Omega-3 for Alzheimer's: New DHA form may help prevent visual decline
Mirtogenol®, An Innovative Patented Combination For Eye Health
According to the World Health Organization (WHO) "globally, more than 2.2 billion people are affected by vision impairment, with at least half of them having an eye condition that could have been prevented or is yet to be addressed".
Diabetes significantly contributes to eye-related health risks, potentially leading to complications such as diabetic retinopathy, cataracts and diabetic macular oedema .
Diabetes type 2 is described as a "modern preventable pandemic" with its global prevalence having tripled in the past 20 years . In India, a recent study estimates that 101 million people, which accounts for 11.4% of the country's population, are currently living with diabetes, and this number shows an increasing trend .
Many of these eye conditions, if undetected or not adequately treated, can lead to blindness. Cataract, uncorrected refractive error, and glaucoma are the three most common causes of blindness worldwide. While cataract and uncorrected refractive error can be reversed by operation or spectacle correction, damages caused by glaucoma cannot be reversed.
Glaucoma comprises a group of eye conditions that damage the optic nerve, the health of which is vital for good vision. This damage is often caused by an abnormally high pressure in the eye . Insufficient blood supply due to increased intraocular pressure (IOP) or reduced ocular blood flow (OBF) are considered major treatable risk factors for glaucoma . Lowering IOP is the only proven method to avoid irreversible damages. Treatments include prescription eyedrops, oral medications, or surgery, but oral supplementation is increasingly popular among consumers looking at natural alternatives.
Mirtogenol®, a patented combination of Mirtoselect® bilberry extract and Pycnogenol® French maritime pine bark extract, is one of the first nutritional approaches developed to address eye health.
In several studies, Pycnogenol® has been shown to positively affect eye health by strengthening retinal capillaries in diabetic retinopathy and by reducing the recurrence of retinal vein thrombosis . Additionally, Pycnogenol® provides potent antioxidant protection for the eyes . Maintaining healthy retinal capillaries helps control leakage of fluids and blood into the retina and reducing retinal edema.
Mirtoselect® was shown to have a positive impact on eye health as well, by improving tear secretion and plasmatic antioxidant potential in subjects suffering from Dry Eye Disease (DED) symptoms.
In 4 clinical studies on more than 200 patients, the unique combination product Mirtogenol® showed significant effects on intraocular pressure (IOP) and ocular blood flow (OBF).
Intraocular pressure significantly reduced with Mirtogenol®A clinical pilot study with 38 asymptomatic subjects with intraocular hypertension showed that after 2 months of supplementation with Mirtogenol®, the intraocular pressure (measured in mmHg) was strongly lowered (16). For a total of 6 months, the subjects were supplemented with two Mirtogenol® capsules per day that contained 40 mg of Pycnogenol® and 80 mg of Mirtoselect® each.
After 3 months, the intraocular pressure exhibited a significant reduction of 13% compared to baseline, whereas no effect was shown in the control group. At that point, 19 out of 20 patients taking Mirtogenol® had an IOP in a normal range. The effects on ocular arterial blood flow velocity were similarly improved after 2 months regarding systolic and diastolic components in different ocular arteries. After 3 months, the increase in arterial flow velocity in the retinal and ciliary arteries was statistically significant as compared to both baseline and control group, in which no alteration of flow velocity was found.
The study suggests the use of Mirtogenol® as a safe preventative solution for lowering the risk of developing symptomatic glaucoma by controlling intraocular pressure and improving ocular blood flow.
Mirtogenol® improves eye blood flowAnother 6-month study with 79 patients with asymptomatic ocular hypertension investigated the effects of a lower dose of Mirtogenol® (1 capsule, containing 40 mg of Pycnogenol® and 80 mg of Mirtoselect®) per day for controlling intraocular pressure in patients medicated with latanoprost eye drops . Latanoprost is a drug used to treat increased pressure inside the eye, including ocular hypertension and open angle glaucoma. It is a prostaglandin analogue and increases the outflow of aqueous fluid from the eyes. In addition to latanoprost eye drops, a part of the patients was also supplemented with Mirtogenol®.
The investigators found that Mirtogenol® further enhances the beneficial effects of latanoprost regarding IOP by 15%. Moreover, Mirtogenol® along with Latanoprost further improved diastolic ocular blood flow velocity by 40% and systolic ocular blood flow velocity by 9% to normal levels in comparison with latanoprost only.
This research suggests that Mirtogenol® in combination with latanoprost potentiates the effects of latanoprost for eye health already after 6 weeks and even better results after 6 months supplementation.
