Tze, Chan Hui (2020) Effect of papaya intake on intraocular pressure, retinal nerve fiber layer thickness, optic nerve head parameters and serum total antioxidant capacity in primary open angle glaucoma patients. Masters thesis, Universiti Sains Malaysia.
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Abstract
INTRODUCTION Primary open angle glaucoma (POAG) is a chronic progressive optic neuropathy which responsible for many irreversible blindness in the world. There are many large randomized controlled trial studies on treatment modalities on various stages and type of glaucoma. These modalities aimed at reduction of intraocular pressure (IOP). However, there are still many patients who shown sign of progression of the disease despite of achieving target IOP. Lately, complementary and alternative medicine (CAM) including lifestyle modification has caught the interest of many researchers. Fruits enriched with antioxidants such as papaya has the potential role as CAM in POAG patients. Papaya is a non-seasonal, easily available, and palatable to elderly and relatively inexpensive tropical fruits in Malaysia. OBJECTIVES To evaluate the effect of papaya intake on IOP, retinal nerve fiber layer (RNFL) thickness, optic nerve head (ONH) parameters and serum total antioxidant capacity (TAC) in primary open angle glaucoma (POAG) patients. METHODOLOGY A randomized single blinded controlled trial involving 40 POAG patients was conducted in Hospital Universiti Sains Malaysia between February 2018 and October 2019. Patients who fulfilled inclusion and exclusion criteria were recruited by simple random sampling method. Block randomization using sequentially numbered, opaque sealed envelopes (SNOSE) was used to randomize POAG patients to group A and B equally. Patients in group A were instructed to consume single serving of raw papaya (~250 gram), 3 times a week for 3 months. Venesection was also conducted to obtain 3 ml of blood to quantify serum TAC level. The IOP, RNFL thickness, ONH parameters and serum TAC were recorded at baseline, 1st, 2nd and 3rd month for both groups. IOP measurement was done using Goldmann applanation tonometer (GAT) in sitting position. Spectral domain Cirrus high definition optical coherence tomography (HD-OCT) was used to measure RNFL thickness and ONH parameters. Serum TAC was analyzed using QuantiChromTM Antioxidant Assay Kit (DTAC-100). Descriptive analysis, repeated measures ANOVA was performed using SPSS. RESULTS A total of 67 POAG patients were screened but only 40 POAG patients were recruited after baseline examination. Patients in group A were older but with shorter duration of the disease but without any significant different to group B. However, there was significant higher number of hyperlipidemia in group B (p=0.028). There was slightly higher baseline mean IOP of group A (15.7±1.6 mmHg) compared to group B (14.9±1.9 mmHg). Based on RM ANOVA there was significant further reduction of IOP in group A compared to group B (p<0.001). There was also significant increase in RNFL thickness in group A compared to group B (p=0.001). However, there was no significant different in ONH parameters between the two groups after 3 months of intervention. There was also no significant different in serum TAC (p=0.210) between group A and B. In fact there was no further increase in serum TAC in group A after 3 months of regular intake of papaya. CONCLUSION Regular consumption of papaya has potential supplementary IOP reduction in POAG patients. Papaya has potential positive effect on RNFL thickness but not on ONH parameters and serum TAC level. Further research with larger number of glaucoma patients and longer follow up is required to determine the potential supplementary effect of papaya in glaucoma management.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | - |
| Subjects: | R Medicine |
| Divisions: | Kampus Kesihatan (Health Campus) > Pusat Pengajian Sains Perubatan (School of Medical Sciences) > Thesis |
| Depositing User: | Mr Abdul Hadi Mohammad |
| Date Deposited: | 08 Jun 2026 04:04 |
| Last Modified: | 08 Jun 2026 04:04 |
| URI: | http://eprints.usm.my/id/eprint/64300 |
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