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Eye Diseases

As they have in other areas of scientific research, Polish investigators have explored the medical value of ozone therapy in treating a wide range of eye problems, including retinal pigment dystrophy, glaucomatous optic atrophy, optic neuritis, eye injuries, degenerative atrophic changes of the choroid, severe myopia, postinflammatory cases, other degenerative diseases, bacterial corneal ulcerations, and cases of unknown etiology. A 1992 article reported the preliminary general findings concerning 206 patients with eye problems. Autohemotherapy was performed on 174 patients; the remaining 32 patients ozone were given intra-arterial oxygen and ozone injections. The researchers observed an improvement in both visual acuity and the visual field. The report added: “Ozone therapy in these conditions seems to be favorable, especially when the pathological process is not extensive.”1

However, the most exciting research in ozone therapy to treat eye diseases has taken place in Cuba. Over the past few years, Cuban scientists have pioneered research in developing treatment protocols for eye diseases with ozone therapy. Studies have been done to evaluate the beneficial effects of ozone for treating glaucoma, corneal ulcers, atrophy of the optic nerve, and diabetic retinopathy. Ozone was also studied as an adjunct to corneal transplant operations.

GLAUCOMA

Glaucoma is a serious disease that affects approximately 2 percent of adults over forty years of age. However, in some countries, up to 11 percent of adults can suffer from glaucoma, making it the third leading cause of blindness in the world. Cuban research to evaluate the therapeutic effectiveness of ozone to treat glaucoma was reported at the Twelfth World Congress of the International Ozone Association in 1995.

Conducted by scientists at both the National Center for Scientific Research and the Carlos J. Finlay Hospital in Havana, the study involved two hundred outpatients suffering from different stages of simple chronic glaucoma. Ninety percent of patients were over forty years of age. After undergoing visual acuity tests, visual field tests, slit lamp examination, fundoscopy, and visual evoked potentials tests, patients were divided into three random groups for fifteen daily treatments. The first group received ozone therapy (through rectal insufflation); the second received magnetotherapy; and the third received both ozone therapy and magnetotherapy. After the course of treatment, patients were subjected to the same battery of examinations as before.

Visual acuity results were basically similar among all groups, although those receiving ozone therapy alone scored several percentage points higher. Overall, 71 to 75 percent of patients showed “highly significant” improvement, while 25 to 29 percent showed “significant” improvement. However, visual field results showed that ozone therapy is more effective: 73 percent of patients receiving ozone therapy alone showed “highly significant” improvement, while 27 percent had “significant” improvement; 58 percent of those receiving magnetotherapy alone experienced “highly significant” improvement, while 42 percent showed “significant improvement”; and 67 percent of patients using combined therapies had “highly significant” improvement, while the remaining 33 percent experienced “significant” improvement.

Overall, the researchers found that best results were attained through ozone therapy alone. They also noted that a fifteen-treatment course of ozone therapy worked best with patients suffering from the earlier stages of the disease.2

OPTIC ATROPHY

Optic nerve dysfunction, or optic atrophy, is a leading cause of blindness in Cuba. A preliminary study with forty patients (sixty-seven eyes) was carried out at the Institute of Neurology and Neurosurgery in 1992. One treatment of major autohemotherapy with ozone was given every weekday for three weeks.

A number of standardized tests were administered before and after the course of treatment, including visual acuity, visual field by Goldmann perimetry, visual evoked potentials, and Pelli-Robson contrast sensitivity test (PRCST). The results were as follows:

Test Percentage of patients improved

Test Percentage of patients improved
Visual Acuity 54.5
Visual Field 82.7
Visual Evoked Potentials 37.0
Pelli-Robson Contrast Sensitivity Test 85.7

While not all patients achieved a total cure with ozone therapy, the results of this preliminary study so impressed the head physician on the research team (which usually comprises chemists, physicians, and technicians) that she decided to treat all of her future patients suffering from optic atrophy with ozone, either alone or as an adjunct to other treatments.3

OPTIC NERVE DYSFUNCTION

A team of researchers at the Institute of Neurology and Neurosurgery in Havana investigated the healing potential of ozone therapy on patients diagnosed with optic nerve dysfunction.