Vascular circle around optic nerve better perfused with Mirtogenol®A study with 88 asymptomatic patients with intraocular hypertension investigated the effects of 3 months Mirtogenol® supplementation (2 capsules/day) in association with traditional antihypertensive drugs (dorzolamide-timolol or latanoprost eye drops) on retinal microcirculatory parameters and oxidative stress .
After 6 weeks, the study showed a positive clinical effect on intraocular pressure and the ocular blood flow when supplementing with Mirtogenol® in addition to latanoprost. Another 6 weeks later at the end of the study, 58.1% of the subjects treated with Mirtogenol® and latanoprost had normal IOP levels, compared to 41.4% in the only-latanoprost patient group.
The oxidative stress levels (measured as plasma free radicals) were decreased significantly by 17% compared to baseline, when supplementing with Mirtogenol®. The diastolic and systolic ocular blood flow velocity could be strongly improved by 63% and 24% respectively, when compared to non-supplemented patients. Moreover, after 12 weeks, blood perfusion around the optic nerve (circle of Zinn-Haller) was significantly improved with Mirtogenol® and latanoprost.
The authors conclude that supplementing with Mirtogenol® in addition to the standard ophthalmic treatments, improves ocular microcirculatory parameters with faster and greater effects compared to non-supplemented single managements and may contribute to lowering intraocular pressure to normal levels.
Retinal nerve fiber layer thickness maintained and visual field improved with Mirtogenol®A prospective, randomized double-blind, placebo-controlled study published in 2017 investigated the effects of Mirtogenol® supplementation on the changes in retinal nerve fiber layer (RNFL) thickness and visual field. 41 patients with primary open angle glaucoma with controlled intraocular pressure levels were supplemented with Mirtogenol® for 2 months in addition to their glaucoma medications.
At the end of the study, Mirtogenol® maintained RNFL thickness, with an insignificant decrease of 0.8%, whereas in the placebo group, a significant thinning of the RNFL by 1.8% was observed. According to the authors, a decrease of the RNFL thickness by 10-12% is related to a glaucomatous change by 1.5-fold. The mean deviation of visual fields in the Mirtogenol® group was increased by 29.6% after the two months, whereas in the placebo group, it decreased by 6.9%. A decrease of the mean deviation of the visual field of 1.4% per month indicates glaucoma progression. This study showed further beneficial effects of Mirtogenol® for eye health as part of addressing risks factors associated with glaucoma.
Mirtogenol® is a patented combination of Mirtoselect® bilberry extract and Pycnogenol® French maritime pine bark extract. It is a safe, natural, and evidence-based solution to help with eye health. For further information, please visit www.Mirtogenol.Com. ?
(The author is Manager of Scientific Communications and Product Development at Horphag Research.)
Making Sense Of Hypertensive Retinopathy
Hypertensive retinopathy occurs when high blood pressure damages the retina's blood vessels. It can cause vision changes and eye swelling and requires treatment.
The retina is the tissue layer located in the back of your eye. This layer transforms light into nerve signals that are then sent to the brain for interpretation.
When your blood pressure is too high, the retina's blood vessel walls may thicken. This may cause your blood vessels to become narrow, which then restricts blood from reaching the retina. In some cases, the retina becomes swollen.
Over time, high blood pressure can cause damage to the retina's blood vessels, limit the retina's function, and put pressure on the optic nerve, causing vision problems. This condition is called hypertensive retinopathy (HR).
You probably won't have any symptoms until the condition has progressed extensively. Possible signs and symptoms include:
Get medical help immediately if your blood pressure is high and you suddenly have changes in your vision.
Prolonged high blood pressure, or hypertension, is the main cause of HR. High blood pressure is a chronic problem in which the force of the blood against your arteries is too high.
The force is a result of the blood pumping out of the heart and into the arteries, as well as the force created as the heart rests between heartbeats.
When the blood moves through the body at a higher pressure, the tissue that makes up the arteries will begin to stretch and eventually become damaged. This leads to many problems over time.
HR generally occurs after your blood pressure has been consistently high over a prolonged period. Your blood pressure levels can be affected by:
High blood pressure also runs in families.
In the United States, high blood pressure is fairly common. According to the Food and Drug Administration (FDA), the condition affects 1 in 3 adults in the United States. It's called a "silent killer" because it usually has no symptoms.
The following conditions put you at a higher risk for HR:
Additionally, the condition is more common in people of African descent, particularly Afro-Caribbean people, according to research from 2003. Women are also more likely to be affected by blood vessel damage than men.
OphthalmoscopeYour doctor will use a tool called an ophthalmoscope to examine your retina.
This tool shines a light through your pupil to examine the back of your eye for signs of narrowing blood vessels or to see if any fluid is leaking from your blood vessels. This procedure is painless. It takes less than 10 minutes to complete.
