Abstract
Purpose: :
Low levels of macular pigment (MP) are supposed to represent a potential risk factor for development of age related macular degeneration (AMD) and the question if the concentration of MP in the eye can be influenced by supplementation of Lutein (L) and Zeaxanthin (Z) is of great clinical relevance.
Methods: :
In a prospective study 108 probands (68females,40male, age 51–87, mean 71,56) were supplemented with 12mg L and 1 mg Z (Ocuvite Lutein) daily. Every six weeks MP levels were analyzed in the eye (by analysis of grey scale values after digital subtraction of two autofluorescence (AF) images taken at 488nm –absorption by MP– and 514 nm–nearly no absorption by MP– using a modified Heidelberg Retina Angiograph, HRA) and in serum. Supplementation stopped after 6 months and patients were observed for an additional 6 months. A control group constisting of 28 probands (16females, 12 males, age 57–83, mean 71,04) was investigated at baseline and again after mean 33weeks.
Results: :
At baseline mean value MP optical density at 0,5° eccentricity (MPOD0,5°baseline) was 0,51D.U. (density units) in the supplementation [S] and 0,53D.U. in the control [C] group. Under intake of L and Z the MPOD0,5° values increased outlasting the intake for three months (visit 6) (MPOD0,5°visit6[S] mean 0,59 D.U., MPOD0,5° [C] at second visit mean 0,55 D.U.), afterwards values began to decline (6months after stop of intake MPOD0,5°visit7 mean 0,55D.U.). Calculation of quartiles of [S] due to (MPOD0,5°visit6)–(MPOD0,5°baseline) resulted in a quartile of no increase of MPOD0,5° although elevation of L and Z serum levels proved resorption.
Conclusions: :
Concentration of MP measured by a modified HRA proved to increase under intake of 12mg L and 1mg Z. One quartile of the probands showed no elevation of MPOD0,5° although serum levels increased. These findings suggest that low levels of MP in the eye may be a result of individual local metabolism and not of deficiencies in the intake.Whether the course of AMD can be influenced by supplementation has to be investigated in further multicentre and placebo controlled studies.
Keywords: macular pigment • age-related macular degeneration • nutritional factors