World Journal of Pharmaceutical Sciences ISSN (Print): 2321-3310; ISSN (Online): 2321-3086 Published by Atom and Cell Publishers © All Rights Reserved Available online at: http://www.wjpsonline.org/ Review Article

Phytochemical Review on

Pasumarthy N.V. Gopal1*, Shaik Shaheda Sultana2, Grandhi Surendra3, Anjana Male2, and Srinivasa Rao Vandavasi4

1Department of Pharmaceutical Biotechnology, Hindu College of Pharmacy, Guntur, Andhra Pradesh- 522002, India. 2Nirmala College of Pharmacy, Atmakuru (V), Mangalagiri-522503, Andhra Pradesh, India. 3Department of Pharmaceutical Chemistry, Hindu College of Pharmacy, Guntur, Andhra Pradesh- 522002, India. 4 Senior Operations Specialist, Quintiles Research Pvt Ltd, Banglore, India.

Received: 08-08-2016 / Revised: 22-09-2016 / Accepted: 25-09-2016 / Published: 30-09-2016

ABSTRACT

Human eye is one of the most sensitive organs of and is permanently exposed to different environmental agents. Common disease of human eye includes , cataract, ocular allergies, and inflammation, etc. Herbal drugs are the main stay for the treatment of ocular diseases in the recent past in view of the side effects of allopathic drugs. Main cause of blindness in the world is cataract among which 50% of cases are even in both developed and developing countries. Cataract is an ocular disorder which is very often treated by means of low cost and safe surgical procedure. This review helps in brief description of literature related different plant materials that helps in the treatment of cataract without surgery.

Keywords: Human eye, ocular diseases, Cataract, treatment, surgery and phytochemical remedy.

INTRODUCTION  Life style: Sometimes the eyes suffer the Human eyes are very delicate organs that require results of negative habits of conduct. constant care to keep them in good health [1].  Excessive reading in low light, smoking, the Cataract is a disturbance of transparency long-term use of steroids and other which is eventually causing in medications humans. It is one of the leading cause of blindness  Inadequate environmental situations: worldwide, which accounts for approximately 42% Working in environments surrounded by of all blindness. More than 17 million people are smoke, pollutants, dust, chlorine in swimming blind because of cataract, and 28000 new cases are pools, strong light contrasts, etc can cause reported daily worldwide. Approximately 25% of aggression to your eyes, being the cause of the populations over 65and about 50% over 80 many cases of conjunctivitis. [2] have serious loss of vision because of cataract .  Inadequate food: Poor eye health is due to poor diet. It has already been proved that Etiology for cataract: Main causes that determine thiamin (Vitamin B1) deficiency is mainly [3] eye diseases are : responsible for hypermetropia, or  Body diseases: Apart from the diseases of the which keep eyes muscles in good eyes, the body has lot diseases that reflect state. Night blindness is an example which is themselves in the health of eyes. produced by a deficiency of vitamin A.  Metabolic diseases - , obesity, digestive diseases , disorders of the liver, Types of cataract: [4, 5] stomach diseases, infections, circulatory Nuclear . Aging is the main reason problems, kidney disorders, allergic reactions, which causes the cataract of les nucleus and radiation therapy etc. symptoms include-  Emotional disorders: nervous or emotional  Hazy distance in vision and increase in problems, such as depression or stress, glare. manifest themselves in the eyes.

*Corresponding Author Address: Dr. Pasumarthy N V Gopal, Department of Pharmaceutical Biotechnology, Hindu College of Pharmacy, Guntur, Andhra Pradesh- 522002, India; Email: [email protected] Gopal et al., World J Pharm Sci 2016; 4(10): 73-80  Progressive nearsightedness and the need  Poor vision may also be caused due to an for frequent changes in eyeglass. increased risk of falling and depression.  Increased sensitivity to glare Cortical Cataracts. These usually start on the  Double vision in the affected eye outside of the cortex part of eye:  A need for frequent changes in  Which have very little initial effect on prescription glasses vision.  Cataracts are the cause of half of blindness  Glare can developed as these cataracts and 33% of visual impairment worldwide. increase and approach the center of the  Images may take on a yellowish tint as eye lens. color vibrancy diminishes.  Problems with distance vision, contrast sensitivity, and clarity may be occurred as Diagnosis: [9] result of progression in cataract. 1. Visual acuity test. 2. Slit lamp exam. Posterior Sub capsular Cataracts: Posterior sub 3. Glare and contrast sensitivity test. capsular cataracts typically start near the center of 4. Contrast sensitivity test. the back part of the capsule surrounding the lens of 5. Ishihara color test. eye which often advance rapidly. For many 6. Tonometry test. patients, major impairment of eyesight, including near-vision problems and glare develops within CATARACT TREATMENT AVAILABLE several months. OTHER THAN NATURAL SOURCE:

