An innovative approach to glaucoma
treatment is electrical stimulation of the retina and optic nerve.
In a study by Gall, transcutaneous
electrical stimulation was applied through supra- and infra-orbital electrodes
to the eyes of 82 patients diagnosed with optic neuropathies. The treated group
had a significant improvement in visual field of 24% compared to baseline. This
improvement persisted for at least 2 months. [1]
Another study by Ota involved five eyes of
four patients suffering from POAG, who underwent transcorneal electrical
stimulation. There was a significant linear relationship between changes in MD
values and the number of electrical stimulation sessions, indicating partially
restored visual fields (p < 0.01). [2]
However, a study by Rock in which
transcorneal electrical stimulation was done the results were equivocal. Patients
were randomized into three groups with no stimulation (sham), and electrical
stimulation intensities below (subthreshold) or above (suprathreshold)
individual phosphene thresholds. No statistically significant differences in
visual fields between groups were reported. [3]
A study of optic nerve stimulation (ONS) by
Erb et al involved 101 eyes in 70 patients (31 female, 39 male). The subjects
included primary open-angle glaucoma (POAG, 65), normal tension glaucoma (NTG,
13), angle-closure glaucoma (ACG, 6), pseudoexfoliative glaucoma (PEX, 6),
juvenile glaucoma (4), pigmentary glaucoma (4), glaucoma fere absolutum (2),
and congenital glaucoma (1). [4]
The ONS treatment was conducted using the
Eyetronic® device (Neuromodtronic GmbH, Potsdam, Germany) that applied
electrical stimulation via goggles with embedded supraorbital and infraorbital
electrodes and recorded EEG signals via an electrode cap.
The study revealed a significant change of
MD by − 0.5 dB/year on average in visual field testing. MD significantly
decreased from PRE 14.0 dB (median) to POST 13.4 dB (p < 0.01). 64 eyes in
49 patients showed constant or reduced MD as compared to baseline (PRE 13.4 dB
vs. POST 11.2 dB). In 37 eyes of 30 patients, MD increased from PRE 14.9 dB to
POST 15.6 dB.
Median MD at baseline before ONS treatment
was 14 dB, more than 58% of eyes had an advanced vision loss with an MD > 12
dB, more than 80% of eyes were classified as moderate or advanced glaucoma,
corresponding to an MD ≥ 6 dB.
The Eyetronic therapy involves the application
of gentle electrical pulses, which stimulate the metabolism of neurons, restoring
their function and stopping further cellular degeneration.
The therapy involves 10 sessions of 60
minutes each, applied over 10 consecutive days.
WEBSITE: https://eyetronic-therapie.de/en/
REFERENCES:
- Gall C, Schmidt S, Schittkowski MP, Antal A, Ambrus GG, Paulus W, et al. Alternating current Stimulation for vision restoration after optic nerve damage: a randomized clinical trial. PLoS One. 2016;11(6):e0156134.
- Ota Y, Ozeki N, Yuki K, Shiba D, Kimura I, Tsunoda K, et al. The efficacy of Transcorneal electrical Stimulation for the treatment of primary open angle Glaucoma: a pilot study. Keio J Med. 2018;67(3):45–53.
- Rock T, Naycheva L, Willmann G, Wilhelm B, Peters T, Zrenner E, et al. Transcorneal electrical stimulation in primary open angle glaucoma. Ophthalmologe. 2017;114(10):922–9.
- Erb C, Eckert S, Gindorf P, Köhler M, Köhler T, Neuhann L, Neuhann T, Salzmann N, Schmickler S, Ellrich J. Electrical neurostimulation in glaucoma with progressive vision loss. Bioelectron Med. 2022 Mar 31;8(1):6. doi: 10.1186/s42234-022-00089-9. PMID: 35361287; PMCID: PMC8969331
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