CITICOLINE OFFERS NEW HOPE IN TREATING AN AGE-OLD SCOURGE
Glaucoma: To Catch a Silent Thief
   

In August of 1983, a 24-foot sailboat arrived in Honolulu with one man on board. Hank Dekker, a former auto dealer and racer, had sailed solo from San Francisco to Hawaii - a 2,500-mile trip that took 23 days.1

Few people have both the seamanship and the courage required to undertake such a perilous journey alone. But there was something even more remarkable about Hank Dekker: he was totally blind and had taken up sailing only after losing his sight ten years earlier. Using specially adapted navigational charts and instruments fitted with Braille readouts, he defied fear, logic, and the elements, landing with pinpoint accuracy at his destination. He became an overnight celebrity, later sailed solo to Tahiti, and is today a successful motivational speaker for large corporations.

Hank Dekker lost his eyesight at the age of 37, to glaucoma. The disease probably could have been detected in time to prevent this outcome, but it wasn't. Hank had not had regular eye exams, and he paid a terrible price for that.

Aqueous Humor Is Not Funny
The human eye - the mirror of the soul - is a marvel of biomechanical and biochemical engineering. Inside the eye is a watery liquid called the aqueous humor, or intraocular fluid, which fills the anterior and posterior chambers of the eye (see Figure 1), bathing and nourishing its component parts. In a finely tuned process of dynamic equilibrium, the aqueous humor is constantly replenished by the body as it slowly drains from the eye.


Figure 1. Anatomy of the eye.

If this equilibrium is upset, there can be hell to pay. Glaucoma is a disease (actually a group of related diseases) characterized by an increase in hydrostatic pressure in the eyeball that occurs when the inflow of aqueous humor is not adequately balanced by the outflow. This defect is caused primarily by deterioration in the composition of collagen, the most common protein in the body, including the eye, where it provides the supportive structure for the eye's component parts.

As the intraocular pressure (IOP) builds up to abnormal levels, it damages the optic disk, or blind spot. This is the small, circular, optically insensitive region in the retina where the fibers of the optic nerve emerge. Damage to this vital spot causes visual defects, notably a progressive loss of peripheral vision, which leads to tunnel vision. Eventually, if caught too late, glaucoma will destroy vision completely and permanently.

You Can't Feel Glaucoma
Glaucoma is an insidious disease. It usually takes its victims slowly and silently, doing damage to their eyes before they even notice any symptoms. That is why early detection is vital. In rare cases, glaucoma can strike suddenly and aggressively, destroying vision within a few days if treatment is not received immediately upon experiencing the primary symptom: acute pain in the eye. It is estimated that there are about two million victims of this terrible disease in the United States, roughly a quarter of whom do not yet know it.

Glaucoma Mostly Age-Related
Glaucoma is primarily associated with aging - it is rare in people under 40 - but it can be caused by eye injuries, eye surgery, certain medications (especially corticosteroids, a major risk factor), and eye tumors. It may also be linked to nutritional deficiencies in the retina and optic nerve and to excessive toxins and metabolic wastes.

There are a number of drugs on the market for the treatment of glaucoma. Their effectiveness varies depending on the type of glaucoma and the condition of the patient, among other things, and some of their side effects are unpleasant or even dangerous. Glaucoma itself is so dangerous, however, that almost anything promising is worth a try.

Citicoline Can Help
In the quest for new or better treatments, a research group at the University of Rome recently completed a double-blind, placebo-controlled study of the effects of citicoline on patients with open-angle glaucoma.2 Citicoline is shorthand for CDP-choline, which itself is shorthand for cytidine-5'-diphosphocholine, a natural substance in our bodies. It is a chemical intermediate in the formation of phosphatidylcholine, also known as lecithin.

This was not the first investigation of citicoline for glaucoma, but it sought to confirm previous positive findings3 by using more sophisticated electrophysiological methods for evaluating visual function than the earlier psychophysical methods.


Figure 2: Blowup of the anterior and posterior chambers of the eye.

Forty volunteer patients with open-angle glaucoma (also known as simple glaucoma, primary glaucoma, chronic glaucoma, and a few other names) and with a mean age of 46 took part in the study, during which they all received topical treatment with beta-blockers only; this held their IOP values in the normal range. None had had filtration surgery for their condition, and all were free of any other ocular, neurologic, or systemic disease.

The patients were randomly divided into two age-matched groups, one to receive intramuscular treatment (1000 mg/day) with citicoline, and the other to receive a placebo. There was no difference in the measured IOP values between the two groups.

The study lasted for 360 days, divided into several periods of treatment followed by periods of nontreatment, or "washout." All the patients were evaluated regularly for visual function (retinal and cortical responses) by several electrophysiological methods, and their IOP values were monitored as well.

The results were unambiguous: whereas the placebo group showed no significant changes in visual function during the course of the study, the citicoline group showed marked improvement during the treatment periods, followed by a decline toward baseline levels during the washout periods. There were no adverse side effects with the citicoline.

The authors concluded that their results "indicate a potential use for this substance in the medical treatment of glaucoma as a complement to hypotensive therapy." If you have glaucoma, make sure your doctor knows about citicoline, insisting that he or she read the literature. Leave no stone unturned in fighting this disease!

You should also know that citicoline has been the subject of a sizeable amount of first-rate studies over the last two decades, especially for its cognitive function benefits (see Memory De-Aging: The City of Choline - February 1999), so there are other good reasons to take this nutrient. Do not miss the boat!

Here's to Your Ocular Health!
Ideally, one would treat glaucoma only with healthful nutritional supplements. There is evidence that some of these are effective - notably vitamin C, a deficiency of which has been implicated in both glaucoma and cataracts.  

The concentration of vitamin C is 25 times greater in the aqueous humor of a normal eye than in the blood serum. It plays a central role in ocular health because it is vital for the continuous synthesis of collagen, the intercellular protein "cement" whose deterioration is the primary cause of glaucoma. Vitamin C is not just a catalyst in collagen synthesis, but a reactant, so it is destroyed in the process and must be constantly replenished. 

Among the other supplements whose value has been substantiated in the treatment of glaucoma, as well as other eye diseases, is vinpocetine, a compound extracted from the evergreen shrub periwinkle (Vinca minor). Vinpocetine is known to increase blood flow in various parts of the body, including the eye.

There are also other nutrients for enhanced eye health: quercetin, lutein, hesperidin, bilberry extract, taurine, L-cysteine hydrochloride, and a variety of vitamins (including C) and minerals.

For more information about your ocular health, see Improve Your Vision - October 1998. (Do you see how casually we all use the word "see," as in that last sentence? Think about that, and about Hank Dekker. See you next month!

References

  1. Dugard M. On the Edge: Four true stories of extreme outdoor sports adventures. Bantam Books, New York, 1995, pp 85-110.
  2. Parisi V, Manni G, Colacino G, Bucci MG. Cytidine-5'-diphosphocholine (citicoline) improves retinal and cortical responses in patients with glaucoma. Ophthalmology 1999;106:1126-34.
  3. Pecori Giraldi J, Virno M, Covelli G, et al. Therapeutic value of citicoline in the treatment of glaucoma (computerized and automated perimetric investigation). Int Ophthalmol 1989;13:109-12.

© Copyright 1999 Life Enhancement Products, Inc. All Rights Reserved.

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