Improving diabetic and hypertensive retinopathy with a medical food containing L-methylfolate: a preliminary report  

作　　者：Jianhua Wang Craig Brown Ce Shi Justin Townsend Giovana Rosa Gameiro Peng Wang Hong Jiang 

机构地区：[1]Bascom Palmer Eye Institute,University of Miami,Miller School of Medicine,1638 NW 10th Avenue,McKnight Building-Room 202A,Miami,FL 33136,USA [2]Department of Ophthalmology,College of Medicine,University of Arkansas for Medical Sciences,Fayetteville,AR,USA [3]School of Ophthalmology and Optometry,Wenzhou Medical University,Wenzhou,Zhejiang,China [4]Department of Ophthalmology,Shanghai General Hospital,Shanghai Jiaotong University School of Medicine,Shanghai,China

出　　处：《Eye and Vision》2019年第1期164-174,共11页眼视光学杂志（英文）

基　　金：Supported by NIH Center Grant P30 EY014801;grant from Research to Prevent Blindness(RPB).

摘　　要：Background:Homocysteine and vitamin D may play a role in the development of diabetic and hypertensive retinopathy in patients with diabetes mellitus(DM)and hypertension.Supplementing food with L-methylfolate and vitamin D theoretically may improve diabetic and hypertensive retinopathy,however,the outcome of these nutritional approaches has not been fully examined.A retrospective case review was done of cases of retinopathy reversal in patients on Ocufolin^(TM) and a similar nonprescription multivitamin,Eyefolate^(TM).In this study,they were administered L-methylfolate(2.7 mg and 3.0 mg,respectively)and vitamin D3(4500 IU each).These dosages are significantly above the RDA but well below levels associated with toxicity.Case presentation:Seven patients had nonproliferative diabetic retinopathy(NPDR)and some of them had hypertension.One patient had only hypertensive retinopathy.All patients were instructed to take Ocufolin^(TM)medical food as a food supplement.Baseline genetic testing for MTHFR polymorphisms was conducted.Fundus photography was used to document the fundus condition of the enrolled eyes in 8 NPDR patients at the initial and follow-up visits.Microaneurysms(MA)and exudates were observed to be improved in some trial patients.All subjects had one or more MTHFR polymorphisms.All had diabetic retinopathy,hypertensive retinopathy,or both.MAs were resolved,and exudates were decreased in 8/8 cases after taking the medical food.Retinal edema was found in 2/8 cases and improved or resolved in both cases after taking the medical food or the supplement.The best corrected visual activity was stable or improved in 8/8 cases.Conclusion:We report a series of diabetic and hypertensive retinopathy cases with MTHFR polymorphisms and the improvement of retinal microvasculature(mainly MAs)in serial fundus photography after taking a medical food or supplement containing L-methylfolate and vitamin D.It appears that the use of nutritional supplements and medical foods containing L-methylfolate and vitamin D may be effective

关 键 词：Diabetes HOMOCYSTEINE L-methylfolate MICROANEURYSMS MTHFR C677T RETINOPATHY Vitamin D 

分 类 号：R58[医药卫生—内分泌]