Senile Cataract: This type of cataract is caused SYNTHETIC DRUGS: [10-19] due to the opacity of the eye lens by natural ageing 1. Aldose reductase inhibitors: Isoflavone process elderly persons, mostly those over the age genistein, Quercetrin-2-acetate, Quercetin, of 60 years. rutin, Hesperidin, Hesperidin chalcone and Naringin Traumatic Cataract This cataract is caused due to 2. NSAIDS: Sulindac, Aspirin, Naproxen, some physical damage to the eye lens capsule, such Nepafenac , Benzsadac as that due to the entry of a foreign object and it is 3. Statin Drugs: Fidarestat, Kinostat, seen in people working in hazardous conditions Alrestatin, Imrestat, Ponalrestat, such as welders and those in glass furnaces. Epalrestat, Zenarestat, Minalrestat, Lidorestat, Complicated Cataract: This type of cataract is the 4. Antioxidants: Lutein, Zeaxanthin, complication of some other chronic disease in the Caratenoids, Bilberry Extract, Alpha person with asthma, Diabetes, Emphysema, etc. lipoic acid 5. Cyclopegics : This cataract is caused in 6. Corticosteroids infants if the mother had contracted German measles during pregnancy. SURGERIES: [20] 1. Phacoemulsification Toxic Cataracts: This cataract is caused due to 2. Extra capsular cataract extraction (ECCE) long term use of medicines or chemicals that are 3. Intracapsular cataract extraction (ICCE) toxic to the eyes and observed in people using eye 4. Manual small incision cataract surgery (MSICS) drops containing prednisone and cortisone for a 5. Cryoextraction long time and also in smokers as they inhale toxic fumes which affect the eye lens. ANIMAL MODELS USED FOR SCREENING OF CATARACT: [21, 22, 23] Radiation cataracts can form after a person Types of animal models: undergoes radiation treatment for cancer. In-vivo models:  Selenite induced cataract Signs and sympto-after a person undergoes  induced cataract [6, 7, 8] radiation treatments:  Streptozocin cataract  Faded colors, blurry vision, halos around  Naphthalene induced cataract light,  Sugar induced lens opacity model.  Trouble with bright lights and trouble seeing at night. In-vitro models:  This may be due to result in trouble  Selenite induced cataract in incubated rat driving, reading, or recognizing faces. lenses. 74

Gopal et al., World J Pharm Sci 2016; 4(10): 73-80  Hydrogen peroxide induced cataract in  Calcium induced cataract in incubated incubated lenses. lenses.  Steroid induced cataract in incubated  Xylose induced lens model lenses  Naphthalene induced cataract in incubated lenses.

PHYTO-CHEMICALS USED IN CATARACT Plant part Biological source Family Animal model Usage used Adhatoda vasica Acanthaceae Selenite- Inhibited the aldose reductase (L.) (Adusa) [22] Flower induced cataract considerably and exhibited anti- Model cataract activity Aegle marmelos Rutaceae Sugar-induced Possess significant anti-cataract (L.) Correa (Bael) Leaf lens model potential to maintain lens opacity [23] as compared to induced lens opacity in bovine lens model Alangium lamarckii Alangiaceae Selenite- Exhibit significant inhibitory Root Thwaits (Akol) [24] induced cataract effects on AR in the rat lens in bark Model vitro Spathodea Bignoniaceae Selenite- Elicited Cataract campanulata[25] Flower bud induced cataract Model Aster koraiensis Asteraceae Streptozocin- Delay the progression of lens Nakai (Korean Aerial induced cataract opacification in the diabetic rats starwort) [26] parts model during the early diabetic cataractogenesis. Azadirachta indica Meliaceae Whole Galactose- Possesses a significant anti- A. Juss. (Neem) [27] plant induced lens cataract activity in vitro model Biophytum Oxalidaceae Selenite- Exhibited anti cataract activity sensitivum (L.) [22] Leaf induced cataract Model Brassica oleracea Brassicaceae Selenite- Prevent Selenite cataract var. italica Flower induced cataract (Cabbage) [28] Model Brassica juncea Brassicaceae Galactose- Effective against hyperglycemia- (L.)Czern. induced sugar induced oxidative and osmotic Leaf (Mustard) [29] cataracts stress as well as the subsequent development of diabetic cataract. Brickellia arguta B. Asteraceae Galactose- Diabetic cataractogenesis L. Rob. (Pungent Leaf induced sugar prevention brickellbush) [30] cataracts Caesalpinia bonduc Caesalpiniaceae Sugar-induced Inhibited the aldose reductase (L.) (Gray nicker Leaf lens model considerably and exhibited anti- bean) [31] cataract activit Camellia sinensis Commelinaceae Selenite- Possess significant anticataract (L.) Kuntze (Green Inflorese induced cataract potential and acts primarily by tea) [13] nces Model preserving the antioxidant defense system Catharanthus Apocynaceae Galactose- Possess significant anti-cataract roseus L. (Rose Whole induced sugar potential to maintain lens opacity Periwinkle) [23] plant cataracts as compared to glucose induced lens opacity in bovine lens model. Cassia fistula (L.) Fabeaceae Selenite- Inhibited the aldose reductase (Golden shower induced cataract considerably and exhibited anti- Leaf tree) [22] Model cataract activity

