Clinical Study of Neurodegenerative Treatment on Glaucoma by Insulin Intravitreal Injection

ABSTRACT

Purpose: Our trail was to study insulin intravitreal injection’s (IIV) efficacity and safety to treat glaucoma neurodegeneration.Methods: Eleven subjects (11eyes) were recruited;10 patients treated in a double masked randomized sham controlled including 5 patients received one IIV injection 3UI and 5 patients received one injection of balanced salt solution(BSS) 3UI. A follow up during 168days was realized using Optical Coherence Tomography(OCT) and visual field(VF).The eleventh patient received two IIV injection without masking the injection content within one month between each injection and followed up for 877days.All the patients have a correct ocular pressure and no ocular treatment was stopped.Results: The 5 patients who received IIV revealed a swift improvement of decibel (DB), and remains stable during the first month. The average improvement was 6.62DB during 168days.The 5 patients treated with one BSS injection showed no significant improvement regaining 1. 45DB.The last patient who received two injections showed increase from 7.54DB to 17.22DB with a functional amelioration of 9. 68DB.The OCT examination showed a structural improvement during the first month, then returned to the initial value. No complication was observed during and after the treatment.Conclusion: Insulin shows not only efficacity and safety but more than that, the visual field(VF) of the patients became stable and show no deterioration in all the follow up, which confirmed that insulin act to improve the function rather than structure. it means insulin reconnect the stoma and improve the neurite outgrowth This treatment will change the evolution of this pathology and protect the glaucomatous patients against blindness.