Sixty patients with optic nerve dysfunction were given a total of fifteen autohemotherapy sessions over a three-week period. Ophthalmologic tests to determine visual acuity, visual field by Goldmann perimetry, visual evoked potentials, and PRCST were done before and after treatment.

The most positive findings were found in PRCST and visual field parameters, indicating improvement in 86 and 83 percent of patients, respectively. Visual acuity improved in 55 percent of the patients, while visual evoked potentials increased in 37 percent of patients. No improvement was found in patients diagnosed with Leber’s optic atrophy.4

RETINAL MACULOPATHY

Retinal maculopathy is an eye disease affecting the muscles of the eye that often appears in one’s later years. The effects of oxygen-ozone therapy on twenty patients affected by age-related degenerative maculopathy was studied by Dr. E. Riva Sanseverino and his colleagues at the University of Bologna in Italy. Before-and-after tests to determine visual acuity and eye fluorangiography were used to evaluate the efficacy of the therapy. Ozone was administered via major autohemotherapy at 1,500 to 2,000 µg/session over a four-month period. The results were very heartening: tests indicated that “the majority of patients showed an improvement of their ocular condition, suggesting continuation of this type of investigation on a larger group of people.”5

RETINITIS PIGMENTOSA

One of the major successes of the Cuban medical system has been in treating retinitis pigmentosa, a chronic progressive disease involving atrophy of the optic nerve and widespread pigmentary changes of the retina. Blindness is often the result. The first major study was carried out at the Salvador Allende Hospital in Havana in 1985 with two hundred patients who had a range of tubular vision of 5 degrees or less. Believing that ozone might be able to help restore blood circulation to the capillaries of the retina, activate protective enzyme systems, and stimulate metabolism of oxygen, researchers gave the patients either major autohemotherapy or intramuscular treatments of ozone and oxygen daily for fifteen to twenty days, depending on the individual and the severity of symptoms. The patient was said to improve when the range of vision increased between 10 and 20 degrees.

The results were surprising. Of the 175 patients in the study who received autohemotherapy, 112 showed “notable improvement,” 45 had “slight improvement,” and 18 experienced “no progression of symptoms,” meaning that although they did not get better, they also did not get worse. Of the twenty-five patients receiving intramuscular oxygen and ozone injections, twelve were notably improved, nine slightly improved, and four with no symptom progression. While a complete cure was not achieved, marked improvement took place in 89 percent of the patients and persisted for at least two years after treatment. Figure 20.1 offers a view of one patient’s visual range (in white) before and one year after ozone therapy was administered.6

A later study was carried out at several hospitals in the city of Holguin, Cuba, as part of a larger research project encompassing other ophthalmologic diseases. Eighty patients with nonsystemic stage I and stage II retinitis pigmentosa were given daily ozone therapy via rectal insufflation for a period of twenty days. Clinical evaluation was made every three months for one year after therapy.

A total of 75 percent realized clinical improvement in their visual acuity up to six months after treatment. However, after one year only 23 percent of patients maintained this improvement. Regarding visual field, 75 percent of the patients improved after treatment for up to nine months, but after a year, only 59 percent maintained their level of improvement. These results led the researchers to recommend that follow-up ozone treatments be scheduled every six months to maintain patient improvement.7

These results reflected the opinions of researchers who completed a ten-year study of twenty patients at the National Reference Center of Retinitis Pigmentosa of the Salvador Allende Hospital in Havana, who wrote: “The best results were achieved when ozone treatment is repeated, at least twice a year, among all these years, with improvement of 70% in the visual field and 42% in the visual acuity.”8

By the beginning of 2007, an estimated eight thousand patients had been treated with ozone at Cuban hospitals for a variety of eye diseases. Ozone is given routinely to the majority of patients with retinitis pigmentosa, retinitis diabetica, keratitis, corneal ulcers, and other eye diseases, either alone or as an adjunct to traditional medical therapies. For retinitis pigmentosa patients, follow-up applications of ozone therapy are recommended twice a year.9

