Department of Ophthalmology, University of California, San Francisco, California, USA.
Clin Exp Ophthalmol. 2023 May-Jun;51(4):380-394. doi: 10.1111/ceo.14218. Epub 2023 Mar 19.
Current glaucoma management centres on intraocular pressure (IOP) reduction through pharmacological and surgical therapy. Despite broad interest in active management of glaucoma through lifestyle modifications, such recommendations have yet to be incorporated into standards of treatment. In this review, noteworthy preclinical studies and their translations in clinical populations are discussed to evaluate the roles of lifestyle factors in lowering IOP, offering neuroprotection, and/or slowing disease progression in those with open-angle glaucoma. Current literature suggests that aerobic exercise may be associated with neuroprotection and decreased disease progression. Mindfulness is associated with IOP reductions and neuroprotection. Caffeine is associated with mild, transient IOP elevations of uncertain significance. Nicotinamide supplementation is associated with neuroprotection and short-term visual function improvement. This review also highlights knowledge gaps regarding these factors and opportunities to strengthen our understanding of their role in glaucoma, including future preclinical studies that elucidate underlying mechanisms and clinical studies with additional functional endpoints and longer follow-up.
目前，青光眼的治疗主要集中在通过药物和手术治疗降低眼内压（IOP）。尽管人们对通过生活方式改变积极治疗青光眼产生了广泛的兴趣，但这些建议尚未纳入治疗标准。在这篇综述中，讨论了值得注意的临床前研究及其在临床人群中的转化，以评估生活方式因素在降低开角型青光眼患者的眼压、提供神经保护和/或减缓疾病进展中的作用。目前的文献表明，有氧运动可能与神经保护和疾病进展减缓有关。正念与眼压降低和神经保护有关。咖啡因与轻度、短暂但意义不明的眼压升高有关。烟酰胺补充剂与神经保护和短期视力功能改善有关。本综述还强调了这些因素的知识空白，并提供了机会来加强我们对它们在青光眼发病机制中的作用的理解，包括未来的临床前研究，以阐明潜在的机制，以及具有额外功能终点和更长随访时间的临床研究。
