On stage at 100% Optical: Using nutrition to help the vitreous
The vitreous will be in the spotlight at 100% Optical 2022, as researchers from the Nutrition Research Centre Ireland share their recent study findings. OT takes a look
09 February 2022
From clinical decision making, to new materials, and social media; 100% Optical 2022 will see a programme of more than 130 engaging education sessions on topics from across optics. Ahead of the event, OT’s Q&A series highlights the key themes from just a few of the sessions that will take place during the show.
Where: Optical Academy
When: 24 April 3:45 – 4:45pm
Who: Professor John Nolan, director of the Nutrition Research Centre Ireland and principal investigator of the Floater Intervention Study (FLIES), and Dr Emmanuel Ankamah, main researcher of the FLIES trial
What is the Nutrition Research Centre Ireland?We are a multidisciplinary team of scientists specialising in targeted nutrition for human health and human function. We are 20 years old in terms of the research we have been doing. Our centre is internationally known for our contributions to macular pigment research, specifically the use of nutrition (macular carotenoids) for enhancing the health and function of the macula and for supporting patients with age-related macular degeneration (AMD, the words leading cause of blindness).
What is the focus of your session at 100% Optical?
This session will discuss a new approach of using nutrition to optimise the health of the vitreous. The vitreous constitutes about 80% of the human eye and is important for intraocular transparency, intraocular pressure maintenance and for ensuring a hypoxic intraocular environment.
The vitreous is made of about 98% water, and 2% structural macromolecules of collagen and hyaluronan. The regular interaction between collagen fibres and hyaluronan ensures the transparency of the vitreous. With aging and disease, this transparent, jelly structure degenerates largely due to oxidative stress and reduction or depletion of vitreous antioxidants. This degeneration is characterised by a separation of collagen fibres from hyaluronan, which then assemble to form dense (and opaque) collagen aggregates that interfere with light transmission through the vitreous, and results in the entoptic phenomenon, vitreous floaters.
Floaters can be annoying in basic terms, but they can also be an indicator of a potential sight-threatening condition that demands immediate medical attention. This session will highlight the evidence of the impact of floaters on quality of life and visual function of sufferers. The current treatment options for vitreous floaters will then be discussed.
We will provide delegates with a background on what the vitreous is, focussing on its biochemical composition in healthy and diseased states. We will also examine the impact of vitreous degeneration on both the quality of life and visual function of floater sufferers. We will then consider the management options for floaters, focussing on the data of the clinical trial. Ultimately, the delegates at our presentation will learn about the outcomes of our randomised control trial and how targeted nutrition can be employed as a safe management option for floater sufferers.
The research behind the presentation
We have studied the vitreous in terms of understanding its nutrition capacities. Through a careful synthesis of the literature, we have summarised the evidence on the different vitreous antioxidant molecules and their concentrations in healthy and diseased states. We have also shown that oxidative stress, reduced/depleted intravitreal antioxidants, increased proteolytic enzymes, and increased intravitreal glycation account for the mechanisms underpinning vitreous degeneration.
This earlier background has allowed us to hypothesise that if you enrich the vitreous with appropriate nutrients of the vitreous, then you could reduce intravitreal oxidative stress, increase vitreous antioxidant capacity and retard vitreous degeneration. This could potentially help with the health of the vitreous and result in improved quality of life of floater sufferers.
We tested our hypothesis by working with local hospitals and optometrists to recruit patients suffering from vitreous floaters. We then assessed, in a double blind, placebo-control trial, the impact of targeted nutrition for improving the quality of life of these patients. In this trial, not only did we capture the patients’ report of their visual discomfort, but also, we employed an objective imaging modality to capture and quantify the vitreous opacities of the patients.
Why is this topic so important?
This topic is important because about 99% of floater sufferers are only observed (and not treated) by their clinicians. Usually, the ophthalmologist or optometrist will counsel patients to live with their floaters, and this is very unsatisfactory for the patient who has to live with the floaters. The 1% who may be fortunate to get a treatment too may be predisposed to numerous sight-threatening complications following their treatment.
Our topic focuses on the use of safe nutrition to improve the integrity of the vitreous. This is in line with our concepts of health promotion via the prevention of diseases, as opposed to trying to treat diseases or fix structures when they get worse. This topic is built upon peer-reviewed science so there is a rationale and evidence behind all the concepts we will discuss as part of this topic.