Eyeworld

93 EW GLAUCOMA March 2018 Nutrition Examination Survey, looking at exercise intensity among the population as measured by a pedometer as well as self-reported. In this study, 3.1% of the weighted population had glaucoma. The most physically active in the study were 73% less likely to have glaucoma compared to those who were the least active. In addition to time spent exer- cising per week, intensity mattered. "You can do it walking, it's just you need to walk at a faster clip," Dr. Coleman said. "That becomes important because with diseases like glaucoma and cataracts, we start losing our vision and our depth per- ception, so patients get more fearful of falling and slow down their pace. It becomes like a catch-22 for patients. Keeping up one's pace is important for heart health and the whole aging process. … Maybe get on a stationary bike if that's going to help you keep up your pace." Overall, Dr. Coleman thinks patients are more open to lifestyle changes they could be making. "They want to know 'What can I do?' and that's why we've been looking into these different poten- tial behavioral modifications," Dr. Coleman said. "Patients are much more involved, and if there is a be- havioral modification that they can do, we want them to do it." In terms of future studies to potentially establish a more defini- tive link between exercise or hot tea drinking, for example, and reduced risk for glaucoma, Dr. Coleman said that becomes difficult because "you can't randomize people to lifestyle behaviors." EW References 1. Wu CM, et al. Frequency of a diagnosis of glaucoma in individuals who consume coffee, tea and/or soft drinks. Br J Ophthalmol. 2017 Dec 14. Epub ahead of print. 2. Tseng VL, et al. Exercise intensity and risk of glaucoma in the National Health and Nutrition Examination Survey. Poster at the 2017 American Academy of Ophthalmology annual meeting. Editors' note: Dr. Coleman has no financial interests related to her comments. Contact information Coleman: coleman@jsei.ucla.edu About 5% of the survey partic- ipants had glaucoma. While there was no statistically significant associ- ation between drinking caffeinated or decaffeinated coffee, iced tea, decaffeinated hot tea, or soda and glaucoma risk, the study authors ob- served that those who drank at least one daily cup of hot tea were 74% less likely to have glaucoma. "This is an association, it's not a causation," Dr. Coleman reminded. What could be driving it? "Prior studies have noted an oxidative and neurodegenerative aetiology in the pathogenesis of glaucoma, suggesting that antioxi- dants may play a protective role in glaucoma," Wu et al. wrote in the study. "Additionally, flavonoids have been shown to inhibit the vascular endothelial growth factor receptor, and potentially prevent neovascular glaucoma, fibrotic scar tissue for- mation after glaucoma surgery and neurodegeneration." Why was this effect seen in caffeinated tea but not caffeinated coffee or iced tea? Dr. Coleman speculated this could be because the antioxidants and other compounds in coffee are different than that of tea, and the caffeine level in coffee is higher. As for iced tea, Dr. Coleman said it could be the study's sample size was too small or that people could be drinking bottled iced tea, not homebrewed, which could carry preservatives or something else counteracting a benefit. "But it's hard to know until we get more information," Dr. Coleman said. While it's not definitive that the act of drinking a hot cup of caffein- ated tea daily will reduce one's risk for glaucoma, Dr. Coleman said, doing so can't hurt. "If someone is drinking hot tea, they should keep on drinking it. Whether coffee drinkers should switch to hot tea, coffee has benefits in other diseases, but it might be they want to consider having a cup of tea as well," Dr. Coleman said. Another study 2 that was present- ed as a poster at the 2017 American Academy of Ophthalmology annual meeting from Dr. Coleman's team looked at exercise and its association with glaucoma risk. Lead researcher Victoria Tseng, MD, and her fellow investigators also used the National Health and A F R E S H P E R S P E C T I V E ™ © 2018 Lacrivera, a division of Stephens Instruments. All rights reserved. lacrivera.com ( 855 ) 857-0518 2500 Sandersville Rd ■ Lexington KY 40511 USA Visit us at ASCRS booth #2209 This is a solution to the discomfort of dry eye. The VeraPlug ™ FlexFit ™ is simple to size and insert, comfortable for your patients, and comes with the confi dence of our industry leading 45 day retention pledge. a plug. This is This is NOT This is a solution to the discomfort of dry eye. The VeraPlug ™ FlexFit ™ a plug. a plug NOT VeraPlug™ FlexFit ™

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