Abstract
Purpose :
In some patients with advanced glaucoma pericentral visual function may continue to deteriorate despite excellent IOP control. This study assesses the potential utility of a recently introduced medical food, Lumega-Z, designed to restore the macular protective pigment layer. It contains >35 micronutrients with antioxidant characteristice and three key carotenoids, lutein, zeaxanthine and meso-zeaxanthene. The latter, an enantiomer of lutein, is produced by isomerase conversion in juvenile primates but this enzyme is lacking in adults. Mesozeaxanthene is not available in standard diet, but can be prescribed in liquid suspension by eye care providers under Section 403(q)(5)(A)(iv) of the FDCA. This study evaluates the effect of Lumega-Z among compliant patients with severe glaucomatous visual field loss whose pericentral visual function was continuing to degenerate in at least one eye despite excellent IOP control.
Methods :
Patients confirmed to have ordered 12 consecutive months supply of Lumega-Z were evaluated by FDT 30-2. The attenuation threshold values for the central 5 loci were summed, and baseline values were compared with those obtained at 12 months. All subjects were perimetrically experienced with >3 prior FDTs and demonstrated high reliability. Statistical significance of change was assessed by paired t-test. This assessment was a retrospective chart review of patients who had already elected to receive this treatment as part of their normal clinical treatment, and their masked alphanumeric data was assessed under noninvasive IRB waiver.
Results :
20 eyes of 11 patients were assessed (2 monocular; 7F4M, mean age 75). Mean cumulative pericentral FDT threshold baseline values were 26.28(sem 1.3) versus 27.28(1.1) 12 months post-initiation of Lumega-Z (P=0.05; t=2.08, df=19, sed 0.48, 95%ci -2.0 to 0.004). No other change in therapy was carried out among any of the eyes under study during this assessment interval.
Conclusions :
Lumega-Z treatment was associated with significant improvement in FDT pericentral function among patients with severe glacuoma who had previously shown degeneration despite having had excellent intraocular pressure control.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.