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Nicole Scripsema, Nishit Shah, Patricia Garcia, David Warrow, Karen Tobias, Gennady Landa, Richard Rosen; Enhancement of Macular Pigment Levels in Diabetics with Early Retinopathy through Supplementation Demonstrated Using Two Objective Techniques. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3779.
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Previously, our group reported objective evidence of lower macular pigment density (MP) levels in patients with Type II Diabetes (DM) with early retinopathy, which inversely correlated with their hemoglobin A1c. The purpose of this study was to determine if lutein (L) or zeaxanthin (Z) supplementation could increase levels of MP in a similar population.
Patients with DM with early retinopathy were enrolled in the clinical trial. Each was assigned to one of four supplementation formulations containing different doses of L or Z (ZeaVision, Chesterfield, MO). Patients were examined at baseline, 1 month, 3 months, 6 months, and 1 year. At each visit, patients were imaged two objective techniques for measuring MP. Total MPOD at 1.0 degree from the fovea was measured with a modified scanning laser ophthalmoscope (HRA Heidelberg Retinal Angiograph, Heidelberg, Germany). Individual LOD and ZOD at 1.0 degee from the fovea were measured with the Macular Pigment Reflectometer (MPR, Maastricht, Netherlands). Paired t-tests were used to compare mean optical densities. We are reporting preliminary 6 month data.
24 eyes of 13 patients were included. Two eyes were excluded due to inadequate image analysis. 38% were male. Mean age was 61.0±8.2 yrs. 46% were Hispanic, 24% Asian, 15% Caucasian, 15% African American. All patients had Type II DM with early retinopathy. Mean duration of DM was 21.3±11.2 yrs and mean HbA1c was 7.4±1.4 mg/dL. Changes in mean MPOD, ZOD, and LOD are shown in Table 1. Each parameter showed significant increases from baseline after 1-3 months of supplementation.
These results suggest that in Type II DM patients with early retinopathy, supplementation of L or Z can increase MP levels in the parafoveal area. This may prevent the onset of maculopathy by maintaining or restoring the oxidant-antioxidant balance in condition associated with increased levels of oxidative stress in the retina.
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