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SP Richer, W Stiles, L Statkute, KY Pei, J Frankowski, J Nyland, J Pulido, D Rudy; The Lutein Antioxidant Supplementation Trial . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2542.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: We describe the results of the Lutein Antioxidant Supplementation Trial (LAST) for atrophic AMD. Methods: The design is prospective 12-month, placebo controlled, double blind, repeated measures and crossover of lutein vs. lutein/antioxidants on 90 mostly male veterans (74.7 yrs +/- 7.1 yrs) with atrophic AMD (CPT 365.2). A serial-visit clinical evaluation protocol previously described and validated with pilot case series data was used. (Richer et al, JAOA 1999; 70: 13-23). The ophthalmic component involved measurement of macular pigment optical density (MPOD), lens opacification rating, contrast sensitivity (CSF), low-luminance low-contrast visual acuity, glare recovery (GR) and activities of daily living associated with AMD (night driving / glare adaptation disturbance). Results: The 3 treatment groups (10 mg lutein, 10 mg lutein/antioxidants & placebo) were matched for these known confounders: age, years diagnosed with AMD, smoking/cardiovascular history, iris color, lens opacification and nutritional status/physical activity level. Average eye MPOD, as measured by heterochromic flicker photometry, increased on average by 0.09 log units (repeated factors ANOVA; p<0.05), or 50 % in both the lutein and lutein/antioxidant treatment groups by 12 months. There was statistically significant concurrent improvement in some measures of visual function including GR, CSF and dist/near visual acuity in both treatment groups. Crossover, double crossover and video-documentation of patient symptoms pre and post treatment, were consistent with objective data. Inclusion of multiple nutrients (besides lutein) appears to provide an added improvement to CSF. Conclusion: This short-term, small population prospective clinical trial agrees with studies suggesting AMD to be, in part, a nutrition responsive disorder. Reversibility of AMD symptoms has important biophysical, physiological and clinical implications. Larger and longer-term clinical trials must confirm these preliminary findings.
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