Four Arm Randomized Controlled Trial to Evaluate the Comparative Neuroprotective Effect of Ayurveda Interventions as an Add on Therapy in Primary Open Angle Glaucoma

Glaucoma is the second leading cause of irreversible but preventable blindness globally, accounting for approximately 8% of global blindness and 12.8% of blindness in India. It ranks third after cataract and uncorrected refractive errors in India. Among its many types, Primary Open-Angle Glaucoma (POAG) is the most prevalent form, typically bilateral and adult onset, with a global prevalence of approximately 2.4%. POAG is characterized by elevated Intraocular Pressure (IOP), open anterior chamber angles, progressive optic nerve damage and characteristic visual field loss.

While reduction in IOP remains the primary and most established treatment and modifiable risk factor for preventing disease onset and progression, many patients continue to experience deterioration of visual function despite effective IOP control. This highlights the potential involvement of pressure independent mechanisms for progressive apoptosis of Retinal Ganglion Cell (RGC) in glaucomatous optic neuro degeneration.

Hence there is increasing interest in exploring neuroprotective strategies that go beyond IOP reduction, including neuroprotective agents and gene therapies that preserve RGDs. Ayurveda provides potential adjunctive option. Studies on Ayurvedic preparations such as Shigru Pallava Arka eye drops and Rasayana therapies have shown beneficial effect in preventing retinal damage. This study aims to assess comparative neuroprotective effect of Ayurveda interventions as an add-on therapy compared to standard care in management of Primary Open Angle Glaucoma (POAG).