Reversing a Root Cause of Glaucoma

Glaucoma is one of the leading causes of blindness, affecting approximately 2.7 million Americans.¹

In the past year, studies have found new links between glaucoma and a host of diverse risk factors, such as tooth loss,² obstructive sleep apnea,³ genetic predisposition⁴ and potentially diabetes.⁵ Drugs such as corticosteroids are also implicated in glaucoma risk.⁶

The most common risk factor for glaucoma is increased pressure in the eye, which can cause irreversible damage to the optic nerve.⁷

There is usually no pain associated with increased eye pressure,⁸ which means you could be at risk for glaucoma—and not even know it.

But while glaucoma itself is irreversible, studies have shown that it is possible to prevent—or even reverse—the major underlying cause.

In a human study, a proprietary extract of French maritime pine bark combined with bilberry extract reduced eye pressure by as much as 24%—with reductions of 40% when combined with standard therapy.⁹

A Vision-Robbing Disease—Without Warning Signs

People who are developing glaucoma generally have no symptoms. They feel no pain.^8,10

One day their vision is normal, the next they begin to realize that they are missing some objects that would normally fall within their peripheral vision. At this first sign, the progression that may eventually lead to blindness is well underway.¹⁰

In most cases, glaucoma occurs when fluid builds up, creating abnormal intraocular pressure within the eye. Over time, this pressure damages the retina and the optic nerve, resulting in reduced visual acuity and possibly leading to blindness.¹¹

What Causes Increased Eye Pressure?

The transparent fluid that fills the anterior part of the eye between the lens and the cornea is called aqueous humor.¹² This fluid has numerous jobs, including providing nutrition to the anterior part of the eye and transporting the metabolic debris produced there to the bloodstream so that we can see clearly.

The appropriate production, circulation, and drainage of this fluid are essential for eye health.

Open angle glaucoma, which is diagnosed in at least 90% of glaucoma patients, is the most common form of the disease.¹³ Over time, the drainage channels become blocked, fluid builds up, and intraocular pressure rises.¹⁰

Additionally, endothelial dysfunction and vascular structural changes can substantially alter blood flow within the tissues and elevate intraocular pressure, leading eventually to open angle glaucoma.¹⁴

Whether or not you develop glaucoma as a result of increased intraocular pressure depends on the level of pressure your optic nerve can tolerate without being damaged.¹⁰ However, once the optic nerve is damaged, it can’t be repaired—even if the raised intraocular pressure is corrected.^15,16

This makes it extremely urgent to find a way to reverse high intraocular pressure before it causes the irreversible damage of glaucoma.

The Search for a Solution

Scientists turned to past research to find the best possible natural candidates for treating this condition. Their search led them to French maritime pine bark and standardized bilberry extract.

Previous studies had shown that these extracts could successfully counteract retinopathy, which is persistent or acute damage to the retina.^9,17 This led investigators to examine the usefulness of these plant extracts in countering the drivers behind increased intraocular pressure.

What they found was that French maritime pine bark could improve the function of the endothelium, the delicate layer of cells lining the blood vessels. Disorders of endothelial function are contributing factors to the development or progression of glaucoma.^9,14

Other studies showed that bilberry extract could counteract hyperpermeability of the ciliary capillaries. The beneficial effect is significantly increased ocular blood flow, resulting in reduced intraocular pressure.¹⁷

It became clear that these two extracts may work together to:

• Decrease inflow of aqueous humor;
• Improve microvascular tone and integrity;
• Decrease resistance across the region of the eye responsible for fluid drainage, and possibly;
• Contribute to better fluid outflow.

The ability of both bilberry and French maritime pine bark to target critical aspects of increased eye pressure led scientists to formulate a compound that combined these two. The next step was to conduct human studies that tested the dual-extract formulation.

Remarkable Drop in Eye Pressure

In an initial controlled study of this dual compound, scientists measured blood flow in the eyes of 38 volunteers who had high intraocular pressure but who had not yet shown evidence of glaucoma. One group took the pine bark-bilberry compound orally for six months and the second group did not.¹⁷

At three months, the group taking the pine bark-bilberry compound showed a statistically significant 13% reduction in intraocular pressure. Compared to untreated participants, the treated group also had improved ocular blood flow in three different blood vessels.¹⁷

A follow-up study showed that taking the same pine bark-bilberry compound for longer led to even greater improvements.

In this study, 79 individuals with high intraocular pressure who had not yet shown signs of open angle glaucoma were divided into three groups:

1. The first group received the pine bark-bilberry extract,
2. The second group received standard medical therapy with latanoprost (Xalatan®) eye drops,
3. The third group received both the pine bark-bilberry compound and the latanoprost drops.⁹

All three treatment groups demonstrated a reduction in intraocular pressure. Subjects using the prescription eye drops lowered their eye pressure by an average of 28%, beginning from the fourth treatment week. Those participants taking the pine bark-bilberry formulation reduced their eye pressure significantly beginning in the sixth treatment week and throughout the study, leading to a 24% reduction in the sixteenth week—comparable to the drug, but with a better safety profile.⁹

But by far, the most compelling results were seen in the group that used the combination of pine bark-bilberry formulation and the latanoprost drops. A significant, average reduction in intraocular pressure of 28% began at four weeks—but when the study ended at 24 weeks, the decrease in eye pressure had reached an approximate 40%!⁹

The pine bark-bilberry compound appeared to have an additive effect with the latanoprost drops to amplify the reduction of intraocular pressure better than either agent alone.⁹

Critically, the subjects experienced a significant increase of ocular blood flow.⁹

The study author noted that, “No serious side effects occurred during the study, apart from standard side effects in patients related to latanoprost.”⁹

French Maritime Pine-Bark Extract

Numerous studies have given us insight into why these two extracts have such beneficial effects on eye pressure.

