Journal of Natural Remedies

Abstract

Background: Diabetic Macular Edema (DME) is the primary cause of visual loss in Diabetic Retinopathy (DR). The hyperglycemic state promotes the activation of multiple interlinked pathways leading to DME. The current guidelines in contemporary science recommend Anti VEG-F injections as the first line of treatment for this condition. Repeated Anti-VEG-F injections cause much financial burden on the patient and their family, at the cost of minimal visual outcome. From the signs and symptoms, it was diagnosed as Sannipataja timira according to Ayurveda. A 53-year-old male patient sought Ayurvedic treatment when his vision in the right eye did not improve after the injection of Accentrix for DME. His ophthalmologist advised him to repeat the injection after six months but did not assure him of complete resolution of edema. So, he opted for Ayurvedic treatment. His treatment comprised internal medicines consisting of Punarnavadi kashaya, Guduchyadi kashaya, Chandraprabha vati, Gomutra haritaki lehya; external treatments like Talpodichil with Punarnavadi churna and Pratimarsha nasya with Anu taila; Kriyakalpas (eye treatments) like Vidalaka and Anjana karma. At the end of 7.5 months of Ayurvedic treatment, his visual acuity improved from 6/60 to 6/6. Optical Coherence Tomography (OCT) affirmed the full resolution of DME. Ayurvedic treatment effectively reversed the process of macular edema, thereby bringing about marked visual outcomes in DME. Such patients shall be encouraged to go for Ayurvedic treatments, not the expensive and invasive Anti- VEGF injections.

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Abstract

Polypoidal Choroidal Vasculopathy (PCV), a subtype of neovascular Age-related Macular Degenerationn (AMD) is a disease characterized by persistent, recurrent serous leakage and hemorrhage in the macular area, mostly seen in the elderly population. While contemporary science offers anti Vasculo Endothelial Growth Factor (VEG-F) monotherapy and combination with Photodynamic Therapy (PDT), the outcomes of these remain doubtful. Repeated anti-VEG-F injections not only cause a financial and mental burden on the patients with no or very little visual outcome. Chronicity paves the way to complete loss of vision due to exudative retinal detachment. Symptoms like Raktavatdristi (to visualize things as if through a column of blood), Pashyatiaasyamanaasikam (unable to recognize the faces of people around) and aaviladarshanam (blurred vision) were suggestive of Raktaja Timira (an eye disease caused by Raktadosa) associated with Kaphadushti), according to Ayurveda.

A 77-year-old male patient diagnosed with PCV sought Ayurvedic treatment after being advised to undergo anti-VEG-F therapy for the 3rd time in a row. His treatment comprised internal medicines consisting of Mahatiktakakashaya, Guduchyadikashaya, Chandraprabhavati and Avipathichurna; external treatments like Pratimarshanasya with Anu tailam and Gandusha with Triphalakashaya; Kriyakalpa (eye treatments) like Seka, Vidalaka, Aschotana and Anjana karma.

At the end of 3 months of Ayurvedic treatment, his visual acuity in the right eye improved to 6/6, Optical Coherence Tomography (OCT) affirmed complete normalcy of the macula and Fundus examination confirmed the absence of neovascularization. Ayurvedic treatment is effective in reversing the process of neovascularization, thereby bringing about the marked visual outcome in PCV. Such patients should be encouraged to adopt Ayurvedic treatment instead of expensive and invasive treatment procedures like intra-vitreal injections even when the absolute effects of these remain doubtful.

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