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GINKGO BILOBA AND GLAUCOMA ~ FATTY ACIDS FOR RELIEF OF DRY EYE SYNDROME Ginkgo Biloba and Field Loss in NTG The nutritional extract of ginkgo biloba (GBE) enhances blood flow and appears to improve preexisting visual field damage in some patients with normal tension glaucoma (NTG), according to a study by the Glaucoma Center, Clinica Oculistica Università di Brescia, and the Clinica Oculistica, Università DI Catania, both in Italy. The prospective, randomized, placebo-controlled, double-masked crossover trial involved 27 patients with bilateral visual field damage resulting from NTG. Patients received 40 mg GBE orally three times daily for 4 weeks, followed by a washout period of 8 weeks, then 4 weeks of placebo treatment (identical capsules filled with 40 mg fructose). Other patients underwent the same regimen, but took the placebo first and the GBE last. Researchers then evaluated visual field tests, performed at baseline and at the end of each phase of the study, for changes. Results showed a significant improvement in visual fields indices after GBE treatment. Mean deviation (MD) at baseline was 11.40 +/- 3.27 dB versus 8.78 +/- 2.56 dB MD after GBE treatment; corrected pattern standard deviation (CPSD) at baseline was 10.93 +/- 2.12 dB versus 8.13 +/- 2.12 dB CPSD after GBE treatment. No significant changes were found in intraocular pressure, blood pressure or heart rate after placebo or GBE treatment. Any ocular and systemic side effects were recorded for the duration of the trial. SOURCE: Quaranta L, Bettelli S, Uva MG, et al. Effect of ginkgo biloba extract on preexisting visual field damage in normal tension glaucoma. Ophthalmol 2003;110(2):359-62. Linoleic/Linolenic Acids for Rheumatoid Arthritis May Provide Dry Eye Relief Therapy with systemic tear substitutes containing linoleic (LA) and [gamma]-linolenic acid (GLA), which are used to decrease chronic inflammation in rheumatoid arthritis, may also reduce ocular surface inflammation and improve dry eye symptoms, according to a multi-departmental study by Italy’s University of Genoa. In this randomized clinical trial, of which partial results were presented as a poster at the 2002 ARVO, researchers evaluated the efficacy and anti-inflammatory properties of LA and GLA on the ocular surface of patients with keratoconjunctivitis sicca. Twenty-six patients with aqueous-deficient keratoconjunctivitis sicca were consecutively selected from patients presenting to the Department of Neurosciences, Ophthalmology and Genetics at the University of Genoa. Diagnoses were based on dry eye symptom survey scores, Schirmer-1 test values, positive vital staining with lissamine green and fluorescein breakup time (FBUT). All patients had ocular surface inflammation based on human leukocyte antigen-DR (HLA-DR) expression, a major histocompatibility class II antigen, on epithelial bulbar conjunctiva samples. Subjects were randomly divided into two groups of 13 patients each. The study group received tablets containing LA (28.5 mg) and GLA (15 mg) twice daily for 45 days and used tears; the control group received a tear substitute and a placebo tablet for 45 days. Results showed that statistically significant changes in symptoms, lissamine green staining and ocular surface inflammation occurred in the study group compared with controls. HLA-DR expression varied from 58.5 +/- 14.1 percent positive conjunctival cells to 41.3 +/- 18.9 percent in the treated group and from 61.4 +/- 21.9 percent to 58.0 +/- 13.3 percent in the controls. Researchers observed no statistically significant difference between groups for FBUT and the Schirmer-1 test. They stress that long-term studies are necessary to confirm whether LA and GLA tear therapy will be a viable option for treating keratoconjunctivitis sicca. SOURCE: Barabino S, Rolando M, Camicione P, et al. Systemic linoleic and gamma-linolenic acid therapy in dry eye syndrome with an inflammatory component. Cornea 2003;22(2):97-101.
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