A recent study in Cell Reports Medicine by scientists at the Karolinska Institutet reveals that targeted nutritional support with B vitamins and choline may help slow the advance of glaucoma.
Current Therapeutic Strategies for Glaucoma Show Reduced Long-Term Efficacy
An estimated 80 million people live with glaucoma globally, a disease marked by optic nerve damage and the risk of permanent vision loss. Treatments typically target intraocular pressure, but often diminish in effectiveness over time.
“Because glaucoma is a progressive disease and we do not have a cure, any new treatment is a welcome addition,” said Dr David I. Geffen, OD, FAAO.
“We know glaucoma medications seem to be less effective over time. Therefore, we need to keep finding more new ways to help control this process and eventually cure the disease.”
Researchers are now looking to B vitamins and choline as a potential option for patients who see limited results with conventional care.
Study Explores Homocysteine and Nutritional Deficiencies in Disease Progression
The researchers targeted homocysteine, an amino acid that naturally occurs in the body and plays a role in protein synthesis. Elevated homocysteine levels have been previously linked to health risks such as cardiovascular disease, cognitive decline, and stroke.
Past studies suggested a connection between high homocysteine levels and optic nerve damage in the context of glaucoma.
However, in the latest study, researchers discovered that increasing homocysteine levels in a glaucoma mouse model did not worsen the disease.
“Our conclusion is that homocysteine is a bystander in the disease process, not a player,” said James Tribble, researcher and assistant professor at the Karolinska Institutet.
“Altered homocysteine levels may reveal that the retina has lost its ability to use certain vitamins that are necessary to maintain healthy metabolism.”
Nutritional Supplementation Demonstrates Protective Effects
The researchers then provided the mice with supplements of B6, B9, B12, and choline. The results were notable:
- In mice with slow-developing glaucoma, the optic nerve damage completely ceased.
- In cases of more aggressive glaucoma, the supplements significantly slowed disease progression.
Importantly, the study did not address intraocular pressure (IOP), the primary target of existing glaucoma treatments. Instead, the researchers suggest that the supplements may protect the optic nerve by supporting metabolic processes independent of eye pressure.
“This could be revolutionary,” Geffen said. “It is one of the first studies to show supplements will help control glaucoma. As our population is ageing, we are seeing a large increase of glaucoma patients in our practice.”
Clinical Experts Highlight Implications for Future Treatment Models
The findings have drawn cautious optimism from eye health experts.
Dr Benjamin Bert, MD, a board-certified ophthalmologist at MemorialCare Orange Coast Medical Centre, emphasised the potential significance of exploring metabolic components in glaucoma treatment.
“Right now, the only treatments that we have for glaucoma specifically are eye drops and surgeries to lower the eye pressure,” Bert said. “But we’re discovering more and more that there’s other things that are happening that can actually cause the progression of the glaucoma.”
Bert added that the study’s focus on homocysteine as a metabolic factor offers new insight into how nutritional interventions might prevent or slow optic nerve damage.
“And with the vitamin supplements showing some prevention benefit, that’s an exciting thing for us to be able to have on the horizon,” he said.
Conclusion
The study’s findings represent a step forward, but further validation is required. Conducted in a mouse model, the research is set to expand into human trials to determine the effects of B vitamin and choline supplementation in real-world glaucoma patients.
“In the future, I would like to see some longer-term studies with glaucoma patients,” said Dr David I. Geffen. “I would also like to see investigations on similar types of treatments utilising other supplements.”