Journal List > J Korean Ophthalmol Soc > v.54(8) > 1009456

Kil, Song, and Chun: The Efficacy of Vaccinium Uliginosum for Early Age-Related Macula Degeneration

Abstract

Purpose

To evaluate the effect of Bog Bilberry (Vaccinium uliginosum) extract in eyes with early age-related macular de-generation (AMD).

Methods

Forty- four eyes of forty four patients with early AMD were included in this randomized, double-blinded, and pla-cebo-controlled study. All participants were randomly assigned to either the placebo group (n = 24), or the bog bilberry ex-tract group (n = 20). Before drug administration, an ophthalmic examination which included slit lamp microscopy, best cor-rected visual acuity, and intraocular pressure was performed, and repeated 1and 3 months after treatment. Objective scat-ter index, glare and tear film break-up time were checked by Optical Quality Analysis System (OQAS, Visiometrics, Spain) and drusen volume, central macular thickness, and RPE and IS/OS junction thickness were investigated with spectral-do-main optical coherence tomography (Spectralis, Heidelberg, Germany).

Results

In the bog bilberry extract group, RPE and IS/OS junction thickness was significantly increased compared to the placebo group after 3 months of drug administration.

Conclusions

Bog Bilberry extract may play a favorable role in preventing the atrophic change of RPE and IS/OS junction layer and the progression of early macular degeneration.

