Macular carotenoid supplementation in subjects with atypical spatial profiles of macular pigment

Nolan, John M.; Akkali, Mukunda C.; Loughman, James; Howard, Alan; Beatty, Stephen

doi:10.1016/j.exer.2012.05.006

Cited by 48 publications

(42 citation statements)

References 35 publications

(65 reference statements)

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“…The authors believe this paper provides the first evidence of resolution of a central dip in macular pigment density from dietary Z supplementation. The ongoing debate over the efficacy of dietary Z versus supra-physiologic/pharmacologic doses of Mz in re-pigmenting the macula remains open to further scientific inquiry, as the few investigations into Mz supplementation have produced contradictory results [30,31]. These issues encompass the larger question of whether the two carotenoids ubiquitous in the human diet (L and Z) are sufficient to address age-related macular degeneration, or if Mz must be included as well.…”

Section: Resultsmentioning

confidence: 99%

“…The patients that received Mz supplementation showed no additional benefits in visual performance or macular pigment when compared to the subjects that received the traditional AREDS2 formula. Taken together, the respective papers by Nolan et al [30] and Akuffo et al [31] provide important insight in understanding how carotenoid supplementation affects AMD progression, but they ignore the effects of dietary Z in re-pigmenting the macula by using a small and non-variable supplemental dose of Z. Xanthophyll carotenoids were initially thought to be absorbed by passive diffusion, but identification of apical membrane transporters in intestinal enterocytes now point to an active absorption process [32]. This is supported by research demonstrating competitive inhibition between carotenoids [33], though the details of this physiological mechanism are still being researched.…”

Section: Discussionmentioning

confidence: 99%

“…The identification of the central dip in macular pigment in patients with AMD is a relatively recent discovery; as such there are a very limited number of peer-reviewed articles investigating treatment options. The first study to investigate the effects of carotenoid supplementation on patients exhibiting the macular dip phenomenon was published by Nolan et al [30] in October 2016. Subjects were divided into three groups, each receiving a different ratio of carotenoid supplementation over an 8-week period.…”

Section: Discussionmentioning

confidence: 99%

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Restoration of Central Macular Pigment Dip with Dietary RR Zeaxanthin Supplementation in Patients with AMD

Richer¹

2017

AOVS

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Objective: Low macular pigment optical density (MPOD) is a major risk factor for age-related macular degeneration (AMD). This paper investigates the impact of 8 mg dietary RR zeaxanthin (Z) supplementation on MPOD distribution and the associated effect on macular scotomas in patients with a central foveal dip in their macular pigment spatial profile.Methods: This is a retrospective review of The Zeaxanthin and Visual Function RCT (FDA IND 78, 973) with respect to the relation between low levels of MPOD and increased risk of age-related macular degeneration (AMD). We retrospectively examine the effect of daily supplementation of 8 mg of dietary Z on n=4 patients having a baseline central foveal dip in their MPOD distribution. The testing modalities used were a 7⁰ 3D specular reflectance and the associated kinetic 20° macular visual fields.Results: Over a 12-month period, all four patients showed a progressive increase in central peak restoration with related kinetic and/or Amsler grid visual field data. Conclusion:The initial results demonstrate marked improvement in macular pigment architecture and overall visual function after 12 months of Z supplementation. These results warrant a prospective clinical trial with a larger number of subjects to investigate the role of Z in central dip amelioration.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Restoration of Central Macular Pigment Dip with Dietary RR Zeaxanthin Supplementation in Patients with AMD

Richer¹

2017

AOVS

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“…2014; Ctori & Huntjens 2017) or an increase relative to central MPOD (Nolan et al. 2012), it is important to consider the reliability of the MPOD measurement not only according to the instrument used but also the repeatability of the MPOD measurement at each of the different retinal eccentricities tested.…”

Section: Introductionmentioning

confidence: 99%

Repeatability of the macular pigment spatial profile: A comparison of objective versus subjective classification