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Gopal et al., World J Pharm Sci 2016; 4(10): 73-80 Ceasalpinia digyna Caesalpiniaceae Selenite- Significant inhibitory effects on Rottler (Teri pod) Root induced cataract AR in the rat lens [24] Model Dehydrocorydaline Fumariaceae Galactose- Inhibited aldose reductase in Corydalis induced sugar turtschaninovii Tuber cataracts Besser (Corydalis tuber) [31] Crataegus Rosaceae Selenite- Prevention and treatment of pinnatifida Bunge Leaf induced cataract cataracts (Hawthorn tree) [32] Model Curcumin in Zingiberaceae Selenite- Possesses a significant Rhizome Curcuma longa induced cataract anticataract activity

Linn. (Turmeric) [33] Model Flavonoids in Asteraceae Selenite- Modulated lens opacification and Emilia sonchifolia induced cataract oxidative stress in selenite- Leaf (L.) DC Model induced cataract (Sadamandi) [34] C-glycosidic Gentianaceae Selenite- Inhibited Cataract Flavonoids induced cataract in Enicostemma Aerial model hyssopifolium parts (Willd.) Verd. (Indian gentian) [35] Conduritol A in Apocynaceae Sugar induced Possesses a significant anti Aerial Gymnema sylvestre cataract model cataract activity in -vitro parts [35] Flavonoids in Asteraceae Aerial Glucose induced Inhibited Cataract Eclipta alba [35] parts cataract model Flavonoids in Menispermacea Glucose induced Possess significant anti-cataract Aerial Tinospora e cataract model potential to maintain lens opacity parts cordifolia [35] Erythrina stricta Fabaceae Naphthalene Inhibited Cataract Roxb. (Tiger claw) Leaf induced [36] cataractogenesis Eucalyptus Myrtaceae Selenite- Prevention of cataracts deglupta Blume induced cataract Leaf (Rainbow model Eucalyptus) [30] Eugenia Myrtaceae Galactose- Prevention of cataracts borinquensis [30] Leaf induced sugar cataracts Eugenia jambolana Myrtaceae Galactose- Prevention of Diabetic cataracts Leaf (Jambu) [37] induced sugar

cataracts Anti-oxidants in Moraceae 'Sugar induced Possess significant anti-cataract Ficus golmerata L. Whole lens opacity potential (Cluster Fig Tree) palnt model' [23] Anti-oxidants in Ginkgoaceae Selenite- Protects the rat lens from Ginkgo biloba L. Leaf induced cataract radiation-induced cataracts. (Maidenhair Tree) model [38] Anti-oxidants in Apiaceae Selenite- Reduced cataract progression Hydrocotyl bonariensis induced cataract Lam [39] model (Pennywort) Leaf

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Gopal et al., World J Pharm Sci 2016; 4(10): 73-80 Mangifera indica Anacardiaceae Bark, Selenite- Cataractogenesis prevention L. (Mango) [40] Leaf induced cataract model Scopoletin in Magnoliaceae Galactose- Useful treatment for sugar Magnolia fargesii induced sugar cataracts Flower (Finet & Gagnep.) cataracts buds W. C. Cheng (Beaver Tree) [41] Momordica Cucurbitaceae Streptozocin- Useful for treatment of sugar charantia Linn. Fruit induced cataract cataracts (Bitter Gourd) [42] model Ocimum sanctum Labiatae 'Sugar induced Possess significant anti-cataract Leaf Linn (Tulsi) [43] lens opacity potential

model Luteolin-7-O-beta- Campanulaceae Selenite- Inhibitory activity on the D: - induced cataract formation of advanced glycation glucopyranoside in model end products and rat lens aldose Platycodon Flower reductase. grandiflorum (Jacq.) A.DC. (Balloon flower) [44] Pterocarpus Fabaceae Streptozocin- Decreased opacity index in the marsupium Roxb. induced cataract Alloxan induced diabetic rats Bark (Indian kino) [45] model

