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Susanne Jentsch, Dietrich Schweitzer, Martin Hammer, Gabriele E. Lang, Jens Dawczynski; The Lutega- Study: Lutein And Omega- 3- Fatty Acids And Their Relevance For Macular Pigment In Patients With Age-related Macular Degeneration (AMD). Invest. Ophthalmol. Vis. Sci. 2011;52(14):3632.
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The long term effect (1 year) of a daily supplementation with lutein (L), zeaxanthin (Z) and omega-3-fatty acids (O-3-FA) on the optical density of macular pigment(MPOD) was investigated in AMD patients. Furthermore the effect of different dosages on MPOD was examined.
MPOD (max OD, mean OD, volume, area) was measured using the 1-wavelength reflection method recording reflection images at 480 nm by a modified fundus camera (VISUCAM NM/FA, Zeiss Meditec, Jena, Germany). Study population was divided into three treatment arms (D1: 10 mg L, 1 mg Z, 255 mg O-3-FA/ D2: 20 mg L, 2 mg Z, 510 mg O-3-FA/ P: placebo). 172 patients, aged older than 50 years, suffering from non-exudative AMD were investigated at baseline and followed up in 4 more visits over 1 year of supplementation. Each visit included MPOD measurement, visual acuity test (ETDRS-charts), slit lamp biomicroscopy, fundus photography and blood analysis (L, Z, O-3-FA). At baseline the MPOD differ between the three treatment arms. To compare between this groups, absolute changes in MPOD were used.
Volume (in ODU*degree²) showed the clearest changes and significantly increased in D1 (0.90 ± 0.44 to 1.07 ± 0.50) and D2 (0.90 ± 0.39 to 1.11 ± 0.44) and significantly decreased in P (1.03 ± 0.46 to 1.01 ± 0.47). A significant difference was found in absolute changes in volume between D1 (0.17 ± 0.01) and P (-0.02 ± 0.06) as well as D2 (0.20 ± 0.09) and P. Decrease of max OD in P (0.58 ± 0.12 to 0.57 ± 0.12 ODU) showed no significance. Area of MPOD reached the same value after 6 months, independently of dosage. Visual acuity significantly improved in D1 (48 ± 8 to 50 ± 9 letters) and D2 (50 ± 7 to 52 ± 8 letters). Plasma concentration of L and Z in µmol/l significantly rose in D1 (0.23 ± 0.15 to 0.59 ± 0.37) and D2 (0.22 ± 0.13 to 0.93 ± 0.73) and significantly decreased in P (0.22 ± 0.12 to 0.21 ± 0.17). In a few cases of D1 and D2 drusen partially disappeared.
MPOD and its changes can be determined by a simple method. We conclude that the supplementation caused an increase of macular pigment and a stabilisation and an improvement of visual acuity. It seems to be reasonable for protection of the macular in AMD patients.
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