case_images: PMC6643316_01
case_images: Follow-up of first case fundus photos and OCT images. The fundus photograph fewer hemorrhages and MAs after taking Eyefolate  (a, b, c). The diabetic cystic macular edema resolved at a later visit (e) on the OCT B-scan using Zeiss Cirrus HD-OCT (Model 5000) compared to the previous visit (d). OCT: optical coherence tomography; MA: microaneurysms
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case_images: PMC6643316_01_40662_2019_147_Fig1_HTML.jpg
case_images: Fig1
case_images: Fundus photos showed multiple MAs, mild dot and blot retinal hemorrhages with some exudates in the right eye (OD) (Fig. 1a). Reduced MAs and retinal hemorrhages were observed (Fig. 1b). At that visit, mild diabetic cystoid macular edema (CME) was found in the OCT image (Fig. 1d). The right eye showed fewer hemorrhages and MA (Fig. 1c) and less CME on OCT examination (Fig. 1e).
case_images: PMC6643316_02
case_images: Follow-up of the second case fundus photos. Intra-retinal hemorrhages and 3 small MAs (black arrows) were seen in the fundus photo in OS eye (a) at the first visit. At the second visit, only 1 faint MA remained, and the hemorrhages were resolved (b) after taking Eyefolate  for four months. MA: microaneurysms
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case_images: PMC6643316_02_40662_2019_147_Fig2_HTML.jpg
case_images: Fig2
case_images: Intra-retinal hemorrhages and 2 small MAs were found in the fundus photo OS (Fig. 2a). In October 2014, her BCVA remained HM in OD and 20/25 OS, but the hemorrhages resolved and only 1 faint MA was seen in the fundus photography in OS (Fig. 2b).
case_images: PMC6643316_03
case_images: Follow-up of third case fundus photos. Some exudate leakage was found at the August 2014 visit (a). After taking Eyefolate , the large MA (yellow arrow) was reduced and the exudate was smaller at the Dec 2014 visit (b). The MA and exudates (yellow arrow) were resolved by the January 2016 visit (c). In addition, at the November 16 visit (e), the diabetic cystic macular edema was reduced from the 2015 visit (d) and later visit
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case_images: PMC6643316_03_40662_2019_147_Fig3_HTML.jpg
case_images: Fig3
case_images: Decreased exudation was found in OS fundus photo (Fig. 3a). The large exudates had almost completely resolved OS (Fig. 3b). The MA was resolved in the OS fundus photo (Fig. 3c) in 2016.
case_images: PMC6643316_04
case_images: Follow-up of the fourth case fundus photos. The number of retinal hemorrhages and MAs on the fundus photo declined and exudates were resolved after taking the supplements (a-c). MA: microaneurysms
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case_images: PMC6643316_04_40662_2019_147_Fig4_HTML.jpg
case_images: Fig4
case_images: Multiple small intra-retinal hemorrhages and MAs with exudates superotemporally were found OS as seen in the fundus image (Fig. 4a). In October 2015, the number of retinal hemorrhages and MAs declined OS (Fig. 4b), then he switched from Eyefolate  to Ocufolin . In April 2016, the number of hemorrhages and MAs continued to decline, and the exudates resolved OS (Fig. 4c).
case_images: PMC6643316_05
case_images: Follow-up of fifth case fundus photos. Baseline findings of drusen, exudates, a cotton wool spot and microaneurysms (a). MAs were smaller and the exudates and cotton wool spot resolved after taking Eyefolate  for 5 months (b). MAs and exudates returned 3 1/2 years after quitting Eyefolate  (c). The foveal drusen did not change. MA: microaneurysms
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case_images: PMC6643316_05_40662_2019_147_Fig5_HTML.jpg
case_images: Fig5
case_images: In June 2014, multiple small MAs with exudates and one cotton wool spot was found OD as seen in the fundus photo (Fig. 5a) inferotemporal to small drusen. In December 2014, resolution of the cotton wool spot, exudates, and MAs was found OD (Fig. 5b). In May 2018, smaller MAs and exudates reappeared in the original locations after he had self-discontinued the Eyefolate  (Fig. 5c).
case_images: PMC6643316_06
case_images: Follow-up of sixth case fundus photos. After taking Eyefolate  then Ocufolin , MAs, and exudates resolved. He remains free of MAs and exudates in 2/2019 (c). OS show resolution of intra-retinal hemorrhages, exudates, and MAs improved and remained stable over more than 3 years of follow up from 12/2015 through February 2019 (a-c). OD show resolution of intra-retinal hemorrhages and MAs between 12/2015 and 5/2018 (d-f). MA: microaneurysms
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case_images: PMC6643316_06_40662_2019_147_Fig6_HTML.jpg
case_images: Fig6
case_images: Figures 6d-f OD shows resolution of intra-retinal hemorrhages and MAs between 12/2015 and 5/2018. Figures 6a-c OS show resolution of intra-retinal hemorrhages and exudates.
case_images: PMC6643316_07
case_images: Follow-up of seventh case fundus photos. Between September 2018 (a) and December 2018 (b), the intra-retinal hemorrhage (yellow arrow) resolved after taking Eyefolate
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case_images: Fig7
case_images: In August 2018, a diabetic intra-retinal hemorrhage was found OS (Fig. 7a) and he then began to take Eyefolate . By December 2018, the intra-retinal hemorrhage was resolved (Fig. 7b).
case_images: PMC6643316_08
case_images: Follow-up of eighth case fundus photos. The top images were taken using Topcon DX fundus camera on October 10, 2017, before the patient took Ocufolin  (a, b). Close inspection of fundus photos showed two MAs in the periphery of the superonasal quadrant OS. The bottom photos were taken using Zeiss Clarus 500 on January 17, 2019, after the patient participated in a clinical trial of Ocufolin  for 6 months (c, d). The MAs in the superior nasal periphery of the OS eye resolved in the photo taken in January 2019
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case_images: PMC6643316_08_40662_2019_147_Fig8_HTML.jpg
case_images: Fig8
case_images: A MA was apparent in the superonasal quadrant OS in 2017 (Fig. 8). April 2018 office visit, the BCVA remained 20/20 OU and the macular edema had resolved (Fig. 8). A dilated fundus examination indicated no visible retinopathy. In January 2019, a dilated fundus documented absence of macular edema and no evidence of background diabetic retinopathy (Fig. 8).
case_images: Retinal blood flow velocity of the eighth case. Retinal blood flow velocity was measured during study period of 6 months when the patient took Ocufolin
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case_images: PMC6643316_08_40662_2019_147_Fig9_HTML.jpg
case_images: Fig9
case_images: The retinal blood flow was increased at the six-month study visit (June 11, 2018, Fig. 9).