Mindfulness Meditation Reduces Intraocular Pressure, Lowers Stress Biomarkers and Modulates Gene Expression in Glaucoma

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Abstract

Reducing intraocular pressure (IOP) in primary open-angle glaucoma (POAG) is currently the only approach to prevent further optic nerve head damage. However, other mechanisms such as ischemia, oxidative stress, glutamate excitotoxicity, neurotrophin loss, inflammation/glial activation, and vascular dysregulation are not addressed. Because stress is a key risk factor affecting these mechanisms, we evaluated whether mindfulness-based stress reduction can lower IOP and normalize typical stress biomarkers.

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Most cited references 29

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Psychological Stress Activates the Inflammasome via Release of Adenosine Triphosphate and Stimulation of the Purinergic Type 2X7 Receptor.

Masaaki Iwata, Kristie Ota, Xiao-Yuan Li … (2016)

The mechanisms underlying stress-induced inflammation that contribute to major depressive disorder are unknown. We examine the role of the adenosine triphosphate (ATP)/purinergic type 2X7 receptor (P2X7R) pathway and the NLRP3 (nucleotide-binding, leucine-rich repeat, pyrin domain containing 3) inflammasome in interleukin (IL)-1β and depressive behavioral responses to stress.

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The primary vascular dysregulation syndrome: implications for eye diseases

Josef Flammer, Katarzyna Konieczka, Andreas J. Flammer (2013)

Vascular dysregulation refers to the regulation of blood flow that is not adapted to the needs of the respective tissue. We distinguish primary vascular dysregulation (PVD, formerly called vasospastic syndrome) and secondary vascular dysregulation (SVD). Subjects with PVD tend to have cold extremities, low blood pressure, reduced feeling of thirst, altered drug sensitivity, increased pain sensitivity, prolonged sleep onset time, altered gene expression in the lymphocytes, signs of oxidative stress, slightly increased endothelin-1 plasma level, low body mass index and often diffuse and fluctuating visual field defects. Coldness, emotional or mechanical stress and starving can provoke symptoms. Virtually all organs, particularly the eye, can be involved. In subjects with PVD, retinal vessels are stiffer and more irregular, and both neurovascular coupling and autoregulation capacity are reduced while retinal venous pressure is often increased. Subjects with PVD have increased risk for normal-tension glaucoma, optic nerve compartment syndrome, central serous choroidopathy, Susac syndrome, retinal artery and vein occlusions and anterior ischaemic neuropathy without atherosclerosis. Further characteristics are their weaker blood–brain and blood-retinal barriers and the higher prevalence of optic disc haemorrhages and activated astrocytes. Subjects with PVD tend to suffer more often from tinnitus, muscle cramps, migraine with aura and silent myocardial ischaemic and are at greater risk for altitude sickness. While the main cause of vascular dysregulation is vascular endotheliopathy, dysfunction of the autonomic nervous system is also involved. In contrast, SVD occurs in the context of other diseases such as multiple sclerosis, retrobulbar neuritis, rheumatoid arthritis, fibromyalgia and giant cell arteritis. Taking into consideration the high prevalence of PVD in the population and potentially linked pathologies, in the current article, the authors provide recommendations on how to effectively promote the field in order to create innovative diagnostic tools to predict the pathology and develop more efficient treatment approaches tailored to the person.

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Glaucoma as a neurodegenerative disease.

Yeni H Yücel, Neeru Gupta (2007)

Glaucoma is a leading cause of irreversible world vision loss characterized by progressive retinal ganglion cell death. Elevated eye pressure is a major risk factor for glaucoma; however, despite effective medical and surgical therapies to reduce intraocular pressure, progressive vision loss among glaucoma patients is common. These observations suggest that mechanisms independent of intraocular pressure are also implicated in glaucomatous degeneration. Numerous similarities exist between glaucoma and neurodegenerative diseases such as Alzheimer's and Parkinson's diseases. Similarities include the selective loss of neuron populations, transsynaptic degeneration in which disease spreads from injured neurons to connected neurons, and common mechanisms of cell injury and death. Glaucomatous injury to retinal ganglion cells has profound effects on target vision structures within the brain, including the lateral geniculate nucleus and visual cortex in experimental primate and human glaucoma. Mechanisms involved in central visual system damage in glaucoma include oxidative injury and glutamate toxicity, as seen in neurodegenerative diseases. Glaucoma as a neurodegenerative disease is a valid working hypothesis to understand neural injury in the visual system. This paradigm may stimulate the discovery of innovative intraocular pressure-independent strategies to help prevent loss of vision in glaucoma patients.

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Author and article information

Journal

Title: Journal of Glaucoma

Abbreviated Title: Journal of Glaucoma

Publisher: Ovid Technologies (Wolters Kluwer Health)

ISSN (Print): 1057-0829

Publication date Created: 2018

Publication date (Print): December 2018

Volume: 27

Issue: 12

Pages: 1061-1067

Article

DOI: 10.1097/IJG.0000000000001088

PubMed ID: 30256277

SO-VID: 4b16a286-8109-4dda-b685-a1312d0fa50f

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Mindfulness Meditation Reduces Intraocular Pressure, Lowers Stress Biomarkers and Modulates Gene Expression in Glaucoma : A Randomized Controlled Trial

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