the effectiveness of neuroprotective agents for slowing the progression of OAG in adults. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 9), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE, (January 1950 to October 2012), EMBASE (January 1980 to October 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to October 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 16 October 2012. Selection criteria We included randomized controlled trials (RCTs) in which topical or oral treatments were used for neuroprotection in adults with OAG. Minimum follow up time was four years. Data collection and analysis Two review authors independently reviewed titles and abstracts from the literature searches. Full-text copies of potentially relevant studies were obtained and re-evaluated for inclusion. Two review authors independently extracted data related study characteristics, risk of bias, and outcome data. One trial was identified for this review, thus we performed no meta-analysis. Two studies comparing memantine to placebo are currently awaiting classification until additional study details are provided. We documented reasons for excluding studies from the review. Main results We included one multi-center RCT of adults with low-pressure glaucoma (Low-pressure Glaucoma Treatment Study, LoGTS) conducted in the USA. The primary outcome was visual field progression after four years of treatment with either brimonidine or timolol. Of the 190 adults enrolled in the study, 12 (6.3%) were excluded after randomization and 77 (40.5%) did not complete four years of follow up. The rate of attrition was unbalanced between groups with more participants dropping out of the brimonidine group (55%) than the timolol group (29%). Of those remaining in the study at four years, participants assigned to brimonidine showed less visual field progression than participants assigned to timolol (5/45 participants in the brimonidine group compared with 18/56 participants in the timolol...

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A two‐year follow‐up of oral antioxidant supplementation in primary open‐angle glaucoma: an open‐label, randomized, controlled trial

Cited by 62 publications

References 41 publications

Neuroprotection for treatment of glaucoma in adults

Neuroprotection for treatment of glaucoma in adults

Oxidative and Anti-Oxidative Stress Markers in Chronic Glaucoma: A Systematic Review and Meta-Analysis

Neuroprotection for treatment of glaucoma in adults

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