June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Glucose-induced Temporary Visual Recovery in Human Glaucoma: A Prospective, Double-blind, Randomised Study
Author Affiliations & Notes
  • Robert Casson
    SA Institute of Ophthalmology, SA Inst of Ophthalmol, Adelaide Univ, Adelaide, SA, Australia
  • Glyn Chidlow
    SA Institute of Ophthalmology, SA Inst of Ophthalmol, Adelaide Univ, Adelaide, SA, Australia
  • Andreas Ebneter
    SA Institute of Ophthalmology, SA Inst of Ophthalmol, Adelaide Univ, Adelaide, SA, Australia
  • Guoge Han
    SA Institute of Ophthalmology, SA Inst of Ophthalmol, Adelaide Univ, Adelaide, SA, Australia
  • Jolly Gilhotra
    SA Institute of Ophthalmology, SA Inst of Ophthalmol, Adelaide Univ, Adelaide, SA, Australia
  • John Wood
    SA Institute of Ophthalmology, SA Inst of Ophthalmol, Adelaide Univ, Adelaide, SA, Australia
  • Footnotes
    Commercial Relationships Robert Casson, None; Glyn Chidlow, None; Andreas Ebneter, None; Guoge Han, None; Jolly Gilhotra, None; John Wood, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 4009. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Robert Casson, Glyn Chidlow, Andreas Ebneter, Guoge Han, Jolly Gilhotra, John Wood; Glucose-induced Temporary Visual Recovery in Human Glaucoma: A Prospective, Double-blind, Randomised Study. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4009.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract
 
Purpose
 

We have previously shown that elevated vitreal glucose levels provide robust neuroprotection against acute and chronic experimental retinal ischemia, and experimental glaucoma. In vitro, the effect is mediated by glycolytic energy supply and the pentose phosphate pathway. In this early translational study, we hypothesised that elevated vitreal glucose levels could temporarily improve psychophysical parameters of visual function in patients with primary open-angle glaucoma (POAG).

 
Methods
 

In a preliminary study on non-diabetic patients scheduled for vitrectomy, we showed that intensive topical application of glucose (50% glucose 5 minutely for 1 hour) significantly elevated the vitreous glucose concentration in pseudophakic but not phakic patients. We then conducted a double-blind, randomized crossover study on 28 pseudophakic eyes of 15 patients with POAG but no other ocular pathology. The main outcome measure was change from baseline in contrast sensitivity (CS) at 12 cycles/degree (using the CSV-1000). CS at 3, 6, and 18 cycles/degree, and the logarithm of the minimum angle of resolution (logMAR) visual acuity (VA) were secondary outcomes. Topical saline was used as a control, with a washout interval of 2-3 weeks. Patients randomly received either glucose/saline or saline/glucose. We applied the same glucose-dosing regimen as per the preliminary study, measuring CS, logMAR VA, refraction, intraocular pressure (IOP), and central corneal thickness (CCT) at baseline and 15-30 minutes after drops. The effect of treatment was modeled by linear regression using a generalized estimating equation approach to parameter estimation.

 
Results
 

There were no adverse effects. Saline had negligible effect on visual function. The mean change from baseline after glucose treatment on the CS at 12 cycles /degree was 0.25 log units (95% C.I 0.09 -0.42) greater than saline (P = 0.003). CS was also significantly enhanced compared to controls at 3, 6, and 18 cycles/degree (P = <0.000; P = 0.006; P = 0.042). The mean change in logMAR VA was 2 letters (95% C.I. 0.7 -3.3) greater after glucose (P = 0.002). The glucose treatment had no significant effect on refraction, IOP, or CCT.

 
Conclusions
 

Intensive topical glucose reached the vitreous in pseudophakes, and improved the mean CS and VA in a group of pseudophakic patients with POAG, suggesting possible temporary neurorecovery at the level of the retina.

  
Keywords: 615 neuroprotection • 466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • 688 retina  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×