Improved Retinal Microcirculation in Mild Diabetic Retinopathy Patients Carrying MTHFR Polymorphisms Who Received the Medical Food, Ocufolin®
Zhiping Liu, Hong Jiang, Justin H. Townsend, Jianhua Wang
Abstract
Purpose: To evaluate the effects of Ocufolin ® on retinal microcirculation in patients with mild diabetic retinopathy carrying MTHFR polymorphisms. Methods: In a prospective, case-controlled study, eight patients with mild diabetic retinopathy and MTHFR polymorphisms and 15 normal controls (NC) were recruited. MTHFR polymorphisms were subtyped as normal, C677T, or A1298C. Best-corrected visual acuity (BCVA) was evaluated. Retinal blood flow velocity (BFV) was measured using Retinal Function Imager. Retinal tissue perfusion (RTP, blood flow rate per inner retinal volume) was calculated within a 2.5 mm diameter circle centered on the fovea. The eight retinopathy patients received Ocufolin ® for 6 months, and their imaging was performed at baseline, 4 months, and 6 months. The NC group was imaged once. Results: BCVA and vascular indices of DR + PM patients at baseline were below those of NC and improved after Ocufolin ® administration. Compared to baseline, DR + PM patients had significantly improved BCVA during the follow-up period (P < 0.05). RTP and arteriolar BFV were significantly increased at 6 months (P < 0.05), approaching NC. Conclusion: Ocufolin ® may be effective in improving both visual acuity and retinal microcirculation in patients with DR + PM. Further studies with increasing sample size, and longer duration, including cases with severe DR, are needed. Keywords: diabetic retinopathy, homocysteine, l-methylfolate, medical food, MTHFR, Ocufolin ® , retinal tissue perfusion, vessel density