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S. P. Rothenbuehler, C. K. Brinkmann, S. Wolf, U. E. K. Wolf-Schnurrbusch; Enhancement of Macular Pigment by Oral Lutein Supplementation Study (EMPOLS) - Do Omega-3 Fatty Acids Alter the Response?. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1706.
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Long term relevance of supplementation with Lutein (L) in patients with age-related maculopathy (ARM) remains unclear. Up to now there are only few randomized prospective trials to compare outcome from L supplementation studies with and without fatty acids. Our study analysed if supplementation of L with omega-3 polyunsaturated fatty acids (PUFA) shows differences in patients outcome compared to supplementation with L only.
Comparison of macular pigment density (MPD), serum L levels, best corrected visual acuity (BCVA), Pelli-Robson contrast sensitivity (PR-CS) and dry eye symptoms with a validated questionnaire in 2 groups of ARM patients with supplementation. Group L&FA were supplemented with 10mg of non-ester L and 169mg of PUFA (134mg thereof DHA/EPA) daily for 6 months. We included 36 subjects (25f, 11m; age: 73±8 yrs). A matched control group (Group L) taking 10mg of non-ester L consisted of 40 subjects (22f, 18m; age: 76±8 yrs). MPD was measured within a 1° diameter foveal circle by 2-wavelength-autofluorescence-densitometry using the modified HRA (Heidelberg Engineering, Dossenheim, Germany) at baseline (BL), month (Mo) 1, Mo 3 and Mo 6.
In the L&FA Group MPD was 0.59±0.2 density units (DU) at BL, 0.57±0.2 DU at Mo1, 0.60±0.2 DU at Mo3, 0.61±0.2 DU at Mo6. MPD in the control group L without PUFA was 0.58±0.2 DU and showed a similar kinetic over the follow-up time. Serum carotenoid levels did not show direct correlation to foveal MPD in both groups. BCVA remained stable in both groups from BL till Mo 6. PR-CS showed a statistically significant increase (p<0.05) in both groups and the reported discomfort of dry eyes was subjectively and objectively reduced in the L&FA group.
Oral L supplementation with or without PUFA leads to significant rise in MPD from BL to Mo 6. The EMPOLS study detected a statistically significant increase in PR-CS in both groups. In our short term results the addition of PUFA may not influence metabolism and build-up of L at the fovea. However, most patients with ARM are aged women having often more than only one disease. In our study the addition of PUFA seems to reduce the discomforts in these aged patients due to dry eye symptoms.
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