Longevinex ® Improves Human Atrophic Aged-related Macular Degeneration (AMD) Photoreceptor / Retinal Pigment Epithelium Mediated Dark Adaptation*

Aim: Gradual photoreceptor/ RPE deterioration/ vision loss in AMD is common, irrespective of US NEI AREDS I/II supplement risk reduction, or intra-vitreal anti-VEGF pharmacology. We evaluated dark adaptation (DA), a broad measure of photoreceptor / RPE health, with / without epigenetic modulation using a resveratrol–based caloric-restriction mimic (Longevinex ®www.longevinex.com). Study Design: Case series, bi-ocular, clinical DA evaluation in deteriorating AMD, before and after supplementation, under medical center compassionate use guidelines. Place and Duration of Study: Captain James A Lovell Federal Health Care Center, Illinois, USA, Optometry/Ophthalmology Departments between 4/2015 and 8/2016. Methods: Baseline clinical DA threshold (log DB), time (min), and fixation (%) were taken for patients with established atrophic AMD (n=14 eyes; 6 M / 1 F; ages 64 - 89 years), using the AdaptDx ® (www.maculogix.com), with pupil dilation and best refraction. Following prescription of Longevinex® 1 capsule qd AM, DA was repeated, with each eye’s response considered independent. Results: All but 2 eyes improved in one or more DA parameters, with 3 cases showing improvement by retinal macula SD OCT. Expected vs. actual (worse vs. same/better), by eye, was significant by Chi Square, P < .01. Additional factors affecting DA: smoking, alcohol, elevated CRP and statins were retrospectively evaluated. Conclusion: These first cases of epigenetic-induced DA stability / improvement are consistent with previous beneficial effects of Longevinex® such as enhanced choriocapillaris circulation. DA is the earliest functional AMD sign and a prime candidate for “AMD prevention”. This work merits expansion to controlled studies

Observation of Human Retinal Remodeling in Octogenarians with a Resveratrol Based Nutritional Supplement

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Resveratrol Based Oral Nutritional Supplement Produces Long-Term Beneficial Effects on Structure and Visual Function in Human Patients

Background: Longevinex® (L/RV) is a low dose hormetic over-the-counter (OTC) oral resveratrol (RV) based matrix of red wine solids, vitamin D3 and inositol hexaphosphate (IP6) with established bioavailability, safety, and short-term efficacy against the earliest signs of human atherosclerosis, murine cardiac reperfusion injury, clinical retinal neovascularization, and stem cell survival. We previously reported our short-term findings for dry and wet age-related macular degeneration (AMD) patients. Today we report long term (two to three year) clinical efficacy. Methods: We treated three patients including a patient with an AMD treatment resistant variant (polypoidal retinal vasculature disease). We evaluated two clinical measures of ocular structure (fundus autofluorescent imaging and spectral domain optical coherence extended depth choroidal imaging) and qualitatively appraised changes in macular pigment volume. We further evaluated three clinical measures of visual function (Snellen visual acuity, contrast sensitivity, and glare recovery to a cone photo-stress stimulus). Results: We observed broad bilateral improvements in ocular structure and function over a long time period, opposite to what might be expected due to aging and the natural progression of the patient’s pathophysiology. No side effects were observed. Conclusions: These three cases demonstrate that application of epigenetics has long-term efficacy against AMD retinal disease, when the retinal specialist has exhausted other therapeutic modalities

Aqueous and Vitreous Penetration of Linezolid and Levofloxacin After Oral Administration

Purpose: To evaluate the time course of drug concentrations achieved in aqueous (AQ), vitreous (V), and serum (S) compartments after oral administration of linezolid and levofloxacin. Design: Randomized, clinical trial. Methods: Settings: Clinical practice. Patient population: Sixteen patients (16 eyes) undergoing vitrectomy who had not had a prior pars plana vitrectomy in the study eye were randomly assigned to one of 4 groups. Intervention: AQ, V, and S samples were obtained from all subjects after single concomitant doses of linezolid 600mg and levofloxacin 750mg between 1 and 12 h before the procedure: group A - 1-3 h; group B - 3-6 h; group C - 6-9 h; group D - 9-12 h. Main outcome measures: AQ, V, and S concentrations of linezolid and levofloxacin. Results: Overall mean concentrations +/- standard deviation (mu g/mL) achieved by linezolid in AQ, V, and S compartments were 3.32 +/- 2.06, 2.98 +/- 1.87, and 7.91 +/- 3.94, respectively. Overall mean concentrations +/- standard deviation (mu g/mL) achieved by levofloxacin in AQ, V, and S compartments were 2.19 +/- 1.92, 1.95 +/- 1.27, and 7.38 +/- 3.47, respectively. Conclusions: Single concomitant doses of linezolid and levofloxacin achieved AQ and V concentrations above the minimum inhibitory concentration for 90% of common ocular gram-positive and gram-negative pathogens up to 12 h after administration. The combination of linezolid and levofloxacin represents a viable option for the prophylaxis and management of endophthalmitis

Aqueous and Vitreous Penetration of Linezolid and Levofloxacin After Oral Administration

Purpose: To evaluate the time course of drug concentrations achieved in aqueous (AQ), vitreous (V), and serum (S) compartments after oral administration of linezolid and levofloxacin. Design: Randomized, clinical trial. Methods: Settings: Clinical practice. Patient population: Sixteen patients (16 eyes) undergoing vitrectomy who had not had a prior pars plana vitrectomy in the study eye were randomly assigned to one of 4 groups. Intervention: AQ, V, and S samples were obtained from all subjects after single concomitant doses of linezolid 600mg and levofloxacin 750mg between 1 and 12 h before the procedure: group A - 1-3 h; group B - 3-6 h; group C - 6-9 h; group D - 9-12 h. Main outcome measures: AQ, V, and S concentrations of linezolid and levofloxacin. Results: Overall mean concentrations +/- standard deviation (mu g/mL) achieved by linezolid in AQ, V, and S compartments were 3.32 +/- 2.06, 2.98 +/- 1.87, and 7.91 +/- 3.94, respectively. Overall mean concentrations +/- standard deviation (mu g/mL) achieved by levofloxacin in AQ, V, and S compartments were 2.19 +/- 1.92, 1.95 +/- 1.27, and 7.38 +/- 3.47, respectively. Conclusions: Single concomitant doses of linezolid and levofloxacin achieved AQ and V concentrations above the minimum inhibitory concentration for 90% of common ocular gram-positive and gram-negative pathogens up to 12 h after administration. The combination of linezolid and levofloxacin represents a viable option for the prophylaxis and management of endophthalmitis