Eyeworld

132 | EYEWORLD | APRIL 2019 G UCOMA RESEARCH HIGHLIGHT by Vanessa Caceres EyeWorld Contributing Writer On the consumer level, CBD users are reporting that they have found relief from sleep problems, inflammation, and stress and anxiety, according to Brenda Green, MEd. There are also many who purchase CBD oil for pet anxiety or inflammation, she added. Some parents are trying CBD for attention deficit disorder in their children. The use of CBD is most effective as a tinc- ture (placed under the tongue) or vaped, although some consumers dislike the idea of using a vape, Ms. Green said. Jordan Tishler, MD, cautions that research on CBD dosing has shown that you can- not vape enough to get an effective treatment. Cannabidiol has few side effects. Some studies have noted fatigue, diarrhea, and change in appetite, but these are considered rare, Ms. Morrison said. For the eyes Ophthalmologists may wonder how all this comes back to eye health. Because marijuana has had a long-time association with glaucoma (even if sci- entific evidence does not back it), medical profes- sionals and patients tend to ponder whether CBD also can improve eye health, be it for glaucoma or other ocular issues. The bottom line: The evidence is mixed, and it's likely too early for a clear answer. A 2016 Canadian study of CB1 and CB2 receptors in monkeys concluded that manipulat- ing the endocannabinoid system may help restore normal vision and protect the retina. 2 "In practice, cannabinoids help regulate the arterial tone within blood vessels in the central nervous system. This has led researchers to study the effect of cannabis on retina ischemia and ret- inopathy in general," Ms. Morrison said. "Clinical trials indicate that cannabinoid receptor antago- nists may inhibit cellular degeneration caused by the release of lactate dehydrogenase induced by retinal ischemia." A U.K. study that reviewed research on cannabinoids and glaucoma reported that because CBD has antioxidant properties not mediated by the CB1 receptor, it could prevent neuronal M any ophthalmologists have fielded questions about marijuana use and eye health, particularly if they are in a state where medical marijuana is legal. Now, expect to get questions about a specific component of cannabis that's growing in popularity. Cannabidiol, or CBD, is a chemical found in the cannabis plant. It does not make users "high," and it has been used by many as an oil or infused into food, skin creams, and even gummies. Under the 2018 Agriculture Act, hemp and CBD were made legal in all 50 states, although some in the medical field say there still is con- fusion over the specifics. Nonetheless, this has helped to set off a brigade of products and companies touting the health benefits of CBD. "This recent legislature significantly lightened the restrictions in industrial hemp, paving the way for CBD," said Samantha Morrison. Outside of the world of eyes, some research- ers and patients have found some specific benefits for CBD. "Researchers have found that CBD has proven anti-inflammatory, antioxidant, anti-aging, and neuroprotective properties," Ms. Morrison said. "As a result, more and more people are turn- ing to the organic compound for treating a wide variety of ailments, including inflammation, anxi- ety, pain, nausea, and even neurologic disorders." "CBD and other cannabinoids have nice re- sults in the reduction of anxiety and chronic pain. It is the workhorse of the cannabinoids. CBD is what does the work on reducing muscle spasms, pain, and inflammation," said Mary Clifton, MD, who provides cannabis consultations in New York and through her virtual telemedicine portal. In clinical trials, CBD has been shown to be an effective treatment for epilepsy, according to a report from the World Health Organization. 1 Last year, the U.S. FDA approved Epidiolex (GW Pharmaceuticals), a CBD-based drug designed to treat two rare and severe forms of epilepsy. Other CBD-based drugs are under development, includ- ing Arvisol (Echo Pharmaceuticals), which is in pre-clinical testing for epilepsy and schizophrenia. Patients interested in whether CBD has a role in eye health About the sources Ray Chan, MD Texas Health Arlington Memorial Hospital Arlington, Texas Mary Clifton, MD Internal medicine physician New York Antonio DeRose, NASM CPT Green House Healthy Boulder, Colorado Brenda Green, MEd CBD specialist Sarasota, Florida Samantha Morrison Cannabis researcher Glacier Wellness New York Alex Straiker, PhD Senior research scientist Department of Psychological and Brain Sciences Indiana University Bloomington, Indiana Jordan Tishler, MD President, Association of Cannabis Specialists Harvard Medical School InhaleMD Boston continued on page 134

• Blank Page
• Blank Page (1)