High-dose vitamin B supplementation for persistent visual deficit in multiple sclerosis: a pilot study.

Area of Science:

• Neuroscience
• Ophthalmology
• Clinical Nutrition

Background:

• Multiple Sclerosis (MS) often causes visual impairment, particularly after acute optic neuritis (AON).
• Persistent visual loss in relapsing-remitting MS (RRMS) impacts patient quality of life.
• The neuroprotective potential of high-dose B vitamins in MS-related visual deficits requires investigation.

Purpose of the Study:

• To investigate the neuroprotective effects of high-dose vitamins B1, B6, and B12.
• To assess the impact of these vitamins on visual function in RRMS patients with post-AON visual loss.
• To correlate visual function changes with clinical parameters.

Main Methods:

• Pilot study involving 16 RRMS patients with persistent visual disability post-AON.
• Add-on oral treatment with high-dose vitamin B1 (300 mg), B6 (450 mg), and B12 (1,500 mcg) for 90 days.
• Evaluation of visual acuity (VA) and visual field (VF) testing changes from baseline; logistic regression for VA predictors.

Main Results:

• Statistically significant improvements in visual acuity (p = 0.002) and foveal sensitivity threshold (p = 0.006).
• Significant improvements in mean deviation (p < 0.0001) and pattern standard deviation (p < 0.0001) in visual fields.
• Foveal sensitivity threshold was the primary predictor of follow-up visual acuity (B = 1.39; p < 0.0001).

Conclusions:

• Supplemental high-dose vitamins B1, B6, and B12 are effective in improving visual function.
• These vitamins show promise as a therapeutic strategy for persistent visual disability in MS.
• Further research is warranted to confirm these findings in larger cohorts.