References

1. Friedman DS, O'Colmain BJ, Muñoz B. . Prevalence of age-related macular degeneration in the United States. Arch Ophthalmol. 2004; 122:564–72.
crossref
2. Youn DJ, Oh HS, Yu HG, Song SJ. The prevalence of vitreoretinal disease in a Screened Korean population 50 years and older. J Korean Ophthalmol Soc. 2009; 50:1645–51.
3. Park KH, Song SJ, Lee WK. . The results of nation-wide regis-try of age-related macular degeneration in Korea. J Korean Ophthalmol Soc. 2010; 51:516–23.
4. Kinnunen K, Petrovski G, Moe MC. . Molecular mechanisms of retinal pigment epithelium damage and development of age-re-lated macular degeneration. Acta Ophthalmol. 2012; 90:299–309.
crossref
5. Evans J. Antioxidant supplements to prevent or slow down the pro-gression of AMD: a systematic review and meta-analysis. Eye (Lond). 2008; 22:751–60.
crossref
6. AREDS group. The relationship of dietary carotenoid and vitamin A, E, and C intake with age-related macular degeneration in a case- control study: Report No.22. Arch Ophtalmol. 2007; 125:1225–32.
7. Sin HP, Liu DT, Lam DS. Lifestyle modification, nutritional and vitamins supplements for age-related macular degeneration. Acta Ophthalmol. 2013; 91:6–11.
crossref
8. Määttä-Riihinen KR, Kamal-Eldin A, Mattila PH. . Distribution and contents of phenolic compounds in eighteen Scandinavian berry species. J Agric Food Chem. 2004; 52:4477–86.
crossref
9. Lätti AK, Jaakola L, Riihinen KR, Kainulainen PS. Anthocyanin and flavonol variation in bog bilberries (Vaccinium uliginosum L.) in Finland. J Agric Food Chem. 2010; 58:427–33.
crossref
10. Kim YH, Bang CY, Won EK. . Antioxidant activities of Vaccinium uliginosum L. extract and its active components. J Med Food. 2009; 12:885–92.
11. AREDS group. The Age-Related Eye Disease Study (AREDS): de-sign implications. AREDS report No. 1. Control Clin Trials. 1999; 20:573–600.
12. Kim SH, Park JY, Park TK. . Use of spectral-domain optical coherence tomography to analyze macular thickness according to refractive error. J Korean Ophthlamol Soc. 2011; 52:1286–95.
crossref
13. Schuman SG, Koreishi AF, Farsiu S. . Photoreceptor layer thinning over drusen in eyes with age-related macular degeneration imaged in vivo with spectral domain optical coherence tomography. Ophthalmology. 2009; 116:488–96.e2.
14. Canton VM, Quiroz-Mercado H, Velez-Montoya R.. 16-Gy low-voltage x-ray irradiation with ranibizumab therapy for AMD: 6-month safety and functional outcomes. Ophthalmic Surg Lasers Imaging. 2011; 42:468–73.
crossref
15. Augustin A. Triple therapy for age-related macular degeneration. Retina. 2009; 29:(6 Suppl). S8–11.
crossref
16. Nishimura T, Machida S, Harada T, Kurosaka D. Retinal ganglion cell function after repeated intravitreal injections of ranibizumab in patients with age-related macular degeneration. Clin Ophthlmol. 2012; 6:1073–82.
17. Blodi BA. Nutritional supplements in the prevention of age-related macular degeneration. Insight. 2004; 29:15–6; quiz 17-8.
18. Kowluru RA, Zhong Q. Beyond AREDS: Is there a place for anti-oxidant therapy in the prevention/treatment of eye disease? Invest Ophthlmol Vis Sci. 2011; 52:8665–71.
crossref
19. Congdon N, O'Colmain B, Klaver CC. . Causes and prevalence of visual impairment among adults in the Unites States. Arch Ophthlmol. 2004; 122:477–85.
20. Age-Related Eye Disease Study Research Group . Risk factors as-sociated with age-related macular degeneration. A case-control study in the age-related eye disease study: age-related eye disease study Report Number 3. Ophthalmology. 2000; 107:2224–32.
21. Zeng S, Hernández J, Mullins RF. Effects of antioxidant compo-nents of AREDS vitamins and zinc ions on endothelial cell activation: implications for macular degeneration. Invest Ophthalmol Vis Sci. 2012; 53:1041–7.
crossref
22. Park KH, Song SJ, Lee WK. . The results of nation-wide regis-try of age-related macular degeneration in Korea. J Korean Ophthalmol Soc. 2010; 51:516–23.
23. Christensen UC, Kroyer K, Thomasdsen J, el al. Normative data of outer photoreceptor layer thickness obtained by software image en-hancing based on Stratus optical coherence tomography images. Br J Ophthalmol. 2008; 92:800–5.
crossref
24. Chan A, Duker JS, Ishikawa H. . Quantification of photo-receptor layer thickness in normal eyes using optical coherence tomography. Retina. 2006; 26:655–60.
crossref
25. Jackson GR, Owsley C, Curcion CA. Photoreceptor degeneration and dysfunction in aging and age-related maculopathy. Ageing Res Rev. 2002; 1:381–96.
crossref
26. Kanai K, Abe T, Murayama K, Yoneya S. Retinal thickness and changes with age. Nihon Ganka Gakkai Zasshi. 2002; 106:162–5.
crossref
27. Kang JH, Kim SA, Song UG, Yoon HS. Macular thickness changes with age in normal subjects measured by optical coherence tomography. J Korean Ophthalmol Soc. 2004; 45:592–8.
28. Kang MS, Kyung SE, Chang MH. Mean macular volume in normal Korean eyes measured by spectral-domain optical coherence tomography. J Korean Ophthalmol Soc. 2010; 51:1077–83.
crossref

Figure 1.
The Photographs of bog bilberries (Vaccinium uliginosum).
jkos-54-1255f1.tif
Figure 2.
Retinal thickness between RPE and IS/OS junction was measured at the fovea. RPE and IS/OS thickness (red line) and fo-veal thicknss (yellow line).
jkos-54-1255f2.tif
Table 1.
Demographic data
Bog bilberries extract group Placebo group Total
Sex (F:M) 13 (59%):10 (41%) 7 (37%):14 (63%) 44
Age (years) 66.27 ± 7.79 67.37 ± 6.06 66.82 ± 69.25
Diabetes mellitus 10 (45%) 6 (32%) 16
Hypertension 12 (55%) 10 (53%) 22

Values are presented as mean ± SD.

