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

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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.

In a prospective, randomized trial 90 POAG patients (180 eyes; age above 45 y) were assigned to a waitlist control or mindfulness meditation group which practiced daily for 21 days. We measured IOP (primary endpoint), quality of life (QOL), stress-related serum biomarkers [cortisol, β-endorphins, IL6, TNF-α, brain-derived neurotrophic factor (BDNF), reactive oxygen species (ROS), total antioxidant capacity (TAC)], and whole genome expression.

Between-group comparisons revealed significantly lowered IOP in meditators (OD: 18.8 to 12.7, OS 19.0 to 13.1 mm Hg) which correlated with significantly lowered stress-biomarker levels including cortisol (497.3 to 392.3 ng/mL), IL6 (2.8 to 1.5 ng/mL), TNF-α (57.1 to 45.4 pg/mL), ROS (1625 to 987 RLU/min/104 neutrophils), and elevated β-endorphins (38.4 to 52.7 pg/mL), BDNF (56.1 to 83.9 ng/mL), and TAC (5.9 to 9.3) (all P<0.001). These changes correlated well with gene expression profiling. Meditators improved in QOL (P<0.05).

A short course of mindfulness-based stress reduction by meditation in POAG, reduces IOP, improves QOL, normalizes stress biomarkers, and positively modifies gene expression. Mindfulness meditation can be recommended as adjunctive therapy for POAG.

Citation

Mindfulness Meditation Reduces Intraocular Pressure, Lowers Stress Biomarkers and Modulates Gene Expression in Glaucoma: A Randomized Controlled Trial.Dada T, Mittal D, Mohanty K, Faiq MA, Bhat MA, Yadav RK, Sihota R, Sidhu T, Velpandian T, Kalaivani M, Pandey RM, Gao Y, Sabel BA, Dada R, - J. Glaucoma - October 21, 2019; 27 (12); 1061-1067

MEDLINE is the source for the citation and abstract for this record

Full Source TitleJournal of glaucomaNLM Citation ID30256277 (PubMed ID)Languageeng,Author Affiliation

 

 

Meditation: A Polypill for Comprehensive Management of Glaucoma Patients.

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Abstract

Meditation is an ancient behavioral intervention, however, its benefits for achieving holistic health have been highlighted in recent times with rigorous scientific studies revealing its benefits in many chronic diseases. It has been specially found useful in neurodegenerative diseases and recent evidence points to the positive effects of meditation in preserving grey and white matter in the adult brain. It is also a potential therapy to downregulate processes implicated in brain aging and confer "neuroprotection"- something we all look forward to for our glaucoma patients. In the current review, we evaluate the benefits of meditation practice for the glaucoma patient and support for its candidature as adjunctive therapy for glaucoma patients. It has multiple potential benefits for normal as well as high pressure glaucoma patients including a reduction in intraocular pressure (IOP), increasing cerebral blood flow and oxygenation, and decreasing action of the sympathetic nervous system with a corresponding increase in parasympathetic nervous system activity. Meditation leads to a "relaxation response" mediated by nitric oxide with decrease in the stress hormone cortisol, increase in neurotrophins and mitochondrial energy production and improves the overall quality of life of glaucoma patients. It can also benefit caregivers of glaucoma patients and health care providers. It appears that meditation can function as a multifaceted management approach for glaucoma using the natural potential of the human body and target not only the eye but the patient behind the eye to ameliorate this "sick eye in a sick body" condition.

Citation

Meditation: A Polypill for Comprehensive Management of Glaucoma Patients.Dada T, Ramesh P, Shakrawal J, - J. Glaucoma - November 8, 2019; ();

MEDLINE is the source for the citation and abstract for this record

Full Source TitleJournal of glaucomaNLM Citation ID31714327 (PubMed ID)Languageeng,Author Affiliation

  1. Glaucoma research facility & clinical services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

AuthorsDada T, Ramesh P, Shakrawal J,