by Toshi Kamiya, Ph.D.
| Citicoline May Aid in the Fight Against Glaucoma |
About 20 years ago a San Francisco
auto dealer took a snazzy new
convertible for a test drive along
Fisherman’s Wharf as part of a
television commercial.
In 1983 a 24-foot sailboat traveled a perilous
2,500 miles in 23 days from Honolulu to
San Francisco with this same auto dealer at
the helm.
In both cases there was something truly
remarkable about the man who participated
in these events. Hank Dekker was blind. He
agreed to test drive the car at the urging of his
advertising agency and he had taken up
sailing only after losing his eyesight 10 years
earlier. Dekker lost his vision to glaucoma
when he was just 37.
Glaucoma, primarily associated with
aging, is estimated to have affected more than
two million people in the United States.
About a quarter of the population with glaucoma
are not even aware they have the disease.
Glaucoma is an insidious disease, taking
its victims slowly and silently, damaging their
eyes before they notice any symptoms.
Glaucoma can usually be detected in time
with regular eye examinations. In rare cases,
glaucoma strikes quickly with acute pain,
aggressively destroying vision within a few
days if treatment is not received within 48 to
72 hours.
Glaucoma is a disease characterized by an
increase in fluid pressure in the eyeball that
occurs when the inflow is not adequately balanced
by the outflow. This defect is caused by
the deterioration in the composition of collagen,
the most common protein in the body
and the eye. Collagen provides the supportive
structure for the component parts of the eye.
As the fluid pressure builds to abnormal
levels, it damages the optic disk. This small,
circular, visually insensitive region in the retina
is where the fibers of the optic nerve emerge.
Damage to this vital spot causes visual defects,
notably a progressive loss of peripheral vision,
which leads to tunnel vision. Eventually, if
detected too late, glaucoma destroys vision
completely and permanently.
It is rare that people under 40 contract
glaucoma. However, glaucoma can be linked
to nutritional deficiencies, including a lack of
vitamin C in the retina and optic nerve and to
excessive toxins and metabolic wastes in the
body. While vitamin C plays a central role in
ocular health because it is vital for the continuous
synthesis of collagen, it is easily
destroyed and must constantly be replenished.
The up and coming C for eye health
may be citicoline, which is commonly used as
an agent to improve loss of consciousness due
to head trauma and brain surgery.
Studies show citicoline is beneficial in the
treatment of glaucoma. Glaucoma is considered
a neurodegenerative disease in which
retinal ganglion cells slowly die.
Clinical trials have also found citicoline is
a well-tolerated ingredient used in the pharmacotherapy
of brain function insufficiency
and other neurological disorders such as
stroke, brain trauma, Alzheimer’s and
Parkinson’s disease.
A double-blind, placebo-controlled study
published in the Journal of Neuroscience
Research found citicoline treatment resulted
in functional improvement in patient vision.
Other reports indicate citicoline treatment
may be beneficial in glaucoma. Citicoline is a
natural precursor of cellular synthesis of
phospholipids, mainly phosphatidylcholine.
Enhancement of phospholipid synthesis may
counteract neuron inefficiency and provide
neuroprotection. Citicoline, when administered,
undergoes a quick transformation to
cytidine and choline, which crosses the blood
brain barrier and enters brain cells separately
to provide neuroprotection by enhancing
phospholipid synthesis. A similar effect is
expected to occur in glaucomatous retinal
ganglion cells.
Furthermore, citicoline stimulates some
brain neurotransmitter systems, including the
system than contains dopamine. Dopamine is
known as a major neurotransmitter in retina
and post retinal visual pathways.
In 1998, at the University of Rome, a
research group led by Vincenzo Parisi, M.D.,
evaluated the effects of citicoline on patients
with glaucoma.
This 12-month study sought to confirm
previous findings by using more sophisticated
methods for evaluating visual functions. Forty
patients at simple, primary and chronic stages
of glaucoma took part in the study.
The group using 1000 mg of citicoline
daily showed marked improvements in visual
function during the treatment periods.
Furthermore, no adverse side effects were
reported with citicoline. Researchers concluded
their results indicated a potential use
for citicoline in medical treatment of glaucoma
as a complement to hypotensive
therapy.
Additional vision research using citicoline
was conducted at the University of Bologna,
Italy with adults who had amblyopia.
Amblyopia is a dimness of sight without an
apparent change in the eye structure. It has
been known to be associated with toxic
effects or dietary deficiencies in the body.
The study aimed to establish whether
visual acuity, contrast sensitivity and visually
evoked potentials changed after citicoline
treatment. All study subjects taking citicoline
showed improved vision in both eyes to different
extents in all test categories.
Citicoline is a revolutionary alternative to
phosphatidylcholine, according to Yutaka
Ouchi, Kyowa Hakko U.S.A., Inc., based in
New York. Citicoline has been used extensively
for the treatment of neurodegenerative
disorders associated with stroke, cerebrovascular
pathology, brain aging, stroke and head
trauma. Numerous citicoline scientific
studies have indicated effectiveness in
treating Alzheimer’s and Parkinson’s disease
and improved stroke recuperation, as well as
glaucoma.
Research indicates citicoline has a targeted
action for increasing brain phospholipid
synthesis. Citicoline is absorbed as a
form of its hydrolyzed products, uridine and
choline within the brain; neuron cells convert
uridine into cytidine, which reacts with
choline to produce citicoline. Citicoline then
moves into the metabolic pathway of phosphatidylcholine
production in the brain.
Citicoline, when taken orally, crosses the
blood-brain barrier and is incorporated into
brain membrane lipids. Citicoline has been
the subject of studies worldwide over the past
two decades. In addition to neurological disorders,
studies have also focused on cognitive
function benefits.
It’s easy to envision a whole new world
would open up for those like Hank Dekker
with proper medical evaluation and new citicoline
treatment options.
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