Abstract
Objective:
The aim of the study is to determine the effect of lutein combined with vitamin and mineral supplementation on contrast sensitivity in people with age-related macular disease (ARMD).
Design:
A prospective, 9-month, double-masked randomized controlled trial.
Setting:
Aston University, Birmingham, UK and a UK optometric clinical practice.
Subjects:
Age-related maculopathy (ARM) and atrophic age-related macular degeneration (AMD) participants were randomized (using a random number generator) to either placebo (n=10) or active (n=15) groups. Three of the placebo group and two of the active group dropped out.
Interventions:
The active group supplemented daily with 6 mg lutein combined with vitamins and minerals. The outcome measure was contrast sensitivity (CS) measured using the Pelli–Robson chart, for which the study had 80% power at the 5% significance level to detect a change of 0.3 log units.
Results:
The CS score increased by 0.07±0.07 and decreased by 0.02±0.18 log units for the placebo and active groups, respectively. The difference between these values is not statistically significant (z=−0.903, P=0.376).
Conclusion:
The results suggest that 6 mg of lutein supplementation in combination with other antioxidants is not beneficial for this group. Further work is required to establish optimum dosage levels.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
References
Bartlett H, Eperjesi F (2003). A randomised controlled trial investigating the effect of nutritional supplementation on visual function in normal, and age-related macular disease affected eyes: design and methodology [ISRCTN78467674]. BMC Nutr J 2, 12.
Bartlett H, Eperjesi F (2004). An ideal ocular nutritional supplement? Ophthal Physiol Opt 24, 339–349.
Bartlett H, Eperjesi F (2005). Adverse reactions and contraindications for ocular nutritional supplements. Ophthal Physiol Opt 25, 179–194.
Beatty S, Murray IJ, Henson DB, Carden D, Koh H, Boulton ME (2001). Macular pigment and risk for age-related macular degeneration in subjects from a Northern European population. Invest Ophthalmol Vis Sci 42, 439–446.
Berendschot TT, Goldbohm RA, Klopping WA, van de Kraats J, van Norel J, van Norren D (2000). Influence of lutein supplementation on macular pigment, assessed with two objective techniques. Invest Ophthalmol Vis Sci 41, 3322–3326.
Bernstein PS, Khachik F, Carvalho LS, Muir GJ, Zhao DY, Katz NB (2001). Identification and quantitation of carotenoids and their metabolites in the tissues of the human eye. Exp Eye Res 72, 215–223.
Bird AEC, Bressler NM, Bressler SB, Chisholm IH, Coscas G, Davis MD et al. (1995). An International classification and grading system for age- related maculopathy and age related macular degeneration. Surv Ophthalmol 39, 367–374.
Bone RA, Landrum JT, Mayne S, Gomez C, Tibor S, Twaroska E (2001). Macular pigment in donor eyes with and without AMD: a case–control study. Invest Ophthalmol Vis Sci 42, 235–240.
Bowen PE, Espinosa SM, Hussain EA, Stacewicz-Sapuntzakis M (2002). Esterification does not impair lutein bioavailability in humans. J Nutr 132, 3668–3673.
Breithaupt D, Bamedi A, Wirt U (2002). Carotenol fatty acid esters: easy substrates for digestive enzymes? Comparative biochemistry and physiology. Part B, BiochemMol Biol 132, 721–728.
Chew E, Ferris FL, de Monasterio F, Thompson D, Kim J, Csaky C et al. (2003). Dose ranging study of lutein supplementation in persons over age 60. Invest Ophthalmol Vis Sci 44 E-Abstract 968.
Chung H-Y, Rasmussen H, Johnson E (2004). Lutein bioavaliability is higher from lutein-enriched eggs that from supplements and spinach in men. J Nutr 134, 1887–1893.
Dagnelie G, Zorge I, McDonald T (2000). Lutein improves visual function in some patients with retinal degeneration: a pilot study via the internet. Optometry (St Louis Mo) 71, 147–164.
DeFreitas Z (2004). Prevalence of Lutein Versus Lutein Estecs in Human Diets. Kemin Health, LC Iowa.
EDCCS Group (1993). Antioxidant status and neovascular age-related macular degeneration. The eye disease case control study group. Arch Ophthalmol 111, 104–109.
