The Utility of Oral Vitamin B1 and Mecobalamin to Improve Corneal Nerves in Dry Eye Disease: An In Vivo Confocal Microscopy Study.

2022-09-11
Nutrients 14(18)
- Xiaotong Ren
- Yilin Chou
- Yuexin Wang
- Dalan Jing
- Yanyan Chen
- Xuemin Li

PubMed: 36145126
DOI: 10.3390/nu14183750

Study Design

Type: Randomized Controlled Trial (RCT)
Sample size: n = 199
Population: 398 eyes from 199 patients with dry eye disease (DED)
Methods: Randomized double-blind controlled trial; treatment group received oral vitamin B1 and mecobalamin plus artificial tears, control group received artificial tears; assessments at baseline, 1 and 3 months
Blinding: Double-blind
Duration: 3 months

Large Human Trial
Rigorous Journal

Our purpose is to demonstrate the changes in cornea nerve parameters and symptoms and signs in dry eye disease (DED) patients after oral vitamin B1 and mecobalamin treatment. In this randomized double-blind controlled trial, DED patients were randomly assigned to either the treatment group (oral vitamin B1 and mecobalamin, artificial tears) or the control group (artificial tears). Corneal nerve parameters via in vivo confocal microscopy (IVCM), DED symptoms, and signs were assessed at baseline and 1 and 3 months post-treatment. In total, 398 eyes from 199 patients were included. In the treatment group, there were significant improvements in corneal nerve length, width, and neuromas, the sign of conjunctival congestion score (CCS), symptoms of dryness, pain, photophobia, blurred vision, total symptom score, and OSDI (OSDI) at 1/3 months post-treatment (all p < 0.05). Patients who received vitamin B1 and mecobalamin showed greater improvement in CCS, dryness scores at 1 month (p < 0.05), corneal fluorescein staining (CFS) (p = 0.012), photophobia (p = 0.032), total symptom scores (p = 0.041), and OSDI (p = 0.029) at 3 months. Greater continuous improvement in CFS (p = 0.045), dryness (p = 0.033), blurred vision (p = 0.031) and total symptom scores (p = 0.023) was demonstrated at 3 months than at 1 month post-treatment in the treatment group. We found that oral vitamin B1 and mecobalamin can improve corneal nerve length, width, reflectivity and the number of neuromas in IVCM, thereby repairing epithelial cells and alleviating some ocular symptoms. Thus, vitamin B1 and mecobalamin are potential treatment options for patients with DED.

Research Insights

Vitamin B1→Improved Corneal Nerve Length
In the treatment group, there were significant improvements in corneal nerve length, width, and neuromas... at 1/3 months post-treatment (all p < 0.05).
Effect
Beneficial
Effect size
Moderate
Vitamin B1→Improved Corneal Nerve Reflectivity
oral vitamin B1 and mecobalamin can improve corneal nerve length, width, reflectivity and the number of neuromas in IVCM
Effect
Beneficial
Effect size
Moderate
Vitamin B1→Improved Corneal Nerve Width
In the treatment group, there were significant improvements in corneal nerve length, width, and neuromas... at 1/3 months post-treatment (all p < 0.05).
Effect
Beneficial
Effect size
Moderate
Vitamin B1→Improved Ocular Surface Disease Index
In the treatment group, there were significant improvements in ... OSDI (OSDI) at 1/3 months post-treatment (all p < 0.05).
Effect
Beneficial
Effect size
Moderate
Vitamin B1→Reduced Blurred Vision
symptoms of dryness, pain, photophobia, blurred vision, total symptom score, and OSDI at 1/3 months post-treatment (all p < 0.05).
Effect
Beneficial
Effect size
Moderate
Vitamin B1→Reduced Conjunctival Congestion Score
Patients who received vitamin B1 and mecobalamin showed greater improvement in CCS... at 1 month (p < 0.05)
Effect
Beneficial
Effect size
Moderate
Vitamin B1→Reduced Corneal Fluorescein Staining
greater improvement in... corneal fluorescein staining (CFS) (p = 0.012) at 3 months
Effect
Beneficial
Effect size
Moderate
Vitamin B1→Reduced Corneal Neuroma
In the treatment group, there were significant improvements in corneal nerve length, width, and neuromas... at 1/3 months post-treatment (all p < 0.05).
Effect
Beneficial
Effect size
Moderate
Vitamin B1→Reduced Dryness
Patients who received vitamin B1 and mecobalamin showed greater improvement in... dryness scores at 1 month (p < 0.05)
Effect
Beneficial
Effect size
Moderate
Vitamin B1→Reduced Ocular Surface Disease Index Score
OSDI (p = 0.029) at 3 months
Effect
Beneficial
Effect size
Moderate
Vitamin B1→Reduced Pain Symptom Score
In the treatment group, there were significant improvements in ... symptoms of dryness, pain, photophobia, blurred vision, total symptom score, and OSDI at 1/3 months post-treatment (all p < 0.05).
Effect
Beneficial
Effect size
Moderate
Vitamin B1→Reduced Photophobia
photophobia (p = 0.032)... at 3 months
Effect
Beneficial
Effect size
Moderate
Vitamin B1→Reduced Photophobia Symptom Score
In the treatment group, there were significant improvements in ... symptoms of ... photophobia ... at 1/3 months post-treatment (all p < 0.05).
Effect
Beneficial
Effect size
Moderate
Vitamin B1→Reduced Total Symptom Score
total symptom scores (p = 0.041)... at 3 months
Effect
Beneficial
Effect size
Moderate