The effect of a specific vitamin supplement containing L-methylfolate (Ocufolin forte) in patients with neovascular age-related macular degeneration

Abstract

Background

Patients with nAMD often have pathologically elevated homocysteine (Hcy) and increased retinal venous pressure (RVP). We tested whether the administration of a specific vitamin preparation containing L-methylfolate (Ocufolin forte) as an addition to anti-VEGF therapy reduces these two risk factors and favorably influences the disease course.

Methods

A total of 27 eyes/27 patients with intra- and subretinal fluid, Hcy above 12 ​μmol/L, RVP of at least 8 ​mm above the IOP, and an IOP between 10 and 20 ​mmHg were included in this study. All eyes received three injections of 0.05 ​ml aflibercept at one-month intervals as clinically indicated. Fifteen patients additionally received one capsule of Ocufolin forte per day (Ocufolin group, OG), and the other twelve patients served as a control group (control group, CG). The following factors were measured before therapy and four months later: blood Hcy, best-corrected visual acuity (BCVA), intra-ocular pressure (IOP), RVP, optical coherence tomography (OCT), and optical coherence tomography - angiography (OCTA).

Results

Hcy decreased on average by 5.58 ​μmol/L in the OG and by 0.57 ​μmol/L in the CG. The RVP decreased on average by 4.60 ​mmHg in the OG and by 0.75 ​mmHg in the CG. The difference between the two groups was significant for both parameters (P ​<0.001); 66% of the OG and 41% of the CG had no retinal fluid at the end of the study. After the completion of the study, the injection intervals could be extended more often in the OG patients than in the CG patients.

Conclusions

When Ocufolin forte was added to the standard therapy, RVP and Hcy were reduced to a significantly greater extent than without Ocufolin forte. In addition, Ocufolin had a positive influence on morphology and future treatment intervals with anti-VEGF therapy.