Edema and Related Medical Conditions

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Tuesday, November 28, 2006

Pycnogenol may reduce edema

Pycnogenol may reduce edema in hypertensives on meds

By staff reporter

15/11/2006 - Daily supplements of the French maritime park bark extract, Pycnogenol, could reduce edema, a typical side-effect of antihypertensive medications, by 36 percent in patients taking these medications, says a new study.

According to lead researcher of the study, Dr. Gianni Belcaro, from the G D'annunzio University in Italy, more than 35 per cent of patients taking antihypertensive medications are believed to suffer from edema as a side-effect. This happens because the antihypertensive medications cause blood vessels to dilate, which allows easier blood flow and thus lowers blood pressure.

“The larger the blood vessel diameter, the easier blood will flow with less pressure,” said Dr. Belcaro. “In order to avoid blood pooling in the lower legs and feet (edema), blood vessel diameters must adjust when a person changes positions from laying down to standing up.”
Pyconogenol supplements have previously been shown to boost circulation, and Dr. Belcaro said that the new study, published in the October issue of the Clinical and Applied Thrombosis/Hemostasis (Vol. 12, pp. 440-444), appears to show the
pine bark extract does improve blood circulation, and therefore avoids blood pooling and edema.

Such conclusions are based on results from 53 hypertensive patients suffering from edema of their ankles and feet as a result of antihypertensive medications. Twenty-three patients were being treated with angiotensin-I converting enzyme (ACE) inhibitors (brand names Mavik, Altace) and 30 patients were being treated with nifedipine (calcium channel blockers) (brand names Adalat, Procardia).

The researchers divided the patients into two groups and supplemented one group (27 patients) with 150 mg Pycnogenol per day or an equivalent dosage of placebo (26 patients).

After eight-weeks of supplementation, Belcaro and his co-workers report that the patients treated with ACE inhibitors and receiving the pine bark extract supplement experienced a 35 per cent decrease in ankle swelling while patients being treated with nifedipine experienced a 36 per cent decrease of ankle swelling. No effect was reported for the placebo group.

“Pycnogenol controls this type of edema, it helps to prevent and limit long-term damage in the microcirculation in hypertensive patients, and allows the dose of anti-hypertensive drugs to be reduced in most patients,” concluded the researchers.
More research is needed to support these effects, with larger and longer interventions desirable.
Horphag Research, manufacturers of Pycnogenol, has been very active in sponsoring and supporting studies into the potential health benefits of the pine bark extract. The first research was conducted on the ingredient 35 years ago. Victor Ferrari, research chief operating officer and executive vice president of Horphag Research, told NutraIngredients recently that the company ploughs $1.5m – “most of its profits” – into research each year.

The product is extracted from the bark of the Maritime pine that grows on the southern coast of France, and is currently used in over 400 dietary supplements, multi-vitamins and health products.


Tuesday, November 07, 2006

Vitrectomy for non-ischaemic macular oedema in retinal vein occlusion.

Vitrectomy for non-ischaemic macular oedema in retinal vein occlusion.

Acta Ophthalmol Scand. 2006 Dec;84(6):812-4.

Hvarfner C,
Larsson J.
Department of Ophthalmology, Lund University Hospital, Sweden.


To evaluate the effect of vitrectomy in eyes with non-ischaemic macular oedema secondary to hemi and central retinal vein occlusion. Methods: This retrospective study analysed the outcome of eight patients with non-ischaemic macular oedema without posterior vitreous detachment. Six patients had a central retinal vein occlusion and two had a hemi retinal vein occlusion. A standard three-port vitrectomy was performed in all patients. Retinal mapping by optical coherence tomography and visual acuity (VA) testing were performed before vitrectomy and at 1, 2 and 12 months postoperatively.


At the 1-month follow-up there was a statistically significant reduction in retinal thickness (Wilcoxon; p = 0.04) that persisted at 2 months (Wilcoxon; p = 0.04). However, at 12 months there was no difference compared with baseline. LogMAR VA was significantly improved at 1 month (Wilcoxon p = 0.04), but at 2 and 12 months there was no difference compared with baseline.


Vitrectomy in hemi and central retinal vein occlusion has the potential to reduce macular oedema and improve VA in the early postoperative phase but does not seem to improve the longterm outcome of the disease.

PMID: 17083544 [
PubMed - in process]

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Macular oedema in central retinal vein occlusion treated with intravitreal triamcinolone.

Acta Ophthalmol Scand. 2006 Jun;84(3):314-8

Gelston CD,
Olson JL,
Mandava N.

Department of Ophthalmology, Rocky Mountain Lions Eye Institute, University of Colorado School of Medicine, Denver, 80041, USA.


To investigate the efficacy of intravitreal triamcinolone as treatment for macular oedema in central retinal vein occlusion (CRVO).


We conducted a retrospective comparative case series of nine patients with macular oedema associated with CRVO (six non-ischaemic and three ischaemic) treated with an intravitreal injection of 4 mg triamcinolone acetonide, compared with 10 control (observation) patients (six non-ischaemic and four ischaemic). Examination included visual acuity (VA) tests and complete ophthalmic examinations at baseline, 1, 2 and 6 months postoperatively.


The mean baseline VA was 20/161 for CRVO treatment group patients and 20/75 for observation group patients (p = 0.15). No significant difference in VA between CRVO treatment group patients (20/99) and controls (20/282) was observed at the final 6-month visit (p = 0.33). Subgroup analysis of the non-ischaemic CRVO treatment patients compared with the non-ischaemic controls also showed no significant difference at the 6-month visit (20/59 and 20/100, respectively; p = 0.20). At 6 months, five of the six non-ischaemic treated patients had VA >or= 20/100, compared with five of the six non-ischaemic control patients. All patients tolerated the procedure well, but there was a significant increase in intraocular pressure by the 2-month visit (p = 0.015).


Intravitreal injection of triamcinolone may not be effective for treatment of macular oedema in all CRVO patients or all non-ischaemic CRVO patients. A trend towards VA improvement was noted but was not statistically significant. Although our treatment was not hindered by severe complications, there was a significant increase in IOP in the 2 months following treatment.