Each extract has its own range of actions that appear particularly suited to aiding the complex balance at the level of the eye chambers.⁹

French maritime pine bark is rich in plant-based proanthocyanidins and was found to have numerous biologic effects, including:

• The scavenging and neutralization of harmful free radicals,
• Regulation of the cell’s antioxidant network and associated genes,
• Anti-inflammatory effects (through the dampening of gene expression related to the nuclear factor-kappaB-dependent pathways inside cells),^18,19
• Improved vascular endothelial function,²⁰ and
• Improved microcirculation from antiplatelet effects and clot-formation prevention.^21,22

One study appeared to show beneficial effects on intraocular pressure when volunteers were given French maritime pine bark combined with extracts of blueberry and green tea.²³

French maritime pine bark’s powerful antioxidative capacity—which can protect the eye’s drainage system—is mirrored in the strong, free radical-quenching effects of bilberry extract.

Standardized Bilberry Extract

Bilberry (Vaccinium myrtillus) and other related berries are known for superior free radical-scavenging activity as well as genetic signaling ability.²⁴ Bilberry has been shown to bolster the body’s defense systems against dangerous oxidative stress,²⁵ and it has also been shown to be beneficial in atherosclerosis.²⁶

Specifically using tissue from the pigmented layer of the retina, scientists found that bilberry positively influenced beneficial pathways involved in the antioxidant response effort.²⁵

Bilberry has also been shown to provide protective effects in other models of inflammatory disease such as uveitis in a dose-dependent manner.²⁷

A Significant Step Toward Prevention

Even with standard medical or surgical therapies, some glaucoma patients still progress to vision loss.⁸ Unfortunately, this loss is permanent. Until a cure is found, research is urgently needed to identify ways to prevent this devastating disease.

There currently is no accepted preventive strategy for glaucoma. The best defense to date involves rigorous and regular eye examinations by a trained professional.

However, delicate eye tissues—under assault by environmental toxins and cellular byproducts associated with aging—can greatly benefit from nutritional and other therapeutic support against glaucoma and other sight-robbing diseases.²⁸

The human studies described in this article are promising and mark an important initial step toward finding ways to prevent glaucoma. The dual-extract formulation of pine bark and bilberry has been shown to lower intraocular pressure by almost 40% in conjunction with prescribed eye drops that do involve some risk.^9,29

While this may bring hope to those with elevated eye pressure, it is important to note that high intraocular pressure may not always be the defining characteristic for diagnosing glaucoma or predicting whether the disease will worsen.³⁰ Statistics show that 15% of patients with characteristic glaucomatous nerve damage have intraocular pressure measurements that fall within the normal range.³¹ Such cases may be partly due to poor blood flow to the optic nerve.³²

Until a cure is identified, greater research into prevention strategies is needed.

Summary

Increased pressure in the eye is the most common underlying cause of glaucoma, and it usually occurs without pain or other warning signs.

Human studies demonstrate that increased intraocular pressure can be significantly reversed with a proprietary extract of French maritime pine bark and bilberry extract.

In a human study, this formulation reduced eye pressure by 24% and—when combined with standard therapy—by up to 40%!

While there is no cure for glaucoma, the pine bark-bilberry formulation we have described appears to represent a substantial breakthrough along the road to even greater preventive or curative discoveries.

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.

