Effect of a Fixed Combination of Curcumin, Artemisia, Bromelain, and Black Pepper Oral Administration on Optical Coherence Tomography Angiography Indices in Patients with Diabetic Macular Edema

• Published in: Nutrients Vol. 14; no. 7; p. 1520
• Main Authors: Chiosi, Flavia, Rinaldi, Michele, Campagna, Giuseppe, Manzi, Gianluigi, De Angelis, Vincenzo, Calabrò, Francesco, D’Andrea, Luca, Tranfa, Fausto, Costagliola, Ciro
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 06.04.2022; MDPI
• Subjects: Administration, Oral; Antioxidants; Artemisia; Bromelains; Case-Control Studies; Curcumin - therapeutic use; Diabetes; Diabetes Mellitus - drug therapy; Diabetic retinopathy; Diabetic Retinopathy - diagnostic imaging; Diabetic Retinopathy - drug therapy; Disease; Edema; Fluorescein Angiography - methods; Humans; Inflammation; Macular Edema - drug therapy; Medical imaging; Microaneurysm; Patients; Piper nigrum; Prospective Studies; Retina; Retinal Vessels - diagnostic imaging; Retrospective Studies; Tomography; Tomography, Optical Coherence - methods; Vascular endothelial growth factor; Italy; OCTA; vascular flow density; artemisia; black pepper; diabetic retinopathy; bromelain; curcumin; diabetic macular edema
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu14071520

Background: To investigate the effects of a fixed combination of Curcumin (200 mg), Artemisia (80 mg), Bromelain (80 mg), and Black pepper (2 mg) on vascular parameters in mild to moderate diabetic macular edema (DME). Design: Prospective, case-control study. Methods: Fifty-six patients affected by diabetes mellitus type II were enrolled in the study. Twenty-eight patients with DME received 2 tablets/day, before meals of a dietary complementary supplement containing in fixed combination Curcumin (200 mg), Artemisia (80 mg), Bromelain (80 mg), and Black pepper (2 mg) (Intravit®, OFFHEALTH Spa, Firenze, Italy) for 6 months. Twenty-eight age-matched subjects affected by diabetes mellitus type II were given placebo and served as control group. Patients underwent best correct visual acuity (BCVA), swept optical coherence tomography (OCT), and OCT-Angiography (OCTA). OCTA images of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were obtained for each eye. By the end of the follow-up patients were defined responder to the therapy when a decrease of more than 30 μm was registered in central retinal thickness (CRT) measurement, while a poor responder was determined by the absence of reduction or an increase in central retinal thickness at 6 months. We assessed the foveal avascular zone (FAZ) area, vessel density and quantified the number of microaneurysms in each layer. Results: A significant improvement of BCVA and CRT reduction was recorded at 6 months follow-up in the dietary complementary supplementation group compared to control (respectively p = 0.028 and p = 0.0003). VD of the total capillary plexus, microaneurysms count, glycaemia and HbA1c did not vary over the follow-up period between groups. Within the Intravit® group, poor responders tended to show a larger FAZ area, more microaneurysms, and a lower VD in the DCP compared to the good responders group (p < 0.0001). Conclusions: A fixed combination of Curcumin, Artemisia, Bromelain, and Black pepper oral administration may have a positive impact on central retinal thickness, visual acuity, and VD of the DCP in compensated type 2 diabetic patients with mild DME.