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Miriam Adriana Ramos-Hernández, Jose A Paczka, Michelle Y. Guzmán Ornelas, Miguel A. Ibañez Sandoval, Luz A. Giorgi-Sandoval; Could a Nootropic Formulation Benefit Patients with End-Satge Glaucoma?. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2368.
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End-stage glaucoma is a challenging clinical situation that required very low IOP to control it. Diverse non-dependent IOP factors are involved in visual function stability and neuroprotective compounds have been proposed as potentially helpful. Nootropic supplements such as Neuro Optimizer (Jarrow Formulas) have been purportedly used due to their neuroprotective effects. The objective of this study is to evaluate the benefit of orally administered Neuro Optimizer in patients with end-stage glaucoma in a real-world setting.
A retrospective assessment of data from 132 consecutive patients with end-stage glaucoma under oral treatment with Neuro Optimizer was performed. Clinical data including BCVA, IOP, number of glaucoma medications, visual field indexes evaluated by applanation tonometry, cup-to-disc (CD) ratio, peripapillary retinal nerve fiber layer (RNFL) and perimacular ganglion cell complex (GCC) thickness by OCT. Tolerability and safety issues were also assessed.
One hundred and thirty-two patients were under oral Neuro Optimizer treatment, from which 31 were excluded. Therefore, 197 eyes of 101 patients (61 females, 40 males; mean age of 64.8±17.6 years) were included. This population showed a greater proportion of POAG (59.4%), and usage of ≥ 2 glaucoma medications (81.1%). Mean time of Neuro Optimizer administration was 9.4±3.3 months. Baseline IOP was 14.5±5.8 mmHg (RE) and 14.7±5.2 mmHg (P=0.79) and no difference was noted with the last visit values (RE, 14.8±6.0 mmHg; LE, 14.4±5.7 mmHg; P=0.63). BCVA, MD, DSM, CD ratio, CFNR and GCC were not statistically different when the two moments were compared (p>0.05). Mean pre-treatment VFI in both eyes (RE, 43.7±32.4 %; LE, 39.8±33.6%) was higher as compared to the post-treatment period (RE, 37.5±31.8 mmHg; p=0.001; LE, 34.1±29.2 mmHg; p=0.02). Heartburn (9.9%), minor headache (7.9%) and a transient cutaneous rash (1.9%) were the side-effects recorded. Two patients (1.9%) interrupted supplement administration because of persistent headache. Eighteen patients (17.8%) claimed to have a subjective improvement in their vision.
The current results of this retrospective “real world” study of end-stage glaucoma patients showed no improvement but a reduced VFI when Neuro Optimizer was orally administered during a short-term period. No relevant safety/tolerability issues were relevant. Subjective perception of improvement was infrequent.
This is a 2021 ARVO Annual Meeting abstract.
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