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    How glucosamine supplements may increase IOP

     

    At month 1, IOP rose to 12.6 mmHg in the glucosamine group and fell to 12.9 mmHg in the placebo group. The differences were still not statistically significant (P = 0.868).

    At month 3, IOP rose to 13.5 mmHg in the glucosamine group and 13.0 mm Hg in the placebo group. At that point, the difference reach statistical significance (P = 0.023).

    In the glucosamine group, 34% of patients had an increase of more than 2 mm HG compared to 23.5% of patients in the placebo group.

    There were no significant differences between the groups in ocular response analyser Goldmann-correlated IOP, cornea-compensated IOP, corneal hysteresis or corneal resistance factor.

    The mean age in those with increases of 2 mm Hg IOP or more was 66 years, compared to 57.7 years in patients who had increases of less than 2 mm Hg.  But the risk of ocular hypertension was not associated with diabetes mellitus, cardiovascular disease and gender were not.

    “The results of this study show that while glucosamine causes statistically significant increase in IOP in patients with [osteoarthritis], corneal biomechanics remain unchanged within 3 months of glucosamine supplement therapy,” the authors wrote.

    Their results suggest that glucosamine supplementation could be “pathological” in the trabecular meshwork after 3 months, they wrote.

    Glycosaminoglycans constitute the ground substance for the outermost part of the trabecular meshwork. Long, flexible chains of glycosaminoglycans interact with each other to form a system of entangled polyanionic macromolecules which act like a gel and contribute to outflow resistance.

    Accumulated glycosaminoglycans in the ground substance of the trabecular meshwork outflow pathways, and increased constriction of the trabecular spaces could explain the rises in IOP seen with even short courses of steroid treatment, the authors wrote.

    They also noted that a high concentration of glycosaminoglycans in acqueous fluid could draw more water into the anterior chamber through osmosis, inducing swelling and compromising pore sizes in a manner that increases IOP.

    In an earlier retrospective study, researchers observed that IOP in patients with poorly controlled glaucoma experienced improvements when they discontinued glucosamine supplements.

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