J Korean Ophthalmol Soc.  2018 Dec;59(12):1152-1159. 10.3341/jkos.2018.59.12.1152.

Long-term Results of Taking Anti-oxidant Nutritional Supplement in Intermediate Age-related Macular Degeneration

• Bang SK
• Kim ES
• Kim JW
• Shin JP
• Lee JE
• Yu HG
• Huh K
• Yu SY

• KMID: 2428687
• DOI: http://doi.org/10.3341/jkos.2018.59.12.1152

Abstract

PURPOSE
We prospectively investigated clinical changes and long-term outcomes after administration of the drugs recommended by the Age-Related Eye Disease Study-2 to patients with intermediate age-related macular degeneration (AMD).
METHODS
This prospective multicenter study enrolled 79 eyes of 55 patients taking lutein and zeaxanthin. The primary endpoint was contrast sensitivity; this was checked every 12 months for a total of 36 months after treatment commenced. The secondary endpoints were visual acuity, central macular thickness, and drusen volume; the latter two parameters were assessed using spectral domain optical coherence tomography.
RESULTS
The mean patient age was 72.46 ± 7.16 years. Contrast sensitivity gradually improved at both three and six cycles per degree. The corrected visual acuity was 0.13 ± 0.14 logMAR and did not change significantly over the 36 months. Neither the central macular thickness nor drusen volume changed significantly.
CONCLUSIONS
Contrast sensitivity markedly improved after treatment, improving vision and patient satisfaction. Visual acuity, central retinal thickness, and drusen volume did not deteriorate. Therefore, progression of AMD and visual function deterioration were halted.

Keyword

Age-Related Eye Disease Study (AREDS)-2 formula; Contrast sensitivity; Drusen volume; Intermediate age-related macular degeneration (AMD)

MeSH Terms

Contrast Sensitivity
Eye Diseases
Humans
Lutein
Macular Degeneration*
Patient Satisfaction
Prospective Studies
Retinaldehyde
Tomography, Optical Coherence
Visual Acuity
Zeaxanthins
Lutein
Retinaldehyde
Zeaxanthins

Figure

• 

  Figure 1 Bar graph showing the results of contrast sensitivity at each spatial frequency. Changing of contrast sensitivity during the follow-up period. *Significantly different than the baseline.

• 

  Figure 2 Changing of variables during the follow-up period. (A) Best-corrected visual acuity (BCVA). (B) Mean central macular thickness. (C) Mean drusen volume. (D) Area of hypo-fluorescence region. *Significantly different than the baseline.

• 

  Figure 3 A case of progression to advanced age-related macular degeneration. (A) Baseline. (B) After 36 months of administration of Age-Related Eye Disease Study-2 formula. FAF = fundus autofluorescence; OCT = optical coherence tomography; FA = fluorescein angiography; ICGA = indocyanine green angiography.

Reference

1. Vingerling JR, Dielemans I, Hofman A, et al. The prevalence of age-related maculopathy in the Rotterdam study. Ophthalmology. 1995; 102:205–210.

2. Klein R, Chou CF, Klein BE, et al. Prevalence of age-related macular degeneration in the US population. Arch Ophthalmol. 2011; 129:75–80.

3. Klein R, Klein BE, Linton KL. Prevalence of age-related maculopathy. The beaver dam eye study. Ophthalmology. 1992; 99:933–943.

4. Krishnaiah S, Das TP, Kovai V, Rao GN. Associated factors for Age-related maculopathy in the adult population in southern India: the Andhra Pradesh eye disease study. Br J Ophthalmol. 2009; 93:1146–1150.

5. Miyazaki M, Nakamura H, Kubo M, et al. Risk factors for age related maculopathy in a Japanese population: the Hisayama study. Br J Ophthalmol. 2003; 87:469–472.

6. Song SJ, Youm DJ, Chang Y, Yu HG. Age-related macular degeneration in a screened South Korean population: prevalence, risk factors, and subtypes. Ophthalmic Epidemiol. 2009; 16:304–310.

