Abstract
Purpose :
We evaluated the effect of Yoga and Meditation based intervention (YMBI) on IOP, quality of life (QOL), stress markers, neurotrophins and gene expression in patients with primary open angle glaucoma (POAG).
Methods :
Eighty POAG patients aged > 45 years on topical medical therapy with best corrected visual acuity of 20/40 or better in both eyes were randomized (40 in each YMBI and control group). Patients with any co-morbid ocular or systemic diseases, performing yoga, meditation or aerobic exercise were excluded. The intervention was a 60 minute YMBI (30 minute deep breathing and relaxation exercises and 30 minutes meditation) for 21 days supervised by a trained instructor. Parameters evaluated before and after the intervention were IOP, QOL (WHO-QOL BREF and GQL-15 questionnaires), serum levels of cortisol, β-endorphin, IL6, TNF-α, BDNF, reactive oxygen stress (ROS), total antioxidant capacity (TAC) and (v) gene expression using microarray studies.
Results :
In YMBI group IOP changed from (OD/OS) 18.8 ± 2.34/19 ± 1.63 to 12.7 ± 1.94/13.1±2.23 mmHg, GQL score from 61.6 ± 5.9 to 36.13 ± 7.5, WHO-BREF score from 25±6.5 to 82.8±4.3, cortisol from 497.3 ± 33.85 to 392.3 ± 55.02 ng/ml, β-endorphins from 38.4 ± 2.42 to 52.7 ± 6.19 pg/ml, IL6 from 2.8 ± 0.56 to 1.5 ± 0.6 ng/ml, TNF-α from 57.08 ± 4.38 to 45.36 ± 7.46 pg/ml, BDNF from 56.1 ± 7.87 to 83.9 ± 12.87 ng/ml, ROS from 1625.2 ± 241.32 to 987.8 ± 160.21 RLU/min/104 neutrophil and TAC from 5.9 ± 1.52 to 9.3 ± 1.4 (all p-values < 0.001 except QOL < 0.05). Microarray studies revealed that 54 genes (e.g. NGFR, TAZ, BNP, IL2, IL4, FGFR1, Metallothionein-I) were upregulated and 56 downregulated (e.g. Neuregulin1, NFKBIA, RAR, CYP26A1, Bim, I-kB, EGFR, ERK7) post YMBI (p<0.01) positively impacting uveoscleral outflow, trabecular meshwork maintenance, synapse maturation, anti-inflammatory and anti-apoptotic mpathways. There was no significant improvement in any of these parameters in the control group (all p > 0.05).
Conclusions :
A 3 week YMBI in POAG was associated with reduction in IOP, inflammatory markers and ROS; an increase in neurotrohins and endorphins along with an improvement in QOL, with corresponding changes in gene expression pattern. YMBI may be a useful adjunct in the treatment of glaucoma patients.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.