The Use of Vitamins and Coenzyme Q10 for the Treatment of Vascular Occlusion Diseases Affecting the Retina.

Nutritional supplementation with antioxidants and vitamins is widely recommended in the treatment of vascular disorders affecting the retina, although there is insufficient evidence on its effectiveness. The vitamin-like compound coenzyme Q10 (CoQ10) is a nutritional supplement of current interest to treat neurodegenerative diseases. Here, we report a retrospective clinical case series study of 48 patients diagnosed with retinal vascular diseases, including non-arteritic ischemic optic neuropathy (NAION), retinal artery occlusion (RAO), and homonymous hemianopia or quadrantanopia following stroke, treated with oral supplementation with CoQ10 (100 mg per day) and vitamins. Patient follow-up was performed using the Humphrey field analyzer and 30-2 testing algorithm to determine the visual field index (VFI) and progression rates. All treated patients showed positive VFI progression rates per year: +11.5 ± 15% for NAION patients (n = 18), +22 ± 17% for RAO patients (n = 7), +9.3 ± 10.5% for hemianopia/quadrantanopia patients (n = 10), and +11 ± 21% for patients with other conditions (n = 13). The interruption of CoQ10 supplementation in one patient resulted in a pronounced decrease of the VFI, which was partially recovered when treatment was restored. This study supports the role of CoQ10 as a nutritional therapeutic agent for vascular diseases affecting the retina. Owing to decreased VFI after interruption of CoQ10, its beneficial effects may be reversible.

Association study of high-frequency variants of MTHFR gene with retinal vein occlusion in a Spanish population.

Background: To study the association of the most common methylenetetrahydrofolate reductase (MTHFR) genetic polymorphisms C677T and A1298C with retinal vein occlusion (RVO) in a Spanish population. Methods: Case-control study involving 359 subjects, 183 unrelated native Spanish patients diagnosed with RVO, distributed in central or branch RVO, and 176 healthy controls. Two SNPs located in the gene MTHFR, C677T (rs1801133) and A1298C (rs1801131) were analyzed by DNA sequencing and TaqMan assays. Results: A high prevalence of the MTHFR variants T and C of the SNP C677T and A1298C, respectively, was observed in our population. Specifically, 88.07% of controls and 85.25% of RVO patients have at least one of these variants. However, the prevalence of these variants was not significantly different when comparing RVO patients and controls. The variant T of C677T was identified in 60.65% of RVO patients and 59.10% of control subjects, while the variant C of A1298C was present in 46.45% of RVO patients and 51.14% of controls. No association of dyslipidemia, diabetes mellitus, glaucoma, thyroid disease and renal disease with RVO was observed, while hypertension was significantly higher in the RVO patients (p < .0001). Conclusions: The MTHFR variants, T of C677T and C of A1298C, did not significantly increase the risk of suffering RVO in a Spanish population and therefore additional risk factors are contributing to the onset of the disease.

Long-term Results of Corneal Cross-linking for Terrien's Marginal Degeneration.

PURPOSE: To report the long-term clinical outcomes of a patient with Terrien's marginal degeneration who underwent successful peripheral corneal cross-linking (CXL) to arrest progression. METHODS: Clinical assessment included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), corneal topography, anterior segment optical coherence tomography, ultrasonic pachymetry, corneal hysteresis, and corneal resistance factor. Eccentric epithelium-off CXL was performed in both eyes after limbal conjunctival resection. Following the Dresden protocol, fluence irradiation was set at 5.4 J/cm2, using 3 mW/cm2 for a total exposure time of 30 minutes. RESULTS: Nine years of postoperative follow-up showed significant bilateral improvement in visual acuity, refraction, and corneal topography with no signs of progression of Terrien's marginal degeneration. In the right eye, UDVA improved from 0.05 to 0.3 decimal and CDVA from 0.8 to 1.2 decimal, cylinder was reduced from -14.00 to -3.00 diopters (D), simulated keratometry improved from 10.50 to 3.70 D, and the thinnest point on pachymetry remained almost unchanged (from 483 to 469 µm). In the left eye, UDVA improved from 0.1 to 0.2 decimal and CDVA remained unchanged at 1.2 decimal, cylinder was reduced from -6.00 to -2.75 D, simulated keratometry improved from 5.60 to 3.30 D, and the thinnest point on pachymetry remained stable at 486 µm. CONCLUSIONS: Eccentric peripheral CXL can be a safe, noninvasive alternative therapeutic approach for the management of Terrien's marginal degeneration with peripheral thinning. [J Refract Surg. 2018;34(6):424-429.].