Efficacy and safety of vitamin supplements with resveratrol in diabetic macular edema: Long-term results of a comparative study.

PURPOSE: To investigate the adjunct efficacy and safety of vitamin supplements, including resveratrol, in patients with diabetic macular edema (DME) treated with intravitreal anti-vascular endothelial factor (anti-VEGF) agents. METHODS: Participants in this prospective study were 45 patients with DME, who were treated with either intravitreal anti-VEGF injections (n = 23, Group I) or with combination of intravitreal anti-VEGF injections and vitamin supplements, including resveratrol (n = 22, Group II). All patients underwent visual acuity measurement, slit-lamp examination and spectral domain-optical coherence tomography (SD-OCT) at baseline and monthly after the loading phase of three-monthly anti-VEGF injections, following a PRN protocol. RESULTS: There was a statistically significant improvement in visual acuity in both groups at month 12 compared to baseline, although the mean change in visual acuity did not differ between the two groups (p = 0.183). Accordingly, there was a statistically significant decrease in central retinal thickness in both groups at month 12 compared to baseline, while the mean difference in central retinal thickness was significantly greater in the "combination" group. The mean number of intravitreal anti-VEGF injection was less in Group II (6.45 ± 1.12 in Group II vs. 7.39 ± 1.31 in Group I, p = 0.018). CONCLUSIONS: Vitamin supplements with resveratrol was found to be an effective adjunct to intravitreal anti-VEGF injections in patients with DME, offering better anatomic restoration with less injections at the 12-month follow-up.

Retinal microcirculation in association with caffeinated and alcoholic drinks in subjects at increased cardiovascular risk.

OBJECTIVES: The association of caffeinated and alcoholic drinks with microcirculation is poorly investigated. The aim of the study was to investigate the associations of daily consumption of caffeinated and alcoholic drinks with retinal vessel calibers. METHODS: In consecutive adults at increased risk but free of CVD and diabetes mellitus, (n=181, age: 51.32±12.42 y, 51.4% women), we determined CRAE, CRVE and AVR, respectively. Daily consumption of caffeinated and alcoholic drinks was assessed through 24 h recalls. RESULTS: After adjustment for potential confounders: (i) caffeine was positively associated with CRVE (b=0.177, P=.006 for left, b=0.208, P=.002 for right eye, respectively) (ii) decaffeinated coffee was positively associated with CRAE (b=0.141, P=.035 for left eye) and negatively associated with CRVE (b=-0.234, P<.001 for left, b=-0.189, P=.006 for right eye, respectively). Regular coffee, tea, alcohol, and any type of alcoholic drink did not associate with retinal vessel calibers. CONCLUSIONS: Alcohol and alcoholic drinks' consumption were not associated, while decaffeinated coffee and caffeine consumption were associated in an opposing pattern with retinal vessel calibers. The reason of this controversy merits further investigation.