A Double-Blind, Placebo-Controlled Study on the Effects of Lutein and Zeaxanthin on Photostress Recovery, Glare Disability, and Chromatic Contrast

PURPOSE. It has been shown that lutein and zeaxanthin accumulate in the macula where they enhance contrast sensitivity and may reduce the risk of progression to advanced age-related macular degeneration (AMD). Furthermore, omega-3 long-chain polyunsaturated fatty acids (PUFA) might further reduce this risk. However, controversy exists regarding whether PUFA may reduce the bioavailability of lutein.METHODS. This was a prospective 12-month, randomized, open label study evaluating the effect of supplementation with lutein, other antioxidants, and minerals on contrast sensitivity (CS) and macular pigment optical density (MPOD) in patients with age-related maculopathy. A total of 79 patients were randomized to either lutein (10 mg) and antioxidant supplement or lutein and antioxidant supplement in combination with PUFA. Patients received supplementation for a period of 6 months and were followed for a total of 12 months.RESULTS. Serum lutein and zeaxanthin increased significantly by the first follow-up visit at 1 month, and remained elevated throughout the intervention period of 6 months in the luteinonly group but not in the luteinþPUFA group. Macular pigment optical density and CS increased significantly in the lutein-only group (P < 0.005) but not in the luteinþPUFA group (P ¼ 0.059) compared to baseline. Best-corrected visual acuity remained unchanged during the entire study period in both groups.CONCLUSIONS. Addition of PUFA may reduce the bioavailability of lutein and therefore lessen the beneficial effect on macular pigment and CS. This needs to be considered when prescribing lutein supplements to patients with low lutein levels. (ClinicalTrials.gov number, NCT00563979.)

Section: Discussionmentioning

confidence: 99%

Oral Lutein Supplementation Enhances Macular Pigment Density and Contrast Sensitivity but Not in Combination With Polyunsaturated Fatty Acids

Wolf

Zinkernagel

Munk

et al. 2015

“…14,15 Given the importance of MP for vision and its role in reducing risk of age-related macular degeneration (AMD) progression, 16 there is clearly a need to measure this pigment accurately in vivo in the clinical and the research setting. Moreover, it is important to be able to measure changes in MP over time.…”

Section: Acular Pigment (Mp) Is Composed Of the Carotenoids Lutein mentioning

confidence: 99%

The Impact of Cataract, and Its Surgical Removal, on Measures of Macular Pigment Using the Heidelberg Spectralis HRA+OCT MultiColor Device

Akuffo

Nolan

Stack

et al. 2016

PURPOSE.To investigate the effect of cataract (and cataract surgery) on macular pigment (MP) measurements using the Heidelberg Spectralis HRAþOCT MultiColor device.METHODS. Thirty-six patients (age, 54-87 years) scheduled for cataract surgery at the Institute of Eye Surgery, Ireland, were enrolled in this study. Cataracts were graded using the Lens Opacities Classification System (LOCS) III, and surgery was performed using standard phacoemulsification technique with implantation of a Tecnis ZCB00 or Tecnis ZCT intraocular lens. Macular pigment was measured before and after cataract surgery in the operated (study) eye and in the fellow (control) eye.RESULTS. In the study eye, there was statistically significant disagreement in measures of MP taken before and after surgery. At all eccentricities, and also for MP volume, the postsurgery measurements were significantly (P < 0.05) greater, ranging from an average 16% greater at 1.728 to an average 35% greater at 0.238 eccentricity. Eyes exhibiting large disagreement between pre-and postsurgery measurements at a given eccentricity also generally exhibited substantial disagreement at other eccentricities. Overall severity of cataract contributed to greater disagreement between pre-and postoperative measures of MP, as did grade of nuclear opalescence, nuclear color, and posterior subcapsular cataract. In control eyes, there was no statistically significant disagreement in terms of measures of MP taken before and after cataract surgery (P > 0.05 for all; 1-sample t-test).CONCLUSIONS. Macular pigment measurements using the Spectralis are affected by cataract. Accordingly, we recommend that cataract be graded when measuring MP with a device that utilizes dual-wavelength fundus autofluorescence and propose the employment of a correction factor to compensate for cataract when measuring MP.

“…Given the importance of MP for visual function in diseased [16][17][18] and nondiseased retinas, 19,20 and the emerging evidence that MP may be a useful biomarker for AD, 21,22 researchers and clinicians must measure MP levels accurately across different populations. A variety of techniques are available for measuring MP (and its constituent carotenoids) and the measurement techniques can be classified broadly as ex vivo (i.e., outside cell/tissue) and in vivo techniques (i.e., inside cell/tissue).…”

mentioning

confidence: 99%

Concordance of Macular Pigment Measurement Using Customized Heterochromatic Flicker Photometry and Fundus Autofluorescence in Age-Related Macular Degeneration

Akuffo

Beatty

Stack

et al. 2015

Citation: Akuffo KO, Beatty S, Stack J, et al. Concordance of macular pigment measurement using customized heterochromatic flicker photometry and fundus autofluorescence in agerelated macular degeneration. Invest Ophthalmol Vis Sci. 2015;56:8207-8214. DOI:10.1167/iovs.15-17822 PURPOSE. We compared macular pigment (MP) measurements using customized heterochromatic flicker photometry (Macular Metrics Densitometer) and dual-wavelength fundus autofluorescence (Heidelberg Spectralis HRA þ OCT MultiColor) in subjects with early agerelated macular degeneration (AMD).METHODS. Macular pigment was measured in 117 subjects with early AMD (age, 44-88 years) using the Densitometer and Spectralis, as part of the Central Retinal Enrichment Supplementation Trial (CREST; ISRCTN13894787). Baseline and 6-month study visits data were used for the analyses. Agreement was investigated at four different retinal eccentricities, graphically and using indices of agreement, including Pearson correlation coefficient (precision), accuracy coefficient, and concordance correlation coefficient (ccc).RESULTS. Agreement was poor between the Densitometer and Spectralis at all eccentricities, at baseline (e.g., at 0.258 eccentricity, accuracy ¼ 0.63, precision ¼ 0.35, ccc ¼ 0.22) and at 6 months (e.g., at 0.258 eccentricity, accuracy ¼ 0.52, precision ¼ 0.43, ccc ¼ 0.22). Agreement between the two devices was significantly greater for males at 0.58 and 1.08 of eccentricity. At all eccentricities, agreement was unaffected by cataract grade.CONCLUSIONS. In subjects with early AMD, MP measurements obtained using the Densitometer and Spectralis are not statistically comparable and should not be used interchangeably in either the clinical or research setting. Despite this lack of agreement, statistically significant increases in MP, following 6 months of supplementation with macular carotenoids, were detected with each device, confirming that these devices are capable of measuring change in MP within subjects over time. (http://www.controlled-trials.com number, ISRCTN13894787.)