7. Park SJ, Lee JH, Woo SJ, et al. Epidemiologic Survey Committee of the Korean Ophthalmologic Society; Age-related macular degeneration: prevalence and risk factors from Korean National Health and Nutrition Examination Survey, 2008 through 2011. Ophthalmology. 2014; 121:1756–1765.

8. Dimitrov PN, Mukesh BN, McCarty CA, Taylor HR. Five-year incidence of bilateral cause-specific visual impairment in the Melbourne visual impairment project. Invest Ophthalmol Vis Sci. 2003; 44:5075–5081.

9. Domalpally A, Danis R, Agrón E, et al. Evaluation of geographic atrophy from color photographs and fundus autofluorescence images: age-related eye disease study 2 report number 11. Ophthalmology. 2016; 123:2401–2407.

10. Ding X, Patel M, Chan CC. Molecular pathology of age-related macular degeneration. Prog Retin Eye Res. 2009; 28:1–18.

11. Age-Related Eye Disease Study Research Group. 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. 2001; 119:1417–1436.

12. Faria BM, Duman F, Zheng CX, et al. Evaluating contrast sensitivity in age-related macular degeneration using a novel computer-based test, the SPAETH/RICHMAN contrast sensitivity test. Retina. 2015; 35:1465–1473.

13. Maynard ML, Zele AJ, Feigl B. Mesopic Pelli-Robson contrast sensitivity and MP-1 microperimetry in healthy ageing and age-related macular degeneration. Acta Ophthalmol. 2016; 94:e772–e778.

14. Richman J, Spaeth GL, Wirostko B. Contrast sensitivity basics and a critique of currently available tests. J Cataract Refract Surg. 2013; 39:1100–1106.

15. Hammond BR, Fletcher LM, Roos F, et al. A double-blind, placebo-controlled study on the effects of lutein and zeaxanthin on photostress recovery, glare disability, and chromatic contrast. Invest Ophthalmol Vis Sci. 2014; 55:8583–8589.

16. Nolan JM, Power R, Stringham J, et al. Enrichment of macular pigment enhances contrast sensitivity in subjects free of retinal disease: central retinal enrichment supplementation trials - report 1. Invest Ophthalmol Vis Sci. 2016; 57:3429–3439.

17. Kvansakul J, Rodriguez-Carmona M, Edgar DF, et al. Supplementation with the carotenoids lutein or zeaxanthin improves human visual performance. Ophthalmic Physiol Opt. 2006; 26:362–371.

18. Loughman J, Nolan JM, Howard AN, et al. The impact of macular pigment augmentation on visual performance using different carotenoid formulations. Invest Ophthalmol Vis Sci. 2012; 53:7871–7880.

19. Nolan JM, Loughman J, Akkali MC, et al. The impact of macular pigment augmentation on visual performance in normal subjects: COMPASS. Vision Res. 2011; 51:459–469.

20. Olmedilla B, Granado F, Blanco I, Vaquero M. Lutein, but not alpha-tocopherol, supplementation improves visual function in patients with age-related cataracts: a 2-y double-blind, placebo-controlled pilot study. Nutrition. 2003; 19:21–24.

21. Ma L, Lin XM, Zou ZY, et al. A 12-week lutein supplementation improves visual function in Chinese people with long-term computer display light exposure. Br J Nutr. 2009; 102:186–190.

22. Bartlett HE, 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. 2007; 61:1121–1127.

23. Woods RL, Wood JM. The role of contrast sensitivity charts and contrast letter charts in clinical practice. Clin Exp Optom. 1995; 78:43–57.

24. Legge GE, Rubin GS, Pelli DG, Schleske MM. Psychophysics of reading--II. Low vision. Vision Res. 1985; 25:253–265.

25. Lovie-Kitchin JE, Mainstone JC, Robinson J, Brown B. What areas of the visual field are important for mobility in low vision patients. Vision Res. 1990; 5:249–263.