Enrichment of Macular Pigment Enhances Contrast Sensitivity in Subjects Free of Retinal Disease: Central Retinal Enrichment Supplementation Trials – Report 1

Abstract

METHODS. Subjects consumed daily a formulation containing 10 mg L, 2 mg Z, and 10 mg MZ (active group; n ¼ 53) or placebo (n ¼ 52) for a period of 12 months. Study visits were at baseline, 3, 6, and 12 months. Contrast sensitivity at 6 cycles per degree (cpd) was the primary outcome measure (POM). Secondary outcome measures included CS at other spatial frequencies, best-corrected visual acuity (BCVA), glare disability, photostress recovery, and light scatter. Macular pigment optical density (MPOD) was measured using dual-wavelength autofluorescence, and serum carotenoid concentrations were analyzed using high performance liquid chromatography (HPLC).RESULTS. Compared to placebo, statistically significant improvements from baseline CS were detected at 6 (P ¼ 0.002) and 1.2 (P ¼ 0.004) cpd in the active group. Additionally, improvements in CS were commensurate with the observed increases in retinal concentrations of these carotenoids (r ¼ 0.342, P ¼ 0.002 at 6 cpd). CONCLUSIONS.These results indicate that dietary fortification with the macular carotenoids can have meaningful effects on visual function.

Preliminary analysis of the relationship between serum lutein and zeaxanthin levels and macular pigment optical density

“…In the current study, significant increases in CS were observed at spatial frequencies of 6 and 18 cpd after L+Z+DHA supplementation, consistent with previous studies showing positive effects of L+Z or L+Z+MZ supplementation on CS 10,32–34. These findings have potentially important implications with respect to the preservation of visual performance in individuals with AMD because low CS is highly predictive of poor vision 32.…”

Macular carotenoid supplementation improves disability glare performance and dynamics of photostress recovery

“…In terms of visual performance, the antioxidant potential of the MCs would appear to impact outcome measures that are particularly dependent on metabolic processes, such as dark adaptation [6, 7], contrast sensitivity [8–12], and temporal vision [13, 14]. Due to its location being anterior to the photoreceptors [15] and aforementioned yellow-orange coloration [16], most of the previous work involving macular carotenoids and visual performance has involved the short-wavelength filtering properties of MP, however.…”

“…These effects, however, appear to be dependent on the presence of an appreciable short-wavelength component in the glare source [22], such as that found in the solar spectrum. For example, a recent investigation of visual performance after augmentation of MP optical density (MPOD) with MC supplementation determined significant improvements in contrast sensitivity, but not PSR [12]. A bright, tungsten source was used as the photostressor in that study, and may not have contained a sufficient amount of short-wavelength energy to reveal effects of MP’s filtering.…”

Putative protective role of lutein and zeaxanthin in diabetic retinopathy

“…Despite optimal control of blood glucose and advances in the treatment of diabetic eye disease, the prevalence rate of DR in the USA have increased considerably over the last decade 88. Experimental studies in animal models provide strong support in favour of oxidative damage in the aetiopathogenesis of DR.…”

“…The reason is that the highest concentration of L and Z within the retina corresponds with the anatomical site of the disease process (ie, macula) in the form of MP. And, there is evidence-based consensus that MP is important for optimal visual performance because of its blue light filtering properties and consequential attenuation of chromatic aberration, veiling luminance, glare disability and blue haze 88. Moreover, MP can be measured in the human eye using subjective or objective non-invasive techniques.…”