References

1. Available at: https://www.cdc.gov/visionhealth/research/projects/ongoing/glaucoma.htm#ref1. Accessed May 30, 2017.
2. Pasquale LR, Hyman L, Wiggs JL, et al. Prospective Study of Oral Health and Risk of Primary Open-Angle Glaucoma in Men: Data from the Health Professionals Follow-up Study. Ophthalmology. 2016;123(11):2318-27.
3. Chaitanya A, Pai VH, Mohapatra AK, et al. Glaucoma and its association with obstructive sleep apnea: A narrative review. Oman J Ophthalmol. 2016;9(3):125-34.
4. Miller MA, Fingert JH, Bettis DI. Genetics and genetic testing for glaucoma. Curr Opin Ophthalmol. 2017;28(2):133-8.
5. Song BJ, Aiello LP, Pasquale LR. Presence and Risk Factors for Glaucoma in Patients with Diabetes. Curr Diab Rep. 2016;16(12):124.
6. Schlote T. Impact of Drugs on Glaucoma and Intraocular Pressure. Klin Monbl Augenheilkd. 2017;234(2):179-84.
7. Available at: http://www.glaucoma.org/glaucoma/does-blood-pressure-affect-glaucoma.php. Accessed May 31, 2017.
8. Available at: http://www.glaucoma.org/glaucoma/glaucoma-facts-and-stats.php. Accessed May 31, 2017.
9. Steigerwalt RD, Jr., Belcaro G, Morazzoni P, et al. Mirtogenol potentiates latanoprost in lowering intraocular pressure and improves ocular blood flow in asymptomatic subjects. Clin Ophthalmol. 2010;4:471-6.
10. Available at: https://nei.nih.gov/health/glaucoma/glaucoma_facts. Accessed May 31, 2017.
11. Aung T, Lim MC, Chan YH, et al. Configuration of the drainage angle, intraocular pressure, and optic disc cupping in subjects with chronic angle-closure glaucoma. Ophthalmology. 2005;112(1):28-32.
12. Available at: https://www.mercy.net/healthinfo/hw121946. Accessed May 31, 2017.
13. Available at: http://www.glaucoma.org/glaucoma/types-of-glaucoma.php. Accessed May 31, 2017.
14. Resch H, Garhofer G, Fuchsjager-Mayrl G, et al. Endothelial dysfunction in glaucoma. Acta Ophthalmol. 2009;87(1):4-12.
15. Moore DL, Goldberg JL. Four steps to optic nerve regeneration. J Neuroophthalmol. 2010;30(4):347-60.
16. Shum JW, Liu K, So KF. The progress in optic nerve regeneration, where are we? Neural Regen Res. 2016;11(1):32-6.
17. Steigerwalt RD, Gianni B, Paolo M, et al. Effects of Mirtogenol on ocular blood flow and intraocular hypertension in asymptomatic subjects. Mol Vis. 2008;14:1288-92.
18. Rohdewald P. A review of the French maritime pine bark extract (Pycnogenol), a herbal medication with a diverse clinical pharmacology. Int J Clin Pharmacol Ther. 2002;40(4):158-68.
19. Peng Q, Wei Z, Lau BH. Pycnogenol inhibits tumor necrosis factor-alpha-induced nuclear factor kappa B activation and adhesion molecule expression in human vascular endothelial cells. Cell Mol Life Sci. 2000;57(5):834-41.
20. Nishioka K, Hidaka T, Nakamura S, et al. Pycnogenol, French maritime pine bark extract, augments endothelium-dependent vasodilation in humans. Hypertens Res. 2007;30(9):775-80.
21. Cesarone MR, Belcaro G, Rohdewald P, et al. Prevention of edema in long flights with Pycnogenol. Clin Appl Thromb Hemost. 2005;11(3):289-94.
22. Belcaro G, Cesarone MR, Rohdewald P, et al. Prevention of venous thrombosis and thrombophlebitis in long-haul flights with pycnogenol. Clin Appl Thromb Hemost. 2004;10(4):373-7.
23. Karhanova M, Eliasova M, Kubena T, et al. [ProVens(R) in the Therapy of Glaucoma and Ocular Hypertension]. Cesk Slov Oftalmol. 71(6):288-92.
24. Zafra-Stone S, Yasmin T, Bagchi M, et al. Berry anthocyanins as novel antioxidants in human health and disease prevention. Mol Nutr Food Res. 2007;51(6):675-83.
25. Milbury PE, Graf B, Curran-Celentano JM, et al. Bilberry (Vaccinium myrtillus) anthocyanins modulate heme oxygenase-1 and glutathione S-transferase-pi expression in ARPE-19 cells. Invest Ophthalmol Vis Sci. 2007;48(5):2343-9.
26. Mauray A, Felgines C, Morand C, et al. Bilberry anthocyanin-rich extract alters expression of genes related to atherosclerosis development in aorta of apo E-deficient mice. Nutr Metab Cardiovasc Dis. 2012;22(1):72-80.
27. Yao N, Lan F, He RR, et al. Protective effects of bilberry (Vaccinium myrtillus L.) extract against endotoxin-induced uveitis in mice. J Agric Food Chem. 2010;58(8):4731-6.
28. Baltmr A, Duggan J, Nizari S, et al. Neuroprotection in glaucoma - Is there a future role? Exp Eye Res. 2010;91(5):554-66.
29. Available at: http://www.glaucoma.org/gleams/glaucoma-medications-and-their-side-effects.php. Accessed June 2, 2017.
30. Varma R, Peeples P, Walt JG, et al. Disease progression and the need for neuroprotection in glaucoma management. Am J Manag Care. 2008;14(1 Suppl):S15-9.
31. Distelhorst JS, Hughes GM. Open-angle glaucoma. Am Fam Physician. 2003;67(9):1937-44.
32. Available at: http://www.umm.edu/health/medical/reports/articles/glaucoma. Accessed June 2, 2017.
33. Available at: http://www.mayoclinic.org/diseases-conditions/glaucoma/basics/risk-factors/con-20024042. Accessed June 12, 2017.
34. Available at: http://www.glaucoma.org/glaucoma/normal-tension-glaucoma.php. Accessed June 12, 2017.