Silymarin in Asteraceae Galactose Silymarin treated group all stage of Silybum marianum Seed Induced cataract development were (L.) Gaertn. Cataract model significantly delayed as compared to (Silymarin) [46] control group Syzygium Myrtaceae Selenite- Prevention of cataracts malaccense (L.) induced cataract Leaf Merr. (Malay model Apple) [30] Lutein in Tagetes Asteraceae Selenite- Prevention of cataracts erecta L. (Marigold Flower induced cataract flower) [47] model Tamarindus indica Fabaceae Leaf, Selenite- Prevention of cataracts L. (Indian Date) [48] flower, induced cataract fruit model Tinospora Menispermacea 'Sugar induced Delaying cataract in STZ-induced Stem, cordifolia Willd. e lens opacity diabetic rats root, (Guduchi) [23] model' Flower

Trigonella foenum- Fabaceae Selenite- Protects against Selenite-induced graecum Seeds induced cataract oxidative stress (Fenugreek) [49] model Tylophora indica Asclepiadaceae Selenite- Prevention of cataract R.Br. (Indian Whole induced cataract Ipecac) [50] plant model

Vaccinium Ericaceae Selenite- Preventive medical treatment of myrtillus L. induced cataract Senile cataract Leaf (Bilberry) [51] model

Vitex nugundo L. Verbenaceae Selenite- Posseses cataract activity (Nirgundi) [52] induced cataract Leaf model

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Gopal et al., World J Pharm Sci 2016; 4(10): 73-80 Procyanidin in Vitaceae Selenite- Prevents cataract formation in Vitis vinifera L. Seed induced cataract hereditary cataractous (Grapes) [53] model Withania Solanaceae Selenite- Inhibited Selenite Cataract Leaf Somnifera Linn. induced cataract

(Ashwagandha) [27] model Zingiber officinalis Zigiberaceae Streptozocin- Delay of diabetic cataract Roscoe. (Ginger) Rhizome induced cataract [54] model Cineraria maritime Compositae Selenite- Prevention of Selenite-induced Whole [55] induced cataract cataractogenesis plant model Drevogenin D in Apocynaceae Selenite- Protection against selenite Dregea volubilis Leaf induced cataract cataract [56] model Aralia Araliaceae Selenite- Prevents cataractogenesis Whole Elata [57] induced cataract plant model Triphala [58] Phyllanthaceae Selenite- Possesses anti cataract activity Whole induced cataract plant model 3,5-Di-O- Asteraceae Selenite- Inhibits protein glycation, caffeoylepi- quinic leaves and induced cataract aldose reductase, and acid in Erigeron stems model cataractogenesis annuus [59] Puerariafuran in Legumenaceae Xylose induced Possesses anti cataract activity Roots Pueraria lobata [60] lens model Acorus calamus Acoraceae Hydrogen Possesses anti cataract activity Linn [61] peroxide Root induced cataract model Embelica offcinalis Phyllanthaceae Selenite- Possesses anti cataract activity Fruit, [62] induced cataract seed model Allium sativum[63] Amaryllidaceae Streptozocin Delaying cataract in STZ-induced Bulb induced cataract diabetic rats model Moringa oleifera Moringaceae Selenite- Prevents Selenite-induced [64] Leaf induced cataract cataractogenesis in rat pups model Furanocoumarins in Umbeliferaceae Selenite- Prevents Selenite-induced Angelica dahurica Root induced cataract cataractogenesis [65] model

PREVENTION OF CATARACTS: DISCUSSION To reduce your risk of developing cataracts: Cataract is a multi-factorial disease process and is  Protect your eyes from UVB rays by induced by various toxic factors, environmental wearing sunglasses outside. stresses, and gene mutations. Based on literature  Have regular eye exams. assessment from the earlier studies plant products  Stop smoking. can be used for rectifying the damage caused by the  Maintain a proper diet. free radicals, which can be able to reduce the  Antioxidants. requirement of surgery for treating cataract. In the  Maintain a healthy weight. last few years researchers are trying to find out the phyto-constituents have been proved to reduce the  Keep diabetes and other medical cataractogenesis or delay in the formation of conditions in check. cataract. Many studies shows that Flavonoids ,  Avoid looking directly at the sun. Furanocoumarins, Quinic acid and some of the  Avoid stress. alkaloids like Silymarin, Scopoletin, are found to  Try to avoid toxins, as alcohol or tobacco. have the anti-oxidant activity which prevents the 78

Gopal et al., World J Pharm Sci 2016; 4(10): 73-80 generation of free radicals or free oxygen screening anti cataract drugs as well as precautions, molecules, thereby reduces the cataractogenesis or etiology of the cataract. So far no single compound delays the onset of cataract. has found widespread acceptance for the eye disorders like cataract, ocular glaucoma and CONCLUSION stressed conditions of eye. Hence, there is a need From the study we conclude that cataract can be for further research in the area of treated from the available phyto constituents which phytopharmaceuticals in the treatment of cataract. can alter the surgery. This review also provides the data based on cataract induced model available for

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