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Editors Selection IGR 16-4

Miscellaneous: Can Mindfulness-based stress reduction improve ONH perfusion?

Comment by Tony Realini on:

96001 Beneficial effect of mindfulness based stress reduction on optic disc perfusion in primary open angle glaucoma: A randomized controlled trial, Dada T; Lahri B; Mahalingam K et al., Journal of traditional and complementary medicine, 2021; 11: 581-586

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Dada and colleagues have reported the results of a randomized clinical trial of mindfulness- based stress reduction (MBSR) as adjunctive therapy to medications for the treatment of primary open-angle glaucoma. Recognizing that psychological stress is detrimental to glaucoma through multiple mechanisms, the research team randomized half of a total of 60 patients to attend a 6-week course of MBSR guided by a certified instructor for 45 minutes daily in the morning. Outcomes included intraocular pressure (IOP) and optic disc perfusion measured by OCT angiography. After 6 weeks, the MBSR group demonstrated significantly increased circumpapillary vascular perfusion in all 4 quadrants, significantly increased circumpapillary vessel diameter in the superior and nasal quadrants, and significantly reduced IOP. Heart rate and both systolic and diastolic blood pressure were also significantly reduced in the intervention group. As eye care providers, we are unavoidably siloed from most of our healthcare colleagues by the very specialized nature of the eye and its care. The eye, however, is not at all siloed and shares innumerable complex relationships with the various systems of human physiology. Characterizing the mechanism(s) of this intriguing result may reveal novel therapeutic targets for glaucoma care. In the meantime, when our patients ask, "What else can I be doing to take care of my glaucoma?" this may among the limited options we can discuss with them and has the added benefit of improving systemic health.

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