Elliott DB, Sanderson K, Conkey A (1990). The Reliability of the Pelli–Robson contrast sensitivity chart. Ophthal Physiol Opt 10, 21–24.
Fletcher D, Schuchard R (2006). Visual functionin patients with choroidal neovascularization resulting from age-related macular degeneration: the importance of looking beyond visual acuity Optom. Vis Sci 83, 178–189.
Goodwin T (1980). The Biochemistry of Carotenoids. Vol 1. London: Chapman and Hall.
Granado F, Olmedilla B, Blanco I (2002). Serum depletion and bioavaliability of lutein in type I diabetic patients. EurJ Nutr 41, 47–53.
Haegerstrom-Portnoy G, Schneck M, Lott L, Brabyn J (2000). The relation between visual acuity and other spatial vision measures. Optom Vis Sci 77, 653–662.
Hammond Jr BR, Johnson EJ, Russell RM, Krinsky NI, Yeum KJ, Edwards RB et al. (1997). Dietary modification of human macular pigment density. Invest Ophthalmol Vis Sci 38, 1795–1801.
Hammond BR, Wooten BR, Curran-Celentano J (2001). Carotenoids in the retina and lens: possible acute and chronic effects on human visual performance. Arch Biochem Biophys 385, 41–46.
Hyvarinen L (1995). Contrast sensitivity testing in clinical practice. Br J Ophthalmol 79, 867–868.
Hyvarinen L, Laurinen P, Rovamo J (1983). Contrast sensitivity in evaluation of visual impairment due to macular degeneration and optic nerve lesions. Acta Ophthalmol (Copenhagen) 61, 161–170.
Jin C, Wu D, Wu L (1992). The contrast sensitivity function in low vision. Yen Ko Hsueh Pao 8.
Klein R, Klein B, Jensen S, Meuer S (1997). The five-year incidence and progression of age-related maculopathy: the Beaver Dam Eye Study. Ophthalmology 104, 7–21.
Krinsky NI (2002). Possible biologic mechanisms for a protective role of xanthophylls. J Nutr 132, 5405–5425.
Landrum JT, Bone RA (2001). Lutein, Zeaxanthin and the macular pigment. Arch Biochem Biophys 385, 28–40.
Landrum J, Bone R (2004). Dietary lutein and zeaxanthin: reducing the risk for macular degeneration. Agro Food Ind. Hi-Tech 15, 22–25.
Landrum JT, Bone R, Dixon Z, Etienne-Levielle V, Formosa M, Saint-Louis M (2004). Influence of lutein dosage on macular pigment response. Invest Ophthalmol Vis Sci 45 E-Abstract 1290.
Landrum JT, Bone RA, Joa H, Kilburn MD, Moore LL, Sprague KE (1997). A one year study of the macular pigment: the effect of 140 days of a lutein supplement. Exp Eye Res 65, 57–62.
Mares-Perlman J (1999). Too soon for lutein supplements. Am J Clin Nutr 70, 431–432.
Moher D, Schulz K, Altman D (2001). The CONSORT statement: revised recommendations for improving the quality of reports of parallel group randomized trials. BMC Med Res Methodol 1, 2.
Mones J, Rubin G (2005). Contrast sensitvity as an outcome measure in patients with subfoveal choroidal neovascularisation due to age-related macular degeneration. Eye 19, 1142–1150.
Newsome D, Miceli M, Liles M, Tate D, Oliver P (1994). Antioxidants in the retinal pigment epithelium. Prog Retin Eye Res 13, 101–123.
Noy N (2000). Vitamin A in Biochemical and Physiological Aspects of Human Nutrition M Stipanuk (Ed), WC Saunders CO: Philadelphia, pp 599–618.
Pease P, Adams A, Nuccio E (1987). Optical density of human macular pigment. Vis Res 27, 705–710.
Rapp LM, Maple SS, Choi JH (2000). Lutein and zeaxanthin concentrations in rod outer segment membranes from perifoveal and peripheral human retina. Invest Ophthalmol Vis Sci 41, 1200–1209.
Reading V, Weale R (1974). Macular pigment and chromatic aberration. J Optom Soc Am 64, 231–238.
Richer S (1999). ARMD – pilot (case series) environmental intervention data. J Am Optom Assoc 70, 24–36.
