Using mathematics to avoid blindness in diabetics (Part 2): eliminating re-emergent diabetic retinopathy caused by blood thinners

Abstract

Purpose: To report the clinical experiences of author AH, who calculated that modest stepwise lowering of arterial blood pressure can reverse (i) re-emergent diabetic retinopathy (DR) caused by antiplatelet and anticoagulant agents, even in the presence of continued use of the latter necessary agents, or (ii) DR induced by common or severe hypertension and so, (iii) simultaneously treat both of AH’s vascular and ocular medical conditions. Methods: In instances of DR and visual impairment with evidence of exudate formation, blood pressure adjustments were applied, based on mathematical models of retinal exudate production developed by one of the authors (AH). Specifically, the model was used to calculate a critical arterial blood pressure below which retinal exudate formation should cease. Antihypertensive agents were then increased gradually until the desired lower target blood pressure was achieved and DR eliminated. Optical coherence tomography (OCT) was used to test for therapeutic effectiveness. Results: In four different clinical situations, which included blood thinners or hypertension, control of retinal exudate formation and elimination of re-emergent DR was achieved solely by blood pressure lowering and confirmed (with OCT) by return, to normal, of retinal measurements and vision. Conclusion: While the evidence presented here is derived from clinical examples in one person and not from a statistically justified large study, this approach to the control of retinal exudate formation offers very effective unintrusive management of a common vision-threatening aspect of DR. In particular, this approach avoids laser treatments and the challenging experience of commonly administered intraocular injections. Clinical and mathematical evidence is presented that treatment with abundant vitamin B1 (300 mg) and vitamin D results in partial cure of DR. A cure to DR has not been reported before. Future perspectives: The reversal of DR and potentially age-related macular degeneration (ARMD), with safe and simple measures, is an incredibly worthy management goal for these two very common conditions. The possibility demands urgent evaluation with what should be zero- or low-risk clinical trials.