Ctori

Mahroo

Williams

et al. 2018

Acta Ophthalmologica

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PurposeClassification of macular pigment (MP) spatial profile phenotypes varies and is often based on subjective visualisation. We investigated repeatability of MP optical density (MPOD) comparing an objective versus subjective profiling system.MethodsThe coefficient of repeatability (CoR) was calculated for point MPOD values (0–3.8°) obtained by dual‐wavelength fundus autofluorescence (FAF) from two scans obtained in a single visit of 40 healthy individuals (39 ± 9 years). For each individual's dataset, the MP profile was classified as exponential, ring‐like or central dip using an objective method (based on deviations away from an exponential fit), as well as by subjective visual profiling. Existing FAF images of 88 monozygotic (MZ) and 69 dizygotic (DZ) twin pairs were reanalysed using the objective profiling method and concordance and heritability of ring‐like profiles determined.ResultsThe CoR was 0.23 at 0° and 0.06 at 0.8°. Agreement of objective profiling between scans was excellent (κ = 0.85, 95% CI 0.69 to 1.00; p < 0.0005). Subjective profiling showed moderate agreement between scans (κ = 0.48, 95% CI 0.23 to 0.73; p < 0.0005). Agreement between objective and subjective classification was low (κ = 0.23, 95% CI 0.04 to 0.42; p = 0.02). Concordance for the ring‐like profile using objective profiling was 0.74 for MZ compared to 0.36 for DZ twins. Heritability was calculated as 81.5% (95% confidence interval 61.1–93.1%).ConclusionCompared to visual assessment, objective MP profiling is a more reliable method and should be considered in future observational and interventional studies. In addition, MP profile phenotypes showed high heritability.

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“…30,40 Indeed, a recent publication reports that the typical central peak of MP can be realised in subjects with atypical MP spatial profiles at baseline when supplemented with a preparation containing all the three macular carotenoids, but not with a supplement lacking MZ. 41 MZ in such supplements is derived from natural L, which has been extracted from the Aztec Marigold flower, and has been used to date in many clinical trials and subjected to toxicity studies. 28,30,40 A recent study of supplemental MZ in human subjects has reported that renal and liver function, as well as lipid profile, haematological parameters, and markers of inflammation, are unaffected following supplementation with a formulation containing MZ, L, and Z.…”

Section: Safety Of Mzmentioning

confidence: 99%

What is meso-zeaxanthin, and where does it come from?

Nolan

Kashani

et al. 2013

Eye

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The carotenoids lutein (L), zeaxanthin (Z), and meso-zeaxanthin (MZ) accumulate in the central retina, where they are collectively known as macular pigment (MP). Each of these three compounds exhibit a regional dominance, with MZ, Z, and L being the dominant carotenoids at the epicentre, mid-periphery, and periphery of the macula, respectively. There is a growing and evidencebased consensus that MP is important for optimal visual performance, because of its blue light-filtering properties and consequential attenuation of chromatic aberration, veiling luminance, and blue haze. It has also been hypothesised that MP may protect against age-related macular degeneration because of the same optical properties and also because of the antioxidant capacity of the three macular carotenoids. Challenges inherent in the separation and quantification of MZ have resulted in a paucity of data on the content of this carotenoid in foodstuffs, and have rendered the study of tissue concentrations of this compound problematic. As a consequence, the few studies that have investigated MZ have, perhaps, been disproportionately influential in the ongoing debate about the origins of this macular carotenoid. Certainly, the narrative that retinal MZ is derived wholly and solely from retinal L needs to be revisited.

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Macular carotenoid supplementation in subjects with atypical spatial profiles of macular pigment

Cited by 48 publications

References 35 publications

Restoration of Central Macular Pigment Dip with Dietary RR Zeaxanthin Supplementation in Patients with AMD

Restoration of Central Macular Pigment Dip with Dietary RR Zeaxanthin Supplementation in Patients with AMD

Repeatability of the macular pigment spatial profile: A comparison of objective versus subjective classification

What is meso-zeaxanthin, and where does it come from?

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