crocin monotherapy in non-central diabetic macular edema

Background: crocin can be utilized as an anti-inflammatory component of saffron in diabetic macular edema (dme), which is known as the most common cause of vision loss in patients with diabetes mellitus (dm). although anti-vascular endothelial growth factor (vegf) agents are common in non-center involving dme (nci-dme), there is no consensus on nci-dme treatment.methods: this before-after study was performed from october 2019 to august 2021. twenty-six eyes of 16 patients with type 2 dm in baghayipoor clinic in yazd, were treated with 15 mg crocin per day for 90 days. patients had at least one eye with non-proliferative dr (npdr) and nci-dme along with no adherence to intravitreal injection or a contraindication of intravitreal injection. central subfield thickness (cst), visual acuity, fasting blood sugar (fbs), and hba1c were assessed once before and once after the study (day 90).results: after 90 days of therapy, the mean cst significantly decreased to 2.8 μm (p-value=0.030), four patients had increased cst and 1 patient had a significantly decreased cst (≥25μm). the mean logarithmic minimum angle of resolution increased during the study. the mean (±sd) fbs showed a significant improvement during the study from 174.7 (±60.41) at baseline up to 161.8 (±47.7) at day 90 (p-value = 0.012). hba1c had no significant reduction. nausea/vomiting and insomnia were among the reported adverse effects. nevertheless, no one withdrew from the study because of the adverse effects. conclusion: this study suggests crocin’s positive impact on nci-dme. it may also improve the glycemic profile of diabetic patients; however, more high-quality randomized clinical trials with larger sample sizes and longer durations are needed for validation.