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

Eye and Vision 2019年第1期6卷 164-174页

作者： Jianhua Wang Craig Brown Ce Shi Justin Townsend giovana rosa gameiro Peng Wang Hong Jiang Bascom Palmer Eye Institute University of MiamiMiller School of Medicine1638 NW 10th AvenueMcKnight Building-Room 202AMiamiFL 33136USA Department of Ophthalmology College of MedicineUniversity of Arkansas for Medical SciencesFayettevilleARUSA School of Ophthalmology and Optometry Wenzhou Medical UniversityWenzhouZhejiangChina Department of Ophthalmology Shanghai General HospitalShanghai Jiaotong University School of MedicineShanghaiChina

Background:Homocysteine and vitamin D may play a role in the development of diabetic and hypertensive retinopathy in patients with diabetes mellitus(DM)and *** 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 *** presentation:Seven patients had nonproliferative diabetic retinopathy(NPDR)and some of them had *** patient had only hypertensive *** patients were instructed to take Ocufolin^(TM)medical food as a food *** genetic testing for MTHFR polymorphisms was *** photography was used to document the fundus condition of the enrolled eyes in 8 NPDR patients at the initial and follow-up ***(MA)and exudates were observed to be improved in some trial *** subjects had one or more MTHFR *** had diabetic retinopathy,hypertensive retinopathy,or *** were resolved,and exudates were decreased in 8/8 cases after taking the medical *** edema was found in 2/8 cases and improved or resolved in both cases after taking the medical food or the *** best corrected visual activity was stable or improved in 8/8 ***: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 *** appears that the use of nutritional supplements and medical foods containin

关键词： Diabetes Homocysteine L-methylfolate Microaneurysms MTHFR C677T Retinopathy Vitamin D

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Retinal tissue hypoperfusion in patients with clinical Alzheimer’s disease

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Eye and Vision 2018年第1期5卷 196-203页

作者： giovana rosa gameiro Hong Jiang Yi Liu Yuqing Deng Xiaoyan Sun Bernardo Nascentes Bernard Baumel Tatjana Rundek Jianhua Wang Department of Ophthalmology Bascom Palmer Eye InstituteUniversity of Miami Miller School of Medicine1638 NW 10th AvenueMcKnight Building-Room 202AMiamiFL 33136USA Evelyn F.McKnight Brain Institute Department of NeurologyUniversity of Miami Miller School of MedicineMiamiFLUSA Department of Ophthalmology Third Affiliated Hospital of Nanjing University of Chinese MedicineNanjingChina State Key Laboratory of Ophthalmology Zhongshan Ophthalmic CenterSun Yat-sen UniversityGuangzhouGuangdongChina School of Nursing and Health Studies University of MiamiMiamiFLUSA

Background:It remains unknow whether retinal tissue perfusion occurs in patients with Alzheimer’s *** goal was to determine retinal tissue perfusion in patients with clinical Alzheimer’s disease(CAD).Methods:Twenty-four CAD patients and 19 cognitively normal(CN)age-matched controls were recruited.A retinal function imager(RFI,Optical Imaging Ltd.,Rehovot,Israel)was used to measure the retinal blood flow supplying the macular area of a diameter of 2.5 mm centered on the *** flow volumes of arterioles(entering the macular region)and venules(exiting the macular region)of the supplied area were *** blood flow was calculated as the average of arteriolar and venular flow *** ultra-high-resolution optical coherence tomography(UHR–OCT)was used to calculate macular tissue *** segmentation software(Orion,Voxeleron LLC,Pleasanton,CA)was used to segment six intra-retinal layers in the 2.5 mm(diameter)area centered on the *** inner retina(containing vessel network),including retinal nerve fiber layer(RNFL),ganglion cell-inner plexiform layer(GCIPL),inner nuclear layer(INL)and outer plexiform layer(OPL),was segmented and tissue volume was *** was calculated as the flow divided by the tissue ***:The tissue perfusion in CAD patients was 2.58±0.79 nl/s/mm^(3)(mean±standard deviation)and was significantly lower than in CN subjects(3.62±0.44 nl/s/mm^(3),P<0.01),reflecting a decrease of 29%.The flow volume was 2.82±0.92 nl/s in CAD patients,which was 31%lower than in CN subjects(4.09±0.46 nl/s,P<0.01).GCIPL tissue volume was 0.47±0.04 mm^(3) in CAD patients and 6%lower than CN subjects(0.50±0.05 mm^(3),P<0.05).No other significant alterations were found in the intra-retinal layers between CAD and CN ***:This study is the first to show decreased retinal tissue perfusion that may be indicative of diminished tissue metabolic activity in patients with clinical Alzheimer’s disease.

