The Impact of Macular Pigment Augmentation on Visual Performance Using Different Carotenoid Formulations

Loughman, James; Nolan, John M.; Howard, Alan; Connolly, Eithne; Meagher, Katie; Beatty, Stephen

doi:10.1167/iovs.12-10690

Cited by 109 publications

(117 citation statements)

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“…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

Invest. Ophthalmol. Vis. Sci.

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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.)

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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

Invest. Ophthalmol. Vis. Sci.

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“…Ав-торы выявили четкую положительную связь между исхо-дной сывороточной концентрацией лютеина и зеаксантина и значением показателя ОПМП, что согласуется с результа-тами других исследований [38,39,40,41,42,43]. Эффект был тем выше, чем ниже была исходная ОПМП.…”

Section: Role Of Dietary Supplementation In Preventing Progressionunclassified

Role of Dietary Supplementation in Preventing Progression of Age-Related Macular Degeneration

Ermakova¹

2016

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резюмеВозрастная макулярная дистрофия (ВМД) является одной из лидирующих причин слепоты в развитых странах у лиц старше 65 лет. Главная роль в механизме возникновения заболевания отводится поражению пигментного эпителия, мембраны Бруха и хорио-капиллярного слоя хориоидеи. Ведущую партию в этом, очевидно, играет пигментный эпителий, который со временем перестает справляться со своими функциями. Развивающаяся ишемия и оксидантный стресс приводят к появлению сначала друз, а за-тем к продвинутой стадии заболевания -хориоидальной неоваскуляризации или атрофии (географической атрофии). Приме-нение ингибиторов факторов роста эндотелия сосудов позволило в последние годы добиться определённых успехов в лечении неоваскулярной формы ВМД, однако возвратить полностью утраченные зрительные функции возможно только у части больных. В связи с этим возникает важная задача предупреждения прогрессирования процесса из фазы друз в продвинутую форму ВМД. В настоящее время накоплены данные о влиянии лютеина и зеаксантина, а также витаминов (С и Е) и минералов (Zn, Se) на риск развития ВМД. На основании многочисленных исследований (CARMA, LUNA, AREDS, AREDS2) стало обоснованным применение витаминно-минерального комплекса с целью снижения риска развития ВМД. Исследование AREDS I (Age-Related Eye Disease Study) показало, что использование витамина С (500 мг), витамина Е (400 IU), бета-каротина (15 мг), цинка (80 мг) снижает на 25% риск прогрессирования заболевания с переходом в продвинутую фазу и предупреждает снижение зрительных функций у 27% больных. Первичный анализ AREDS II не выявил дальнейшего снижения риска перехода ВМД в развитую стадию при добавлении к формуле AREDS лютеина (10 мг)+зеаксантин (2 мг) и/или докозагексаеновой кислоты (DHA 350 мг)+эйкозапентаеновая кис-лота (EPA, 650 мг). Однако в данном исследовании отсутствовала истинная группа контроля, а одновременное использование бета-каротина, лютеина и зеаксантина может снижать захват тканями последних двух из-за конкуренции каротиноидов. Замена бета-каротина в формуле AREDS на лютеин и зеаксантин привела к снижению риска развития неоваскулярной стадии ВМД. Ис-следование LUNA (Lutein Nutrition effects measured by Auto-fluorescence) показало, что приём лютеина (12 мг), зеаксантина (1 мг) и витаминов С (120 мг) и Е (17,6 мг), селена (40 мг) и цинка (10 мг) привёл к повышению сывороточной концентрации лютеина и зеаксантина и оптической плотности макулярного пигмента (ОПМП) в зоне 0,5° от центра глазного дна. Эффект был тем выше, чем ниже была исходная ОПМП. Исследование CARMA (The Carotenoids in Age-Related Maculopathy) выявило, что применение лютеина (6 мг), зеаксантина (0.3 мг), витаминов С (75 мг) и Е (7.5 мг), цинка (10 мг) и меди (0.2 мг) способствовало сохранению зрительных функций и замедляло переход заболевания в продвинутую фазу ВМД. Данные препараты следует использовать в ран-ней стадии заболевания и принимать постоянно или с небольшими перерывами. При длительных перерывах в лечении исчезает феномен насыщения пигментов в сетчатке, а, следовательно, снижается и эффект т...