Fluorescein angiographyIn some cases, a special test called fluorescein angiography is performed to examine retinal blood flow. In this procedure, your doctor will apply special eye drops to dilate your pupils and then take pictures of your eye.
After the first round of pictures, your doctor will inject a dye called fluorescein into a vein. They'll typically do this on the inside of the elbow. Then, they'll take more pictures as the dye moves into the blood vessels of your eye.
The extent and severity of the retinopathy is generally represented on a scale of 1 to 4. The scale is called the Keith-Wagener-Barker Classification System. The four grades increase in severity:
On the lower end of the scale, you may not have any symptoms. At grade 4, however, your optic nerve may begin to swell and cause more serious vision problems. High-grade retinopathy tends to indicate serious blood pressure concerns.
People with HR are at risk of developing complications related to the retina. These include the following:
People with HR are also at an increased risk of having a stroke or heart attack. One 2013 study of 2,907 people between the ages of 50 and 73 found that those with HR were more likely to have a stroke than people without the condition.
This was true even in people with blood pressure controlled by treatment. A 2008 study of 5,500 people between the ages of 25 and 74 showed both an increased risk of stroke or cardiovascular disease in those with HR.
Effective treatment for HR involves controlling and lowering high blood pressure with a combination of medications and lifestyle changes.
Lifestyle changesA diet high in fruits and vegetables may help lower blood pressure. Regular physical activity, reducing salt intake, and limiting the amount of caffeine and alcoholic beverages you drink can all contribute to healthy blood pressure.
If you smoke, take steps to quit. If you're overweight, your doctor may recommend losing weight as a strategy for controlling high blood pressure.
MedicationsYour doctor may prescribe blood pressure medications such as diuretics, beta-blockers, or ACE inhibitors.
You can control this condition by controlling your blood pressure. If your condition is severe, however, you may have irreversible eye damage that causes permanent vision problems.
The prognosis is worse for higher grades of HR. Grades 3 and 4 are associated with higher rates of:
People with uncontrolled hypertension and grade 4 HR, sometimes called the malignant stage, have a generally poor prognosis for survival, according to the journal Retinal Physician.
Structural changes to the arteries in the retina are generally not reversible. Even with treatment, patients diagnosed with HR are at a higher risk for retinal artery and vein occlusions, and other problems of the retina.
If you have high blood pressure or HR, your primary care doctor can work with your eye doctor (ophthalmologist) to determine an appropriate treatment plan and monitor your condition.
To prevent HR, take steps to avoid high blood pressure. Here are a few things you can do:
High Blood Pressure Treatment
Hypertension, or high blood pressure, increases your risk of heart attack and stroke. There are a variety of treatments that can help you manage your blood pressure, including lifestyle changes and medications.
A normal blood pressure reading is less than 120/80 mm Hg. When you have high blood pressure, also known as hypertension, your reading is consistently in a higher range.
High blood pressure treatment typically involves a combination of medication and lifestyle changes to help you manage the condition and prevent or delay related health problems. The goal is to get your blood pressure below the high range.
If normal is less than 120/80 mm Hg, what's high? When the systolic blood pressure — the top number — is between 120 and 129, and the diastolic blood pressure — the bottom number — is less than 80, this is considered elevated blood pressure.
Elevated blood pressure doesn't necessarily raise your risk for heart attack or stroke. But without attention, it will often progress to high blood pressure — which definitely does raise your risk. Hypertension (or high blood pressure) is present once the systolic pressure is 130 or higher, or the diastolic pressure is 80 or higher.
A healthy lifestyle is the first line of defense against high blood pressure. Habits that help control blood pressure include:
Some people find that lifestyle changes alone are enough to control their high blood pressure. But many also take medication to treat their condition. There are many different types of blood pressure medications with different modes of action.
If one drug doesn't lower your blood pressure enough, another might do the job. For some people, a combination of two or more drugs may be needed to keep their blood pressure under control.
Hypertension medications can be divided into the categories listed below, based on how they work. The drugs in each section are just a sampling of what's available.
DiureticsDiuretics, sometimes called water pills, help the kidneys get rid of excess water and salt (sodium). This reduces the volume of blood that needs to pass through the blood vessels. As a result, blood pressure goes down.
There are three major types of diuretics defined by how they work. They include:
Diuretics in the thiazide group generally have fewer side effects than the others, particularly when taken at the low doses commonly used in treating early high blood pressure.
