The Roles of Vitamins in Diabetic Retinopathy: A Narrative Review

There have been attempts to evaluate the roles of vitamins for the prevention or treatment of eye conditions, such as glaucoma, age-related macular degeneration, and diabetic retinopathy (DR). Regarding DR, two main groups of studies can be identified. The first group focuses on the association between serum levels of an individual vitamin and DR. Many studies have found that lower serum levels of vitamins, particularly vitamin D, are significantly associated with the development, or severity, of DR, while some studies have not supported this trend. The second group evaluates dietary vitamin intakes and DR. A small, randomized placebo-controlled trial did not show any benefit of vitamin E intake on improving the area of retinal hemorrhage or diabetic macular edema at 12 months. A pilot study of patients with mild-to-moderate non-proliferative DR received tablets of combined vitamins B6, B9, and B12 for 6 months and significant improvement in retinal sensitivity and retinal thickness resulted. Two large prospective cohorts showed that high dietary intake of vitamin B6, and fruit rich in vitamin C and E, could significantly lower the risk of DR by 50% after an eight-year follow-up. Properly designed, randomized controlled trials are needed to support the results.