Glaucoma, Open-Angle Clinical Trial
Official title:
The Effect of Ginkgo Biloba on Ocular Blood Flow in Primary Open-Angle Glaucoma Patients: A Double-Blind Randomized Crossover Trial
Glaucoma is one of the leading causes of blindness. Ginkgo biloba may be part of an effective treatment strategy for glaucoma because it has been shown to improve blood flow, it has antioxidant properties, it can relax smooth muscle, and it can protect neurons from damage. The goal of our study was to determine whether Ginkgo biloba would result in increased ocular blood flow which may protect against glaucoma damage.
Glaucoma is one of the leading causes of blindness. Glaucoma progression sometimes occurs
despite apparent control of intraocular pressure. Therefore, there may be other factors
involved in glaucoma progression in some patients. Evidence is mounting that glaucoma
patients are more likely to have abnormal ocular blood flow and vasospasm compared to those
without glaucoma. Also, a study showed that those with progressive glaucoma had decreased
blood flow compared to those with stable glaucoma or healthy controls. Endothelin-1, a
potent vasoconstrictor, may be involved in these blood flow abnormalities. If the
dysregulation of blood flow is causally related to the progression of glaucoma, then
therapies aimed at improving the regulation of blood flow may help to prevent this
progression.
Ginkgo may be part of an effective treatment strategy for glaucoma because it has been shown
to improve peripheral and cerebral blood flow. Other properties of Ginkgo that may aid in
the treatment of glaucoma include antioxidant properties, inhibition of platelet activating
factor, relaxation of smooth muscle, and neuroprotective properties. Ginkgo may be
particularly useful in relaxing vasospasm. Two controlled trials have examined the effect of
Ginkgo on ocular blood flow in healthy subjects. One randomized crossover trial found that 2
days of Ginkgo increased the end diastolic velocity in the ophthalmic artery compared to
placebo. However, another trial found that 1 dose of Ginkgo had no significant effects on
ocular blood flow parameters. In people with normal tension glaucoma, Park et al found that
4 weeks of Ginkgo increased peripapillary retinal blood flow. Two randomized controlled
trials have examined the impact of Ginkgo biloba on visual field in people with normal
tension glaucoma with conflicting results. Clearly, there is a need for more research on
this topic.
The goal of our study was to determine whether Ginkgo biloba would result in increased
ocular blood flow, reduced vasospasm, and reduced endothelin-1 levels.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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