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“…Three published human intervention studies Rodriguez-Carmona et al, 2006;Loughman et al, 2012) and one unpublished human intervention study (DSM Nutritional Products Ltd and Kemin Foods L.C., 2013) investigated the effects of lutein, either alone or in combination with zeaxanthin, on measures of vision. Two of these studies Rodriguez-Carmona et al, 2006) were already evaluated by the Panel in relation to a claim on lutein and maintenance of normal vision (EFSA NDA Panel, 2012a).…”

Section: Scientific Substantiation Of the Claimed Effectmentioning

confidence: 99%

Scientific Opinion on the substantiation of a health claim related to a combination of lutein and zeaxanthin and improved vision under bright light conditions pursuant to Article 13(5) of Regulation (EC) No 1924/2006

Products¹

2014

EFSA Journal

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Following an application from DSM Nutritional Products and Kemin Foods, submitted for authorisation of a health claim pursuant to Article 13(5) of Regulation (EC) No 1924 via the Competent Authority of France, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the scientific substantiation of a health claim related to a combination of lutein and zeaxanthin and improved vision under bright light conditions. The Panel considers that the food is sufficiently characterised. Improved vision under bright light conditions is a beneficial physiological effect. The applicant provided a total of 10 published and one unpublished human intervention studies as being pertinent to the health claim. Five studies investigated the effects of lutein and/or zeaxanthin on macular pigment optical density, but did not assess vision, whereas two studies investigated the effects of lutein only. Two further studies had already been evaluated by the Panel in a previous assessment. No conclusions could be drawn from one further small (no effect) study. In a further trial with a large number of missing data owing to drop-out/non-compliance of study subjects, a combination of lutein and zeaxanthin had no effect on any outcomes of visual function in the population of subjects completing the protocol as planned. In weighing the evidence, the Panel took into account that the one study from which conclusions could be drawn did not show an effect of lutein plus zeaxanthin on vision. The Panel concludes that a cause and effect relationship has not been established between the consumption of a combination of lutein and zeaxanthin and improved vision under bright light conditions. The scope of the application was proposed to fall under a health claim based on newly developed scientific evidence. The application included a request for the protection of proprietary data. © EuropeanThe food that is the subject of the health claim is a combination of lutein and zeaxanthin. Lutein and zeaxanthin are xanthophyll carotenoids naturally present in food, especially in green leafy vegetables. Lutein and zeaxanthin can be measured in foods by established methods. The Panel considers that the food, a combination of lutein and zeaxanthin, which is the subject of the health claim is sufficiently characterised.The claimed effect relates to improved visual performance, in particular under bright light conditions. The target population proposed by the applicant is the general healthy population. The Panel considers that improved vision under bright light conditions is a beneficial physiological effect.The applicant provided a total of 10 published and one unpublished human intervention studies as being pertinent to the health claim.Five studies investigated the effects of lutein and/or zeaxanthin on macular pigment optical density, but did not assess vision, whereas two studies investigated the effects of lutein only, and not of the combination of lutein plus zeaxanthin that is the subject of the health claim...

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The Impact of Macular Pigment Augmentation on Visual Performance Using Different Carotenoid Formulations

Abstract: These results suggest that supplementation with all three macular carotenoids potentially offered advantages over preparations lacking MZ, both in terms of MPOD response and visual performance enhancement.

Cited by 109 publications

References 63 publications

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

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

Role of Dietary Supplementation in Preventing Progression of Age-Related Macular Degeneration

Scientific Opinion on the substantiation of a health claim related to a combination of lutein and zeaxanthin and improved vision under bright light conditions pursuant to Article 13(5) of Regulation (EC) No 1924/2006

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