关键词： Clinical Alzheimer’s disease Retinal tissue perfusion Blood flow Retinal tissue volume Hypoperfusion Retinal function imager Optical coherence tomography

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Microcirculation in the conjunctiva and retina in healthy subjects

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Eye and Vision 2019年第1期6卷 81-86页

作者： Ce Shi Hong Jiang giovana rosa gameiro Jianhua Wang School of Ophthalmology and Optometry Wenzhou Medical UniversityWenzhouZhejiangChina Bascom Palmer Eye Institute University of MiamiMiller School of Medicine1638 NW 10th AvenueMcKnight Building-Room 202AMiamiFL 33136USA

Background:The aim was to determine the relationship between bulbar conjunctival microcirculation and retinal microcirculation in a healthy ***:A functional slit-lamp biomicroscope(FSLB)was used to measure blood flow velocity(BFV)and blood flow rate(BFR)in the conjunctiva while a retinal function imager(RFI)was used to measure macular BFV and BFR in the *** eye of each subject of 58 self-reported healthy subjects was imaged in the same session on the same ***:The mean BFV in the venules of the conjunctiva was 0.49±0.13 mm/s,which was significantly slower than that in the retinal arterioles(3.71±0.78 mm/s,P0.05).Conclusion:The microcirculation in the retina appeared to be different from that in the conjunctiva.

关键词： Variability Bulbar conjunctiva Blood flow velocity Microvascular network Functional slit-lamp biomicroscopy(FSLB) Hemodynamics Microcirculation Retina Conjunctiva Retinal function imager

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Quantitative analysis of conjunctival microvasculature imaged using optical coherence tomography angiography

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Eye and Vision 2019年第1期6卷 32-40页

作者： Zhiping Liu Hua Wang Hong Jiang giovana rosa gameiro Jianhua Wang Ophthalmic Center the Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongChina Department of Ophthalmology Bascom Palmer Eye InstituteUniversity of Miami Miller School of Medicine1638 NW 10th AvenueMcKnight Building-Room 202AMiamiFL 33136USA. Department of Ophthalmology Xiangya HospitalCentral South UniversityChangshaHunanChina

Background:The goal was to quantitatively analyze the bulbar conjunctival microvascular density using optical coherence tomography angiography(OCTA)and compare it to the vessel density using functional slit-lamp biomicroscopy(FSLB).Methods:Temporal bulbar conjunctiva of 20 eyes(10 healthy subjects)was imaged using both OCTA and *** processing was performed including equalization,de-noising,thresholding,and *** vessel density was measured by fractal analysis(box counting,Dbox)and pixel counting(%).Results:Vessel density(Dbox)of the bulbar conjunctiva obtained using OCTA was 1.28±0.01 Dbox,which was significantly lower than the result(1.32±0.01 Dbox,P0.05)between both instruments were found in both vessel density methods(Dbox and percentage).However,in each of the devices,vessel density in Dbox was significantly correlated with the vessel density in percentage(r=1.0 for FSLB and r=0.98 for OCTA,both P<0.001).Conclusion:This study demonstrated that the vessel density of the bulbar conjunctiva obtained using OCTA can be quantified,and the results were not compatible with that obtained using slit-lamp biomicroscopy photography.

关键词： Conjunctival microvasculature Optical coherence tomography angiography(OCTA) Functional slit lamp bio-microscopy(FSLB) Anterior segment

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