Abstract
Purpose: :
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.
Methods: :
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.
Results: :
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.
Conclusions: :
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.
Clinical Trial: :
http://www.clinicaltrials.gov NCT00763659
Keywords: macular pigment • age-related macular degeneration