Other research is taking place in Russia. A study by Dr. V. V. Neroev and colleagues studied the effects of ozone therapy on patients with involutional central chorioretinal dystrophy, another disease involving retinal degeneration. They found that ozone leads to increased activity of neurons in the muscular region and better functional activity of the retinal peripheral segments. They concluded that ozone has “a positive influence on the dynamics of functional retinal activity” and recommended that ozone therapy be implemented with electroretinography monitoring.10

Not all researchers have had such positive results. Dr. Bocci found that after providing fourteen autohemotherapy treatments over a seven-week period to patients diagnosed with retinitis pigmentosa, there was only slight and occasional improvement.11 However, he believes that ozone therapy could indeed be a useful complementary treatment for this and other eye diseases to do the following:

image

Figure 20.1. Diagram showing range of vision (in white) of patient with retinitis pigmentosa before and after ozone therapy. (From Revista CENIC 20, no. 1-2-3, 1989.)

AGE-RELATED MACULAR DEGENERATION

Age-related macular degeneration (ARMD) is an eye disease affecting approximately 25 percent of individuals over sixty-five years of age. The “dry” form of this disease comprises approximately 90 percent of cases and there is currently no cure. However, several clinical trials were carried out by scientists at the University of Siena in Italy, and it was found that ozone therapy can stop the progression of the disease while improving both the visual acuity and the well-being of the patient.

One trial was performed by Emma Borrelli, M.D., and her colleagues in the Department of Biotechnologies. They enrolled 140 dry ARMD patients from 2008 to 2011 with ages ranging from fifty-nine to eighty-two. A total of seventy patients underwent ozone therapy while the control group (also seventy patients) received multivitamin therapy. Ophthalmic examination was recorded for each eye at baseline and after six months and twelve months for both groups.

The results showed that patients receiving ozone therapy did far better than those who did not. At six months and twelve months, ozone treated eyes showed an average acuity change of −0.1 and of −0.2 logMAR respectively, while control group eyes had a change of 0.2 and of 0.3, respectively. As far as the best corrected visual acuity (BCVA) changes over time, at six months none of the eyes treated with ozone had a deterioration in BCVA of more than two lines. In the control group, 16 percent had eyes with more than two lines of loss, and 25 percent had more than three lines of loss (P<0.05). At six months, 4 percent of the treated group eyes had an improvement of 1 line compared to 0 percent of the control group patients. At twelve months, none of the treated group eyes showed a loss of more than three lines in BCVA. In the control group, 40 percent had a loss of more than two lines, and 38 percent lost more than three lines (P<0.05).

The researchers also found that plasma oxidative stress was significantly decreased after ozone treatment, confirming the role of antioxidant enzymes in the increase and the reduction of oxidative stress. In addition, patients receiving ozone therapy reported an improvement of their general condition, particularly in terms of increased efficacy, mental concentration, and memory as assessed by the National Eye Visual Function Questionnaire (NEI-VFQ) before and after the end of the study.

The researchers commented that ozone therapy appears to trigger a number of defense mechanisms against ischemic and neurotoxic injury of the eye, thus preventing the death of photoreceptors. They outlined the effects of ozone therapy on patients with ARMD:

  1. Improvement of blood rheology (blood flow)
  2. Improvement of the glycolytic pathways on erythrocytes (red blood cells that deliver oxygen); the increased concentration of ATP levels may facilitate a microrelease at hypoxic sites
  3. Activation of chemicals that increase oxygen availability to hypoxic tissues
  4. Vasodilation due to enhanced release of nitric oxide and prostacyclin (a vasodilator)
  5. Release of growth factors from platelets
  6. The upegulation of antioxidant enzymes, proteins and heme-oxygenase-1, an enzyme, which facilitate healing

The authors concluded: “The observation that visual acuity improves more rapidly in patients with an initial deficit than in almost blind patients strongly suggests that patients should be encouraged to start ozone therapy as early as possible. It appears obvious that the therapy minimizes the death of photoreceptors.”13