Table 2.
Survey questions of subjective symptoms
Number Questions 0 1 2 3 4
1 Have a feeling of eyeball fatigue
2 Have eyeball pain
3 Have dim eyes
4 Have a discomfort due to tearing
5 Have red eyes
6 Have a distorted vision
7 Have a difficulty in reading on books or smart phones
8 Have a difficulty to go out at night
9 Have a joint pain in waist, shoulders, or knees
10 Have a heavy feeling in the head
Table 3.
Analysis of the rate of change in study group and control group
4 weeks 12 weeks
Bog bilberries Placebo p Bog bilberries Placebo p
VA -0.94 ± 12.40 38.74 ± 160.33 0.296 1.38 ± 15.90 62.08 ± 300.77 0.3912
VAo 2.04 ± 14.23 -4.25 ±1 6.13 0.1969 -0.15 ± 29.89 0.86 ± 17.83 0.8949
OSI 5.80 ± 26.30 27.96 ± 50.45 0.0967 30.07 ± 55.15 8.61 ± 40.27 0.1638
CMT 0.09 ± 2.44 -0.79 ± 1.68 0.2018 0.52 ± 2.39 -0.26 ± 3.48 0.4347
CMV 0.76 ± 3.15 -0.75 ± 2.44 0.0961 0.99 ± 3.69 0.47 ± 6.07 0.7463
CMOT 0.91 ± 6.12 -3.12 ± 8.39 0.0927 2.41 ± 5.64 -5.11 ± 5.79 0.0002

VA = visual acuity; VAo = visual acuity of OQAS (Optical Quality Analysis System); OSI = objective scattering index; CMT = central macular thickness (micron); CMV = central macular retinal volume (micron3); CMOT = central macular outer segment thickness (micron) (ANCOVA).

Table 4.
The result of the survey for subjective symptoms
Questions Bog bilberries Placebo p
Baseline 1 0.36 ± 0.73 0.37 ± 0.68 0.9828
2 0.00 ± 0.00 0.05 ± 0.23 0.3306
3 0.77 ± 0.87 0.37 ± 0.68 0.1040
4 0.59 ± 0.80 0.37 ± 0.83 0.3889
5 0.18 ± 0.50 0.05 ± 0.23 0.2866
6 0.18 ± 0.50 0.16 ± 0.69 0.9009
7 0.27 ± 0.70 0.05 ± 0.23 0.1774
8 0.09 ± 0.43 0.16 ± 0.50 0.6506
9 0.86 ± 0.99 0.68 ± 1.06 0.5801
10 0.41 ± 0.67 0.11 ± 0.46 0.0940
Total 3.32 ± 2.53 2.26 ± 3.11 0.2461
4 weeks 1 0.05 ± 0.21 0.16 ± 0.37 0.2574
2 0.00 ± 0.00 0.05 ± 0.23 0.3306
3 0.36 ± 0.58 0.11 ± 0.46 0.1201
4 0.55 ± 0.80 0.26 ± 0.73 0.2460
5 0.05 ± 0.21 0.05 ± 0.23 0.9184
6 0.09 ± 0.29 0.16 ± 0.69 0.6969
7 0.00 ± 0.00 0.05 ± 0.23 0.3306
8 0.09 ± 0.43 0.11 ± 0.46 0.9184
9 0.41 ± 0.80 0.37 ± 0.76 0.8682
10 0.09 ± 0.29 0.00 ± 0.00 0.1621
Total 1.68 ± 1.70 1.32 ± 2.26 0.5671
12 weeks 1 0.05 ± 0.21 0.11 ± 0.32 0.4891
2 0.00 ± 0.00 0.05 ± 0.23 0.3306
3 0.27 ± 0.55 0.11 ± 0.32 0.2328
4 0.41 ± 0.67 0.05 ± 0.23 0.0263
5 0.09 ± 0.29 0.00 ± 0.00 0.1621
6 0.00 ± 0.00 0.11 ± 0.46 0.3306
7 0.05 ± 0.21 0.05 ± 0.23 0.9184
8 0.09 ± 0.43 0.05 ± 0.23 0.7179
9 0.18 ± 0.39 0.11 ± 0.46 0.5736
10 0.09 ± 0.29 0.00 ± 0.00 0.1621
Total 1.23 ± 1.31 0.63 ± 1.34 0.1596

Values are presented as mean ± SD.

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