June 2026, Volume 4, Issue 6

Author

Lavanya R, Archana Settu and R Kavitha

Abstract

Background: Oxidative stress plays a vital role in the development of diabetes and its complications like retinopathy. Free radical generation in diabetic patients is also responsible for alterations in RBC morphology. This study aims to assess the effect of ?-tocopherol (vitamin E) and ascorbic acid (vitamin C) in arresting the progression of diabetic retinopathy and uses red blood cell (RBC) morphology as a biomarker of oxidative stress. Materials and methods: This interventional, randomized, open-label pilot study was conducted on 60 adult patients with non-proliferative diabetic retinopathy (NPDR) at a tertiary ophthalmic hospital. Patients were randomized into two groups (n=30 each). The control group received standard antidiabetic treatment, while the study group received add-on therapy with vitamin C 500 mg and vitamin E 400 mg twice daily for 12 weeks. Assessments were performed at baseline and every 4 weeks, with a 4-week post-treatment follow-up. Results: There was a statistically significant reduction in fasting blood glucose in the study group compared to control at 12 weeks (ANCOVA p<0.001). The study group showed a highly significant reduction in crenated RBCs with Heinz bodies (from 80.40% to 7.20%, p<0.001) versus minimal change in control (82.57% to 82.33%). Hemoglobin and total RBC count increased significantly in the study group only (p<0.001). Conclusions: Supplementation with vitamins C and E as add-on therapy arrested progression of NPDR, improved visual acuity, normalized RBC morphology, and improved hematological parameters. These findings support the role of oxidative stress in diabetic retinopathy and the potential disease-modifying effect of antioxidants.