Glucose-induced temporary visual recovery in primary open-angle glaucoma: a double-blind, randomized study.
OBJECTIVE
To investigate the effect of topical glucose on visual parameters in individuals with primary open-angle glaucoma (POAG).


METHODS
Double-blind, randomized, crossover study.


METHODS
Nondiabetic pseudophakic patients with definite POAG were recruited; 29 eyes of 16 individuals participated in study 1. A follow-up study (study 2) included 14 eyes of 7 individuals.


METHODS
Eyes were randomly allocated to receive 50% glucose or saline eye drops every 5 minutes for 60 minutes.


METHODS
The contrast sensitivity and best-corrected logarithm of the minimum angle of resolution (logMAR).


RESULTS
The 50% glucose reached the vitreous in pseudophakic but not phakic individuals. Glucose significantly improved the mean contrast sensitivity at 12 cycles/degree compared with 0.9% saline by 0.26 log units (95% confidence interval [CI], 0.13-0.38; P < 0.001) and 0.40 log units (95% CI, 0.17-0.60; P < 0.001) in the follow-up study. The intraocular pressure, refraction, and central corneal thickness were not affected by glucose; age was not a significant predictor of the response.


CONCLUSIONS
Topical glucose temporarily improves psychophysical visual parameters in some individuals with POAG, suggesting that neuronal energy substrate delivery to the vitreous reservoir may recover function of "sick" retinal neurons.
South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, South Australia. Electronic address: robert.casson@adelaide.edu.au.
Robert J
RJ
Casson
South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, South Australia.
Guoge
G
Han
South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, South Australia.
Andreas
A
Ebneter
South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, South Australia.
Glyn
G
Chidlow
South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, South Australia.
Jagjit
J
Glihotra
South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, South Australia.
Henry
H
Newland
South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, South Australia.
John P M
JP
Wood
D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D015350:Contrast Sensitivity / Q000502:physiology*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology; D005947:Glucose / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D009883:Ophthalmic Solutions; D009994:Osmolar Concentration; D020127:Recovery of Function / Q000502:physiology; D012965:Sodium Chloride; D013549:Sweetening Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D014792:Visual Acuity / Q000502:physiology*; D014822:Vitreous Body / Q000378:metabolism
D009883:Ophthalmic Solutions; D013549:Sweetening Agents; D012965:Sodium Chloride; D005947:Glucose