Abstract
Purpose:
To assess the effect of multiple xanthophyll supplementation on visual function in patients with retinal diseases.
Methods:
51 patients with retinal diseases attending Medical Retina clinics at Moorfields Eye Hospital were recruited to have xanthophyll supplementation (once daily for 6 months). Each participant underwent tests of refracted best corrected visual acuity (BCVA; ETDRS letters), Pelli-Robson contrast sensitivity (CS) and functional acuity contrast test (FACT; photopic and mesopic), glare disability (FACT), macular pigment densitometry (MPOD), ocular coherence tomography (OCT), dual wavelength autofluoresence (DWAF), 2 field fundus photographs, vision-related quality of life (NEI-VFQ25), health status (EQ-5D), drug compliance, ophthalmic and physical examination at baseline, month 3 and month 6. Univariate analysis to determine the mean change in BCVA, CS, FACT and MPOD; and correlation of drug compliance, visual function and OCT were conducted using SPSS v20. Significance set at p≤0.01 due to multiple testing.
Results:
45 (88.2%) participants completed the study. Median drug compliance was 100% (IQR 6.7) at both 3 and 6 months. BCVA, CS and MPOD were not significantly different between baseline, month 3 and month 6. Mesopic FACT improved for 6.0cpd and 12.0cpd at month 3 (p≤0.01) and for all ranges of mesopic FACT at month 6 (p≤0.001). Photopic FACT demonstrated improvement at month 6 only for 12.0cpd and 18.0cpd (p≤0.006). Mesopic FACT under glare conditions improved for all the spatial frequencies with the exception of 18cpd at month 3 and month 6 (p≤0.009). Only spatial frequency 3.0cpd at month 3 improved in photopic FACT under glare conditions (p=0.007). Photopic FACT at 6.0cpd demonstrated a moderate correlation with total drug compliance (rs= 0.395, p=0.007). At 6 months, mesopic FACT at 1.5cpd and 3.0cpd was moderately correlated to OCT central macular thickness (rs=0.451 and rs=0.469, p=0.001 respectively).
Conclusions:
Multiple xanthophyll supplementation improved glare sensitivity in patients with retinal diseases. Improvement in mesopic contrast sensitivity was seen for all spatial frequencies at month 6. Supplementation may be recommended in persons suffering glare disability but larger studies are required.
Keywords: 444 carotenoids/carotenoid binding proteins •
462 clinical (human) or epidemiologic studies: outcomes/complications •
587 macular pigment