Cataract future or investigational therapies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief: Joseph Nasr, M.D.[2]
Future or Investigational Therapies
At present, no pharmacologic treatments have been shown to prevent, delay, or reverse cataract formation in humans, and cataract management therefore remains surgical rather than medical.[1] Investigational approaches have focused on mechanisms such as lens protein aggregation and oxidative stress. Compounds such as lanosterol have demonstrated the ability to reduce lens opacity in animal models and in vitro studies, but these findings have not translated into proven clinical efficacy in humans, and such agents are not part of standard care.[2]
Although statins are known for their ability to lower lipids, they are also believed to have antioxidant qualities. Oxidative stress is thought to play a role in the development of nuclear cataracts, the most common type of age-related cataract. To explore the relationship between nuclear cataracts and statin use, a group of researchers studied 1,299 patients at risk of developing nuclear cataracts, some of whom were treated with statins. Their results suggest that statin use in a general population may be associated with a lower risk of developing nuclear cataract disease[3].
Research evaluating nutritional interventions is limited and mixed but weakly positive for the carotenoids lutein and zeaxanthin.[4][5][6][7] Bilberry extract has demonstrated potential benefit in animal models [8][9] and in limited clinical studies.[10]
Accordingly, current advances in cataract care are focused primarily on refinements in surgical techniques, intraocular lens technology, and perioperative management, rather than on medical therapies aimed at reversing lens opacification.[11]
References
- ↑ Liu YC, Wilkins M, Kim T, Malyugin B, Mehta JS. Cataracts. Lancet. 2017;390(10094):600-612. doi:10.1016/S0140-6736(17)30544-5
- ↑ Zhao L, Chen XJ, Zhu J, et al. Lanosterol reverses protein aggregation in cataracts. Nature. 2015;523(7562):607-611. doi:10.1038/nature14650
- ↑ Klein, Barbara. "Statin Use and Incident Nuclear Cataract". Journal of the American Medical Association. 295 (23): 2752–2758. Unknown parameter
|coauthors=ignored (help) - ↑ Nutrition. 2003 Jan;19(1):21 Lutein, but not alpha-tocopherol, supplementation improves visual function in patients with age-related cataracts: a 2-y double-blind, placebo-controlled pilot study
- ↑ Invest Ophthalmol Vis Sci. 2006 Sep;47(9):3783-6. Lutein and zeaxanthin and the risk of cataract: the Melbourne visual impairment project
- ↑ Invest Ophthalmol Vis Sci. 2006 Jun;47(6):2329-35. Plasma lutein and zeaxanthin and other carotenoids as modifiable risk factors for age-related maculopathy and cataract: the POLA Study
- ↑ J Am Coll Nutr. 2004 Dec;23(6 Suppl):567S-587S Lutein and zeaxanthin and their potential roles in disease prevention
- ↑ Dietary supplementation with bilberry extract prevents macular degeneration and cataracts in senesce-accelerated OXYS rats Adv Gerontol. 2005;16:76-9
- ↑ Yamakoshi J, et al. J Agric Food Chem. 2002 Aug 14;50(17):4983-8.
- ↑ Ann Ottalmol Clin Ocul, 1989
- ↑ Miller KM, Oetting TA, Tweeten JP, et al; American Academy of Ophthalmology Preferred Practice Pattern Cataract/Anterior Segment Panel. Cataract in the adult eye preferred practice pattern. Ophthalmology. 2022;129(1):1-P126. doi:10.1016/j. ophtha.2021.10.006