2023 · Chen et al. — The Clinical Research on the Effect of Hydrogen-Rich Water on Primary Retinitis Pigmentosa
Super-Abstract
In 13 patients with primary retinitis pigmentosa (24 eyes), best corrected visual acuity was slightly but statistically significantly better after four weeks of drinking hydrogen-rich water twice a day than before (P < 0.05). Several electroretinogram amplitudes also increased, while intraocular pressure, retinal thickness and choroidal thickness showed no statistically significant change. The study had no control group, so these changes cannot be attributed to hydrogen. (Heliyon, 2023.)
Commentary
The study asked whether drinking hydrogen-rich water is feasible and effective in patients with retinitis pigmentosa (RP). Patients clinically diagnosed with RP at the authors' hospital drank 400 to 500 ml of hydrogen-rich water twice a day for four consecutive weeks. Per full text, the water contained 1.6 mg/L of H₂, and each portion was drunk within 15 minutes. Thirteen patients (3 men and 10 women aged 27 to 65 years) contributed 24 eyes. There was no control group: per full text, each patient's values after drinking were compared with their own values before. Outcomes were best corrected visual acuity (BCVA), intraocular pressure, retinal and choroidal thickness, and amplitudes and peak times of the electroretinogram (ERG) and visual evoked potentials. Pattern visual evoked potentials were analysed in the six patients (11 eyes) with BCVA above 20/200, flash visual evoked potentials in the seven patients (13 eyes) below 20/200. The abstract does not name a primary endpoint and does not report adverse events.
Key quotes
- „The BCVA after HRW drinking was 0.34 ± 0.25, which was statistically improved compared with that before (P < 0.05).“ — the visual acuity result; the abstract gives only the value after drinking
- „The amplitudes of the b-wave in Dark-adaptation 0.01 response, a and b waves in Dark-adaptation 3.0 response, the Dark-adaptation Ops total wave, a and b waves in Light-adaptation 3.0 response, and the Light-adaptation Flicker response of electroretinogram (ERG) were significantly higher than those before HRW drinking (all P < 0.05).“ — retinal function in the electroretinogram, compared only with the patients' own baseline
- „Short-term HRW drinking slightly improved visual function in patients with primary RP, whereas no significant improvement was found in the thickness of the retina and choroid.“ — the authors' conclusion, which also states the null result on retinal structure
Our assessment
This small before-and-after study at one hospital can show that measurements changed over four weeks, not why. Without a control group, the changes cannot be attributed to hydrogen. Visual acuity improved statistically, but per full text the mean decimal acuity moved only from 0.33 ± 0.26 to 0.34 ± 0.25 (P = 0.007), and the abstract does not discuss whether this difference matters in daily life. Retinal and choroidal thickness and the flash visual evoked potentials did not change significantly. Limitations: 13 patients, four weeks of drinking, no randomisation, no blinding reported, no primary endpoint named and many electrophysiological measures tested. Per full text, the 24 eyes were analysed as separate units although most patients contributed both eyes, and the COVID-19 pandemic limited follow-up. The abstract does not report adverse events. The results can at most justify a controlled trial.
Study design
- Type: single-arm before-and-after study at one hospital, no randomisation, no control group · n: 13 patients (24 eyes) · H₂ delivery: drinking hydrogen-rich water, 400–500 ml twice a day for four weeks; 1.6 mg/L H₂ per full text
- Comparator: none; values before drinking in the same eyes
- Result: no primary endpoint named. BCVA 0.34 ± 0.25 after drinking, improved compared with before (P < 0.05; per full text 0.33 ± 0.26 before, P = 0.007). Several ERG amplitudes higher and peak times improved (all P < 0.05). Intraocular pressure, retinal and choroidal thickness: no significant change (all P > 0.05). Pattern VEP: no change at 1°, statistically different at 15' (P < 0.05). Flash VEP: no significant change (all P > 0.05)
Abstract
OBJECTIVE: To investigate the feasibility and effectiveness of hydrogen in the treatment of retinitis pigmentosa (RP) patients through the drinking of hydrogen-rich water (HRW). METHODS: RP patients clinically diagnosed in our hospital were selected and given HRW for drinking at 400-500 ml twice a day for four consecutive weeks. Changes in best corrected visual acuity (BCVA), intraocular pressure, the retinal thickness, and choroidal thickness, as well as the amplitude and peak time of visual electrophysiological examinations before and after HRW drinking were observed. Data were statistically analyzed. RESULTS: In total, 24 eyes of 13 patients with RP (3 males and 10 females aged-27-65 years old, were enrolled in the study. The BCVA after HRW drinking was 0.34 ± 0.25, which was statistically improved compared with that before (P < 0.05). There were no significant differences in intraocular pressure, retinal lhickness, or choroidal thickness before and after HRW drinking (all P > 0.05). The amplitudes of the b-wave in Dark-adaptation 0.01 response, a and b waves in Dark-adaptation 3.0 response, the Dark-adaptation Ops total wave, a and b waves in Light-adaptation 3.0 response, and the Light-adaptation Flicker response of electroretinogram (ERG) were significantly higher than those before HRW drinking (all P < 0.05). The corresponding peak times iwere mproved to some extent compared to those before HRW consumption (all P < 0.05). Six patients with RP (11 eyes) had a BCVAm ore than 20/200. The amplitude and peak time of the P100 -ave from the 1°p attern visual evoked potentials (PVEP) were not significantly different from those before HRW drinking (P > 0.05), while the data from the 15' PVEP were statistically different (P < 0.05). Seven patients with RP (13 eyes) had a BCVA less than. 20/200 No significant differences were found in the amplitude and peak time of the P2 wave from the 1.0 Hz flash visual evoked potentials (FVEP) and the amplitude from the 12 Hz FVEP compared with those before HRW drinking (all P > 0.05). CONCLUSION: Short-term HRW drinking slightly improved visual function in patients with primary RP, whereas no significant improvement was found in the thickness of the retina and choroid.
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