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Gingko Biloba as an adjuvant to Timolol in Moderate Primary Open Angle Glaucoma

Background: Timolol eye drops is used in the treatment of Primary Open Angle Glaucoma (POAG). Gingko Biloba has neuroprotective and anti-oxidative effects and increases the blood flow thus it is a potentially useful treatment in glaucoma. Aim of The Work: Assessing the safety and efficacy of using Ginkgo Biloba with Timolol in moderate POAG. Patients and Methods: A case group “90 eyes” with moderate POAG were instructed to add 120 mg/day of Gingko to daily dose of Timolol and a control group “90 eyes” continued on Timolol only. We used Visual Field Analyzer and Optical coherence tomography angiography “OCTA” in assessment. We also tested its effect on coagulation. Duration was 6 months. Results: No significant differences among the two groups regarding age and gender. Regarding coagulation tests; there were no significant differences or changes in both groups before or after treatment . In case group; there were significant improvements about 7.7% in VFI% (p 0.014), 13.5% in MD (p 0.018), 2.6% in outer region perfusion % of ONH (p 0.003), 4.6% in outer region flux index of ONH (p 0.009), 6.4% in full perfusion density % of Macula (p 0.049), and 6.5% in full vessel density of Macula (p 0.008 .) There was non-significant change in control group with no significant difference between the groups regarding baseline level but there was a significant difference between them at the study end. No side effects were found. Conclusion: Ginkgo Biloba is a beneficial adjuvant to Timolol in Moderate POAG.