Shamabadi Ahmad, Asadigandomani Hassan, Kazemzadeh Kimia, Farahmand Kimia, Arabzadeh Bahri Razman, Akhondzadeh Shahin
Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran.
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Med Hypothesis Discov Innov Ophthalmol. 2024 Oct 14;13(3):139-150. doi: 10.51329/mehdiophthal1505. eCollection 2024 Fall.
Age-related macular degeneration (ARMD) leads to impaired vision and potential blindness. Globally, it accounts for approximately 9% of vision loss cases, and a projected 288 million individuals will be affected by 2040. Current treatments have limitations such as variable effectiveness, high costs, and potential side effects. Additionally, atrophic ARMD management remains challenging. As saffron has shown promising neuroprotective and antioxidant effects by potentially delaying disease progression, this study aims to review the mechanistic, pre-clinical, and clinical evidence of the effects, safety, and tolerability of saffron in ARMD treatment.
The Scale for the Assessment of Narrative Review Articles was applied in this narrative review. To find relevant literature, the syntax "(saffron OR crocus) AND (retin* OR "geographic atrophy" OR "choroidal neovascular*" OR "macular degeneration")" was searched in PubMed/MEDLINE. Pre-clinical and clinical original investigations of the effects of saffron in ARMD along with the eligible studies cited in their reference lists were identified and included.
Saffron and its active compounds, crocin and crocetin, have shown promising results in improving visual function and delaying ARMD progression. Several clinical studies have found that daily supplementation with 20-50 mg of saffron or 5-15 mg of crocin for 3-12 months significantly improved best-corrected visual acuity, contrast sensitivity, and retinal function as measured by electroretinogram and microperimetry, with benefits observed in both dry and wet forms of ARMD. The effects were independent of genetic risk factors and maintained during the follow-up periods, suggesting the potential role of saffron as a long-term treatment option. Saffron reduces ARMD progression via anti-angiogenic, neuroprotective, and antioxidant mechanisms. Moreover, saffron is safe and well tolerated.
Although further research is needed to confirm long-term safety and efficacy, current evidence supports the use of saffron or crocin supplements as a safe and tolerable adjunct therapy for ARMD management.
年龄相关性黄斑变性（ARMD）会导致视力受损甚至失明。在全球范围内，它约占视力丧失病例的9%，预计到2040年将有2.88亿人受到影响。目前的治疗方法存在局限性，如疗效不一、成本高昂以及潜在的副作用。此外，萎缩性ARMD的管理仍然具有挑战性。由于藏红花已显示出通过潜在地延缓疾病进展而具有有前景的神经保护和抗氧化作用，本研究旨在综述藏红花在ARMD治疗中的作用机制、临床前和临床证据、安全性及耐受性。
本叙述性综述采用了叙述性综述文章评估量表。为了查找相关文献，在PubMed/MEDLINE中搜索了语法“（藏红花或番红花）AND（视网膜或“地图样萎缩”或“脉络膜新生血管”或“黄斑变性”）”。确定并纳入了藏红花对ARMD影响的临床前和临床原始研究以及其参考文献列表中引用的符合条件的研究。
藏红花及其活性成分藏红花素和藏红花酸在改善视觉功能和延缓ARMD进展方面显示出有前景的结果。多项临床研究发现，每天补充20 - 50毫克藏红花或5 - 15毫克藏红花素，持续3 - 12个月，可显著改善最佳矫正视力、对比敏感度以及通过视网膜电图和微视野检查测量的视网膜功能，在干性和湿性ARMD中均观察到有益效果。这些效果与遗传风险因素无关，且在随访期间得以维持，表明藏红花作为长期治疗选择的潜在作用。藏红花通过抗血管生成、神经保护和抗氧化机制减少ARMD进展。此外，藏红花安全且耐受性良好。
尽管需要进一步研究来证实长期安全性和有效性，但目前的证据支持使用藏红花或藏红花素补充剂作为ARMD管理的安全且耐受性良好的辅助治疗方法。
