Lutein and Zeaxanthin for Age-related Macular Degeneration (AMD)

Published on December 30, 2012 by

Effect of supplementation with lutein and zeaxanthin on visual performance, development and progression of age-related macular degeneration.

Lutein and zeaxanthin help with night vision, distance vision, close vision and colour vision.

Lutein and zeaxanthin are macular carotenoids of dietary origin. Lutein is the main pigment in macula and together with its isomer zeaxanthin are also known as macular pigments or zanthophylls. There is large body of scientific evidence on eye health benefits of macular pigments, which have been tested in many clinical studies including the AREDS2 clinical study currently underway in the United States.

According to reports by British Nutrition Foundation (BNF), natural carotenoids lutein and zeaxanthin may help protect against poor eye health in later life.

Lutein is a naturally occurring pigment found in dark green leafy vegetables such as spinach, kale and collard greens. Lutein is also found in marigold flowers.  Lutein is thought to act as an antioxidant and photoprotectant. It plays an important protecting role in our eye by acting as a kind of natural sun block protecting the retina against damaging effects of too much light. Because free radicals may play a role in macular degeneration, the effect of lutein on eye is also attributable to its antioxidant property, protecting retina from damaging effect of light.Lutein for macular degeneration treatment

It is well established that low dietary intake of lutein/zeaxanthin is inversely associated with development of age-related macular degeneration (AMD).

Experiments have shown that regular consumption of lutein at 10 mg/day can increase the macular pigment optical density (MPOD) in the eye, which may potentially reduce the risk for development of AMD. Lutein supplementation also stabilized visual acuity, and increased vision related quality of life in patients with AMD. No evidence of harmful side effect was found in many of the related studies.

Individuals using lutein supplements experienced significant improvements in several objective measurements of visual function including glare recovery, contrast sensitivity, and visual acuity compared to individual who took only placebo.

Functional and morphologic benefits were observed after supplementation with lutein and zeaxanthin in persons with early AMD13, suggesting that increased intake of these carotenoids may be associated with a reduced risk for AMD. 14

A study from China showed improvement in early functional abnormalities of the central retina in the early AMD by lutein and zeaxanthin supplementation. 15

This confirmed an earlier study in China that supplementation with lutein and zeaxanthin improved macular pigment boosted visual function and therefore might have an important role in preventing the progression of AMD. 16

Many studies have shown that macular pigments have the capacity to affect processes implicated in pathogenesis of AMD, as they have been shown to:

-interact with membrane-bound proteins and lipids of the retina.

- absorb or attenuate energy in the range of damaging ambient blue light.

-  modulate oxidative stress and redox balance by scavenging oxidizing agents and re-reducing oxidized macromolecules,neutralizing singlet oxygen, peroxyl radicals, and nitric dioxide

-  interact with key molecules in various signal transduction cascades for example involved in maintaining cellular homeostasis. 17

The in vitro findings support the epidemiologic evidence that dietary supplements may act as factors that modulate processes implicated in AMD pathogenesis and its progression.

Lutein may also be useful for treatment of retinitis pigmentosa, an inherited form of eye disease that causes progressive vision loss.

Despite the importance of eye health benefits of xanthophylls, recent data suggest that dietary intake levels of these two pigments declined in Europe and the US. The average American ingests about one to two mg of lutein daily, supporting the discussion for daily supplementation with lutein at levels of 6 to 10 mg daily.

It is important to remember that our body cannot synthesise lutein and zeaxanthin, and they need to be supplied through a balanced diet or by a nutritional supplement. Despite the beneficial effects of macular pigments, their dietary intake levels declined in Europe and the US. Fortunately, dietary supplementation by lutein and zeaxanthin can help increase serum and macular levels of these important carotenoids.



Science References:
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2- Chucair AJ, Rotstein NP, Sangiovanni JP, During A, Chew EY, Politi LE. (2007). Lutein and zeaxanthin protect photoreceptors from apoptosis induced by oxidative stress: relation with docosahexaenoic acid. Invest Ophthalmol Vis Sci 48:5168-5177.
3- Rotstein NP, Politi LE, German OL, Girotti R. (2003). Protective effect of docosahexaenoic acid on oxidative stress-induced apoptosis of retina photoreceptors. Invest Ophthalmol Vis Sci 44: 2252-2259.
4- Landrum JT, Bone RA, Kilburn MD. (1997). The macular pigment: a possible role in protection from age-related macular degeneration. Adv Pharmacol 38:537-556.
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11-Bartlett H, Eperjesi F. (2004). An ideal ocular nutritional supplement? Ophthalmic Physiol Opt 24:339-49.
12- Barker, FM. (2010) Dietary supplementation: effects on visual performance and occurrence of AMD and cataracts. Current Medical Research & Opinion 26: 2011–2023.

13- Beatty S, Chakravarthy U, Nolan JM, Muldrew KA, Woodside JV, Denny F, Stevenson MR. (2012). Secondary Outcomes in a Clinical Trial of Carotenoids with Coantioxidants versus Placebo in Early Age-Related Macular Degeneration. Ophthalmology pii: S0161-6420(12)00850-0. doi: 10.1016/j.ophtha.2012.08.040.

14- Aslam T, Delcourt C, Silva R, Holz FG, Leys A, Garcià Layana A, Souied E. (2012). Micronutrients in Age-Related Macular Degeneration. Ophthalmologica  DOI: 10.1159/000343708

15- Ma L, Dou HL, Huang YM, Lu XR, Xu XR, Qian F, Zou ZY, Pang HL, Dong PC, Xiao X, Wang X, Sun TT, Lin XM.. (2012). Improvement of retinal function in early age-related macular degeneration after lutein and zeaxanthin supplementation: a randomized, double-masked, placebo-controlled trial. Am J Ophthalmol. 154(4):625-634.e1. doi: 10.1016/j.ajo.2012.04.014.

16- Ma L, Yan SF, Huang YM, Lu XR, Qian F, Pang HL, Xu XR, Zou ZY, Dong PC, Xiao X, Wang X, Sun TT, Dou HL, Lin XM. Effect of lutein and zeaxanthin on macular pigment and visual function in patients with early age-related macular degeneration. Ophthalmology. 119(11):2290-7. doi: 10.1016/j.ophtha.2012.06.014.

17- SanGiovanni JP, Neuringer M. (2012). The putative role of lutein and zeaxanthin as protective agents against age-related macular degeneration: promise of molecular genetics for guiding mechanistic and translational research in the field. Am J Clin Nutr. 2012 Nov;96(5):1223S-33S. doi: 10.3945/ajcn.112.038240.

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