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Published July, 2012 American Journal of Ophthalmology – Abstract and Commentary by Drs Gerson and Pizzimenti below:
To examine the effects of lutein and zeaxanthin supplementation on retinal function using multifocal electroretinograms (mfERG) in patients with early age-related macular degeneration (AMD).
Randomized, double-masked, placebo-controlled trial.
One hundred eight subjects with early AMD were randomly assigned to receive 10 mg/d lutein (n = 27), 20 mg/d lutein (n = 27), 10 mg/d lutein plus 10 mg/d zeaxanthin (n = 27), or placebo (n = 27) for 48 weeks. Thirty-six age-matched controls without AMD were also enrolled to compare baseline data with early AMD patients. MfERG responses and macular pigment optical densities (MPODs) were recorded and analyzed at baseline and at 24 and 48 weeks.
There were significant reductions in N1P1 response densities in ring 1 to ring 3 in early AMD patients compared with the controls (P < .05), whereas neither N1P1 response densities in ring 4 to ring 6 nor P1 peak latencies significantly changed. After 48-week supplementation, the N1P1 response densities showed significant increases in ring 1 for the 20 mg lutein group and for the lutein and zeaxanthin group, and in ring 2 for the 20 mg lutein group. The increases in MPOD related positively to the increases in N1P1 response density in ring 1 and ring 2 for nearly all active treatment groups. N1P1 response densities in ring 3 to ring 6 or P1 peak latencies in all rings did not change significantly in any group.
Early functional abnormalities of the central retina in the early AMD patients could be improved by lutein and zeaxanthin supplementation. These improvements may be potentially attributed to the elevations in MPOD.
Supplementation with Macular Pigments Improves Retinal Function
When we recommend nutritional therapy that includes foods and/or supplements high in xanthophylls, we may not only be protecting the retina, but also enhancing its function. The latest evidence comes from China, where Ma and colleagues examined the effects of lutein and zeaxanthin supplementation on retinal function in patients with early age-related macular degeneration (AMD).
In a randomized, double-masked, placebo-controlled trial, investigators assigned one hundred eight subjects with early AMD to receive one of four interventions: 10 mg/d lutein, 20 mg/d lutein, 10 mg/d lutein plus 10 mg/d dietary zeaxanthin, or a placebo for 48 weeks. Thirty-six age-matched controls without AMD were also enrolled to compare baseline data with early AMD patients.
Multifocal electroretinography (MfERG) responses and macular pigment optical densities (MPODs) were recorded and analyzed at baseline and at 24 and 48 weeks. After 48-weeks, significant improvements in MfERG responses were found in the 20 mg lutein group and in the 10 mg/d lutein plus 10 mg/d dietary zeaxanthin group. Increases in MPOD related positively to the improvements in MfERG responses for nearly all active treatment groups.
This study is notable for its high-level design and relatively high doses of macular pigments, including 10mg of dietary zeaxanthin. Of further importance is the finding of retinal function improvement in early AMD patients as documented by an objective test of MfERG. The authors noted that larger studies are needed to validate their findings and assess the long-term effects of lutein and zeaxanthin on reducing AMD progression.
This study reflecting improvement in retinal function by MfERG correlates nicely with recent studies showing improvement in visual function parameters. Dr. Stuart Richer has conducted several such studies, most recently the Zeaxanthin and Visual Function Study. (8mg’s/d dietary zeaxanthin for 12 months) In this study, Dr. Richer demonstrated that dietary zeaxanthin intake can improve contrast sensitivity, acuity, foveal shape discrimination and other important visual parameters. These improvements could significantly improve patient quality of life.
Supplementation in AMD is no longer just about slowing disease progression. It has now taken a welcome turn towards optimization of remaining vision and the possibility of measured improvement!
There are several powerful take-aways from these recent studies. As far as patient education, we can let our patients know there are objective and subjective measurements of improved vision supported by good scientific research. We can also use these important findings to achieve better acceptance and compliance from our patients.
Jeffry D. Gerson, O.D., F.A.A.O.
Dr. Jeffry Gerson graduated from the Indiana University School of Optometry and completed a residency at VA medical center in Kansas City before becoming faculty at the University of Kansas School of Medicine Ophthalmology department. Later he became a staff member at Mid America Retina Consultants. His practice, WestGlen Eyecare provides full scope Optometric care. Dr. Gerson is a distinguished lecturer and has authored many papers in numerous scientific journals.
Joseph J. Pizzimenti, O.D., F.A.A.O.
Dr. Pizzimenti graduated from the University of IL School of Optometry, owned and operated his own Optometric practice, and is currently Associate Professor at Nova Southeastern University College of Optometry. Dr. Pizzimenti has conducted important clinical research in the areas of diabetes, AMD, and low vision. Dr. Pizzimenti is a distinguished educator, lecturer, and author of many papers in numerous scientific journals.
ZeaVision® and EyePromise® thank Dr. Gerson and Dr. Pizzimenti for their insights regarding the role of nutrition in ocular health. To learn more about unique (and only) ocular supplements that contain the dosage of dietary zeaxanthin studied in the aforementioned published clinical trials please contact ZeaVision at 1-866-833-2800 or firstname.lastname@example.org
Download the Science Summary by clicking the PDF icon or read as text below.
The following 4 studies (Pola, Rotterdam, Blue Mountain, and AREDS Report 22) represent 4 countries, 3 continents, and more than 10,000 subjects…all had the same results: higher levels of Zeaxanthin reduced the risk for AMD!