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Neuroprotection: Herbal Treatment for Glaucomatous Optic Neuropathy
A summary of the work by Professor You Qin Jiang, of Changsha, Hunan, China
Erigeron Breviscapus Hand-Mazz (EBHM) is a herb that has often been used by Chinese people over the centuries: it possesses the ability to inhibit blood coagulation, enhance the microcirculation, and dilate brain blood vessels, as is evidenced by its clinical application in the treatment of brain thrombosis and associated paralysis, myocardial ischemia and coronary arteriosclerosis.
Experience with EBHM in glaucoma is based on two clinical trials which took place in the early 1990s, and on several laboratory studies.
In the clinical trials, glaucoma patients with controlled IOP after trabeculectomy were divided into an EBHM group and a placebo group. After six months of treatment, the EBHM group did better than the placebo group, as measured by object V/4/e of the Goldmann Perimeter in the Esterman grid.
A similar study was performed using the Oculus Automated Perimeter. Again,
the visual fields improved significantly in the treatment group (mean sensitivity
+1.42 dB versus -0.95 dB in the placebo group after six months). The herb
had no side-effects.
In rats with induced OHT, EBHM was injected intramuscularly one week prior
to, and three weeks post-, OHT. The treated group did significantly better
using the cytochrome oxidase technique for RGC survival. Positive results
were also reported in axoplamic flow studies and after partial optic nerve
crush injuries. Finally, EBHM was shown to have a partial neuroprotective
effect on NMDA-induced neuronal (retinal ganglion cell layer) loss in rats.
Professor Jiang concluded that EBHM seems to have a neuroprotective effect in glaucoma. Studies of longer duration are needed in order to demonstrate a more pertinent effect of EBHM in human glaucoma. The molecular mechanism of the drug also needs further investigation.
References
- Jiang Y, Liu X. New concepts in glaucoma therapy: neuroprotection. In: Yuan J, Lim ASM (eds) The Frontier of Ophthalmology in the 21st Century, pp 541-554. Tianjin Science and Technology Press 2001
- Li Jun Jia, You Qin Jiang, Zhen Zhong Wu. Erigeron Breviscapus (vant) Hand-mazz to treat the patients with intraocular pressure controlled late stage glaucoma. Journal of Chinese Practical Ophthalmology 1994; 12: 269-273
- Chang Hua Ye, You Qin Jiang. A clinical study of the neuroprotection effect of Erigeron Breviscapus (vant) Hand-mazz on glaucoma patients. Chinese Ophthalmic Research, submitted by Chinese Ophthalmic Research
- Li Jun Jia, Zhong Hao Liu, You Qin Jiang. The effect of EBHM on the metabolism of retinal ganglion cells of rats after artificial acute high intraocular pressure. Chinese Journal of Ophthalmology 1995; 31: 129-132
- Yi Hua Zhu, You Qin Jiang, Zhong Hao Liu et al. The effect of EBHM on the axoplasmic flow of the optic nerve in rats with experimentally elevated intraocular pressure. Chinese Journal of Ophthalmology 2000; 36: 289-291
- Bing Jiang, You Qin Jiang. The effect of Erigeron Breviscapus (vant) Hand-mazz on retinal ganglion cells after optic nerve crush injury. Submitted to Chinese Journal of Ophthalmology