Richer S, Stiles W, Statkute L, Pulido J, Frankowski J, Rudy D et al. (2004). Double-masked, placebo-controlled, randomized trial of lutein and antioxidant supplementation in the intervention of atrophic age-related macular degeneration: the Veterans LAST study (Lutein Antioxidant Supplementation Trial). Optometry 75, 216–230.
Rubin G, Bandeen-Roche K, Huang G, Munoz B, CSchein O, Fried L et al. (2001). The association of multiple visual impairments with self-reported visual disability: SEE project. Invest Ophthalmol Vis Sci 42, 64–72.
Rubin G, Roche K, Prasada-Rao P, Fried L (1994). Visual imparment and disability in older adults. Optom Vis Sci 71, 750–760.
Rubin G, West S, Munoz B, Bandeen-Roche K, KZeger S, Schein O et al. (1997). A comprehensive assessment of visual impairment in a population of older Americans. Invest Ophthalmol Vis Sci 38, 557–568.
Scott I, Feuer W, Jacko J (2002). Impact of visual function on computer task accuracy and reaction time in a cohort of patients with age-related macular degeneration. Am J Ophthalmol 133, 350–357.
Seddon JM, Ajani UA, Sperduto RD, Hiller R, Blair N, Burton TC et al. (1994). Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye disease case–control study group. JAMA 272, 1413–1420.
Snodderly DM, Brown B, Delori F, Auran J (1984). The macular pigment I. Absorbance spectra, localisation, and discrimination from other yellow pigments in primate retinas. Invest Ophthalmol Vis Sci 25, 660–673.
Sommerburg O, Siems W, Hurst J, Lewis J, Kliger D, van Kuijk F (1999). Lutein and zeaxanthin are associated with photoreceptors in the human retina. Curr Eye Res 19, 491–495.
Sujak A, Gabrielska J, Grudzinsnki W, Borc R, Mazurek P, Gruszecki W (1999). Lutein and zeaxanthin as protectors of lipid membranes against oxidative damage: The structural aspects. Arch Biochem Biophys 15, 301–307.
The AREDS Research Group (2001). A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss – AREDS Report No. 8. Arch Ophthalmol 119, 1417–1436.
The ATBC Cancer Prevention Study Group (1994). The effect of vitamin E and beta-carotene on the incidence of lung cancer and other cancers in male smokers. New Engl Med J 330, 1029–1035.
Wald G (1945). Human vision and the spectrum. Science 101, 653–658.
World Medical Association (1997). Declaration of Helsinki. J Am Med Assoc 277, 925–926.
Yemelyanov A, Katz N, Bernstein P (2001). Ligan-binding characterization of xanthophyll carotenoids to solubilized membrane proteins derived from human retina. Exp Eye Res 72, 381–392.
Yeum K-J, Taylor A, Tang G, Russell R (1995). Measurement of carotenoids, retinoids, and tocopherols in human lenses. Invest Opthalmol Vis Sci 36, 2756–2761.
Zarbin M (2004). Current concepts in the pathogenesis of age-related macular degeneration. Arch Ophthalmol 122, 598–614.
Acknowledgements
The project was sponsored by the UK College of Optometrists. Intervention and placebo tablets were provided by Quest Vitamins Ltd UK.
Author information
Authors and Affiliations
Corresponding author
Additional information
Guarantor: HE Bartlett.
Contributors: HEB and FE contributed to the design of the trial, statistical analyses, and preparation of the manuscript. HEB collected the data. HEB and FE read and approved the final manuscript.
Rights and permissions
About this article
Cite this article
Bartlett, H., Eperjesi, F. Effect of lutein and antioxidant dietary supplementation on contrast sensitivity in age-related macular disease: a randomized controlled trial. Eur J Clin Nutr 61, 1121–1127 (2007). https://doi.org/10.1038/sj.ejcn.1602626
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ejcn.1602626
Keywords
This article is cited by
-
Productivity and selective accumulation of carotenoids of the novel extremophile microalga Chlamydomonas acidophila grown with different carbon sources in batch systems
Journal of Industrial Microbiology & Biotechnology (2011)
-
Welchen Stellenwert haben Vitamine für das Auge
Der Ophthalmologe (2010)
-
Vitamine für das Auge?
Der Ophthalmologe (2009)