…..Glaucoma more complex than lowering eye pressure – Ophthalmologist
An eye specialist, Prof. Adeola Onakoya, said recent advances in glaucoma management had gone beyond the control of intraocular (eye) pressure (IOP) alone.
Onakoya, a Professor of Ophthalmology, said this during the 6th Inaugural Lecture Series of the University of Lagos, on Wednesday, in Lagos.
The lecture theme of the lecture is “Protecting and Preserving the ‘Cables’: The Race Against Darkness.”
Onakoya acknowledged that lowering IOP was known to be effective in delaying or preventing glaucoma disease onset.
She, however, said that a significant percentage of patients would continue to experience disease progression even with lowered IOP.
According to her, research has shown that glaucoma can occur even when intraocular pressure is normal, which sometimes makes it harder to diagnose.
Onakoya emphasised that beyond IOP, additional care should be taken for comorbid conditions such as diabetes and hypertension.
The professor defined glaucoma as a complex multifactorial, progressive, optic nerve disease typified by retinal ganglion cell (RGC) death, thinning of the retinal nerve fibre layer (RNFL) and cupping (excavation) of the optic nerve head with characteristic visual field defect.
Onakoya noted that elevated IOP was the only known modifiable risk factor, noting that recently, glaucoma has been described as a brain disease.
“As a disease, glaucoma is not well understood. It is still fraught with controversies; the cause is still unknown, the cure is elusive, and it progresses despite intervention.
“It remains a devastating affliction of our time,” she said.
According to her, glaucoma is the most common cause of irreversible blindness in Nigeria and worldwide.
“Africans with glaucoma have been projected to rise from 10.3 million people in 2020 to 19.2 million by 2040.
“The dramatic increase is because of increased life expectancy and an aging population. This underscores the need for improvements in early case detection and improved glaucoma care services,” she said.
Onakoya noted that she and other scientists conducted a study on the anti-inflammatory and antioxidant properties of garcinia kolanut (GK), to find out the bioavailability and bioactive compounds in comparison to anti-glaucoma medications.
She described garcinia kolanut as a dimeric flavonoid. Flavonoids are a large family of polyphenolic plant compounds found naturally in fruits and vegetables.
“Undoubtedly, GK possesses anti-inflammatory, antioxidant, free radical scavenging, and neuroprotective properties.
“However, the bioavailability of these natural compound hasn’t been well studied.
“Different approaches should be adopted in clinical trials not to compromise the bioavailability and absorption.
“Decisively, more research work is needed to resolve and investigate the therapeutic applications such as administration format, dosing, and concentration,” she said.
She appealed to funding agencies to facilitate research on GK, saying it plays a versatile role in health and wellness.
“Glaucoma in Africans progresses despite adequate control of lOP and with a possible endothelial dysfunction, could GK be the answer to these factors beyond IOP?
“This question can only be answered through a properly designed clinical trial,” she said.
Onakoya underscored the need for collaboration in glaucoma research with neuroscientists and cardiologists based on the current association of glaucoma with other neurodegenerative diseases such as alzheimers and parkinsons.
She affirmed that these would give the long sought answer to protecting and preserving the optic nerves to prevent a lifetime of blindness.
On her part, Prof. Folashade Ogunsola, Vice-Chancellor, UNILAG, said that the lecture underscored the importance of public awareness, early detection and screening for glaucoma.
