The clinical research on the effect of hydrogen-rich water on primary retinitis pigmentosa

Heliyon · 8 authors, 1 centre

AI SUMMARY

FIDELITY 100%

POPULATION13 patients (24 eyes) with primary retinitis pigmentosa, aged 27–65 years, BCVA ≥20/2000, no other ocular or systemic diseases

INTERVENTIONHydrogen-rich water (HRW) 400–500 ml twice daily for 4 weeks (H₂ concentration 1.6 mg/L)

COMPARISONBefore vs. after HRW drinking (within-subject comparison)

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TL;DR

This study found that drinking hydrogen-rich water (HRW) for four weeks led to a small but statistically significant improvement in best corrected visual acuity and several electroretinogram parameters in patients with retinitis pigmentosa, though retinal and choroidal thickness did not change. The results suggest short-term HRW may slightly improve retinal function without adverse effects on intraocular pressure or retinal structure. These preliminary findings support further research with larger samples and longer follow-up to confirm the potential of HRW as a supportive therapy for RP.

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**Background:** Retinitis pigmentosa (RP) is a hereditary retinal degenerative disease with progressive photoreceptor loss, affecting about 1 in 4000 people. Oxidative stress is considered a key factor in RP pathogenesis. Molecular hydrogen (H₂) is a selective antioxidant with anti-inflammatory and anti-apoptotic properties. Hydrogen-rich water (HRW) is a safe, convenient form of H₂ delivery. Previous animal studies showed HRW protected retinal morphology and function in RP models, but clinical evidence in humans was lacking. This study aimed to evaluate the feasibility and effectiveness of HRW in RP patients.

**Methods:** Thirteen patients (3 males, 10 females; mean age 50.54 ± 10.26 years; 24 eyes) with clinically diagnosed RP were enrolled between July and September 2019. Inclusion criteria included progressive night blindness, decreased visual field, fundus characteristics, abnormal ERG, age ≤65 years, BCVA ≥20/2000, and no other ocular or systemic diseases. Patients drank 400–500 ml of HRW (H₂ concentration 1.6 mg/L) twice daily for four consecutive weeks. Before and after the intervention, the following were measured: BCVA (decimal chart), IOP (non-contact tonometer), retinal and choroidal thickness (Spectralis OCT, manual measurement at fovea and 500 μm intervals nasally and temporally), full-field ERG (dark-adapted 0.01, 3.0, OPs; light-adapted 3.0 and 30 Hz flicker) and VEP (PVEP for eyes with BCVA >20/200, FVEP for eyes with BCVA <20/200). Statistical analysis used paired t-tests (SPSS 26.0).

**Key Results:** After HRW drinking, mean BCVA improved from 0.33 ± 0.26 to 0.34 ± 0.25 (t = -2.954, P = 0.007). IOP did not change significantly (14.04 ± 2.12 vs. 13.71 ± 1.92 mmHg, P = 0.276). Retinal thickness (143.54 ± 55.89 vs. 144.79 ± 55.29 μm, P = 0.256) and choroidal thickness (188.88 ± 79.09 vs. 187.67 ± 74.42 μm, P = 0.571) were not significantly different. ERG showed statistically significant improvements in several parameters: Dark-adapted 0.01 b-wave amplitude (42.83 ± 31.20 vs. 43.63 ± 31.55 μV, P = 0.020); Dark-adapted 3.0 a-wave amplitude (110.19 ± 121.42 vs. 112.75 ± 122.92 μV, P = 0.010) and peak time (19.18 ± 6.05 vs. 16.86 ± 5.59 ms, P = 0.010); Dark-adapted 3.0 b-wave amplitude (106.25 ± 74.79 vs. 110.81 ± 76.93 μV, P = 0.010) and peak time (45.75 ± 5.75 vs. 45.27 ± 5.85 ms, P = 0.010); Dark-adapted OPs total amplitude (184.53 ± 74.97 vs. 186.07 ± 75.28 μV, P = 0.010) and O₂ peak time (43.01 ± 9.47 vs. 39.34 ± 9.93 ms, P = 0.010); Light-adapted 3.0 a-wave amplitude (29.44 ± 29.56 vs. 32.32 ± 29.12 μV, P = 0.010) and peak time (20.62 ± 8.04 vs. 18.86 ± 7.37 ms, P = 0.010); Light-adapted 3.0 b-wave amplitude (63.75 ± 50.02 vs. 65.35 ± 50.05 μV, P = 0.010) and peak time (39.76 ± 14.63 vs. 37.47 ± 14.48 ms, P = 0.010); Light-adapted 30 Hz flicker amplitude (61.40 ± 55.93 vs. 62.80 ± 55.87 μV, P = 0.001). For VEP, in the 6 patients (11 eyes) with BCVA >20/200, only the 15′ PVEP P100 peak time showed a statistically significant change (132.78 ± 14.69 vs. 132.49 ± 14.62 ms, P = 0.018); other PVEP parameters and all FVEP parameters in the 7 patients (13 eyes) with BCVA <20/200 were not significantly different.

**Clinical Implications:** This preliminary study suggests that short-term HRW consumption may slightly improve visual function (BCVA and some ERG parameters) in RP patients without adversely affecting IOP or retinal/choroidal structure. The improvements were modest and mainly in cone-system ERG responses, possibly because rod function was already severely compromised. The lack of change in VEP parameters indicates no significant effect on the overall visual pathway. The study is limited by small sample size, short duration, lack of a control group, and no dietary assessment. These findings support the need for larger, longer, controlled trials to validate HRW as a potential adjunctive therapy for RP. The safety and feasibility of HRW are reinforced, but its clinical benefit remains uncertain.

PICO

PPOPULATION

13 patients (24 eyes) with primary retinitis pigmentosa, aged 27–65 years, BCVA ≥20/2000, no other ocular or systemic diseases

IINTERVENTION

Hydrogen-rich water (HRW) 400–500 ml twice daily for 4 weeks (H₂ concentration 1.6 mg/L)

OOUTCOME

Best corrected visual acuity (BCVA), intraocular pressure (IOP), retinal and choroidal thickness (OCT), electroretinogram (ERG) amplitudes and peak times, pattern visual evoked potentials (PVEP) and flash visual evoked potentials (FVEP) parameters

STUDY TYPE

other

SPECIALTY

ophthalmology

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100% · A

ORIGINAL PAPER

PMC10582286

The clinical research on the effect of hydrogen-rich water on primary retinitis pigmentosa

Heliyon

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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.

CITATION EXPORT

Xiaohong Chen, Yanjian Chen, Xingchui Lin et al.. The clinical research on the effect of hydrogen-rich water on primary retinitis pigmentosa. Heliyon. (2023). https://doi.org/10.1016/j.heliyon.2023.e20671

AUTHORS

8 · 1 CENTRES

Xiaohong Chen, Yanjian Chen, Xingchui Lin, Qian Ye, Sheng Zhang, Yunpeng Wang, Meizhu Chen, Weiming Yan

Department of Ophthalmology, Fuzong Clinical Medical College of Fujian Medical University (900th Hospital of Joint Logistic Support Force of PLA, Dongfang Hospital Affiliated to Xiamen University), 350025, Fuzhou, China