Suri Manjula ¹, Mamta Bhardwaj ², Kapur Punam ³, Pathak Ashok ³

Affiliations
1 Dept. of Physiology and Promotive Health, Institute of Home Economics, University of Delhi, New Delhi, IN
2 Dept. of Biology, Institute of Home Economics, University of Delhi, New Delhi, IN
3 Dept. of Ophthalmology, Ram Manohar Lohia Hospital, New Delhi, IN

Abstract

Various researchers suggest that in up to 50% of patients with type 1 diabetes and 30% of those with type II diabetes, potentially vision-threatening retinal changes develop over time. Diabetic retinopathy is a common micro-vascular complication of diabetes mellitus. The present review outlines the dietary strategies to manage these complications of diabetes mellitus and studies the relationship between diet and retinopathy-associated risk factors in the development and progression of diabetic retinopathy. Though retinopathy therapy is currently limited to invasive procedures like laser photocoagulation and vitrectomy but there is a paradigm shift in favor of a preventive and protective, natural and safe dietary approach which can be used in treatment or prevention of diabetic retinopathy. Dietary carbohydrates, fats, proteins, dietary fibers, vitamins, antioxidants, minerals, phyto-estrogens, exogenous advanced glycation end-products, herbs, spices and protective dietary approaches play a role in development of diabetic retinopathy. This rationale can be applied to food interventions e.g. changing the composition of diet which favors metabolic improvements in type II diabetes and diabetic retinopathy. The ophthalmologists should encourage an interdisciplinary approach with endocrinologists and dietitian for optimal care of diabetic patient so as to prevent the development of diabetic retinopathy.

Keywords

Diabetic Retinopathy, Exogenous Advanced Glycation End-Products, Microvascular Complication.

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Punam Kapur ¹, Ashok Pathak ¹, Shipra Gupta ², Mamta Bhardwaj ³, Manjula Suri ⁴

Affiliations
1 Department of Ophthalmology, Ram Manohar Lohia Hospital, New Delhi, IN
2 Department of Food and Nutrition, Institute of Home Economics, University of Delhi, New Delhi, IN
3 Department of Biology, Institute of Home Economics, University of Delhi, New Delhi, IN
4 Department of Physiology and Promotive Health, Institute of Home Economics, University of Delhi, New Delhi, IN

Abstract

Glaucoma, the second-leading cause of blindness worldwide, silently and without warning can cause disabling vision loss that result from damage to the eye’s optic nerve. Glaucoma is characterized by Increased Intraocular Pressure (IOP) in some but not all cases. Faulty glycosaminoglycan (GAG) synthesis or breakdown in the trabecular meshwork associated with aqueous outflow as well as compromised antioxidant defense systems have also been implicated. Researchers have found nutrient interventions may impact this vision-robbing glaucoma. Nutrients that can influence GAGs such as vitamin C and glucosamine sulfate may hold promise for glaucoma treatment. Vitamin C in high doses has also been found to lower IOP via its osmotic effect. Other nutrients holding some potential benefit for glaucoma include antioxidants, vitamins, minerals, caffeine, melatonin and herbs etc. Role of dietary fats and proteins in glaucoma is an emerging field of research with potential therapeutic benefits. Diabetics and persons without diabetes but at the higher levels of fasting glucose, fasting insulin and HbA1c may also be at greater risk of glaucoma suggesting that dietary sugars also play a role in development of glaucoma. Similarly, Mediterranean diet and Caloric restriction are safe, non-invasive and low-cost treatments which may be used as auxiliary measures for a long-term therapy of age-related eye diseases such as glaucoma. In this review, various modifiable nutrient factors, that may influence intraocular pressure and that have been studied in relation to the risk of developing glaucoma are discussed. This review also outlines future directions for research into the primary prevention of glaucoma.

Keywords

Glaucoma, Intraocular Pressure, Glycosaminoglycan, Antioxidant, Melatonin.

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