Beta-blockersBeta-blockers help the heart to beat with less speed and force. The heart pumps less blood through the blood vessels with each beat, so blood pressure decreases. There are many drugs within this classification, including:
Alpha-beta-blockersAlpha-beta-blockers have a combined effect. They're a subclass of beta-blockers that block the binding of catecholamine hormones to both alpha and beta receptors. They can decrease the constriction of blood vessels like alpha-1 blockers, and slow down the rate and force of the heartbeat like beta-blockers.
Carvedilol (Coreg) and labetalol hydrochloride (Normodyne) are common alpha-beta-blockers.
Angiotensin converting enzyme (ACE) inhibitorsACE inhibitors help the body produce less of a hormone called angiotensin II, which causes blood vessels to narrow. These medications decrease blood pressure by helping blood vessels expand and let more blood through.
Some ACE inhibitors include:
ARBs block the action of angiotensin II directly on the blood vessels. It attaches at the receptor site on the blood vessels and keeps them from narrowing. This causes blood pressure to fall.
ARBs include:
Movement of calcium into and out of muscle cells is necessary for all muscle contractions. Calcium channel blockers limit calcium from entering the smooth muscle cells of the heart and blood vessels. This makes the heart beat less forcefully with each beat and helps blood vessels relax. As a result, blood pressure decreases.
Examples of these medications include:
Your body produces types of hormones called catecholamines when under stress, or chronically in some disease states. Catecholamines, such as norepinephrine and epinephrine, cause the heart to beat faster and with more force. They also constrict blood vessels. These effects raise blood pressure when the hormones attach to a receptor.
The muscles around some blood vessels have what are known as alpha-1 or alpha adrenergic receptors. When a catecholamine binds to an alpha-1 receptor, the muscle contracts, the blood vessel narrows, and blood pressure rises.
Alpha-1 blockers bind to alpha-1 receptors, blocking catecholamines from attaching. This keeps them from narrowing blood vessels so blood is able to flow through the blood vessels more freely, and blood pressure falls.
Alpha-1 blockers are primarily used to treat benign prostatic hyperplasia (BPH) in men, but are also used to treat high blood pressure.
These drugs include:
Alpha-2 receptors are different from alpha-1 receptors. When an alpha-2 receptor is activated, the production of norepinephrine is blocked. This decreases the amount of norepinephrine produced. Less norepinephrine means less constriction of blood vessels and a lower blood pressure.
Methyldopa (Aldomet) is an example of this type of drug. It's a common choice for high blood pressure treatment during pregnancy because it generally poses few risks to the mother and fetus.
Other examples include:
Since alpha-2 receptor agonists can work in the brain and central nervous system, they're also known as "central agonists." This makes these medications useful for treating a large range of medical conditions beyond high blood pressure.
VasodilatorsVasodilators relax the muscles in the walls of blood vessels, especially small arteries (arterioles). This widens the blood vessels and allows blood to flow through them more easily. Blood pressure falls as a result.
Hydralazine hydrochloride (Apresoline) and minoxidil (Loniten) are examples of these.
Treatment for high blood pressure includes ongoing care, as well as individual treatments tailored for specific situations and younger age groups, including children and teens.
Ongoing medical careTo make the most of your treatment, it's vital to get regular medical checkups and blood pressure tests. Regular checkups allow your doctor to monitor how well your treatment is going and make any necessary adjustments to your treatment plan.
If your blood pressure starts inching back up, your doctor can respond promptly. Doctor's visits also give you an opportunity to ask questions and bring up any concerns.
Treatment for specific situationsAdditional treatment options may be needed in certain situations like resistant hypertension or secondary hypertension.
Resistant hypertension refers to blood pressure that remains high after trying at least three different types of blood pressure medication. Someone whose high blood pressure is controlled by taking four different kinds of medication is considered to have resistant hypertension.
Even such hard-to-treat cases can often be managed successfully in time. Your doctor might prescribe a different medication, dose, drug combination, or more aggressive lifestyle changes.
Getting a referral to a heart or kidney specialist may also be useful in treating resistant hypertension.
Secondary hypertension is high blood pressure that's directly caused by another health condition or drug side effect. Blood pressure often drops substantially or even goes back to normal once doctors diagnose and treat the root cause.
Treatment options for children and teensThe first line of treatment for children and teens with high blood pressure is a healthy lifestyle. This includes:
Children may take the same blood pressure medications as adults when necessary. For children with secondary hypertension, blood pressure often returns to normal once the underlying condition is treated.
High blood pressure treatment usually involves a combination of lifestyle changes and medication. Sometimes, lifestyle changes are enough to return your blood pressure to normal levels. These changes may include diet, exercise, and weight loss.
If your high blood pressure continues, be sure to consult a doctor who can prescribe the appropriate medication.
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