TY - JOUR
T1 - The impact of supplemental antioxidants on visual function in nonadvanced age-related macular degeneration
T2 - A head-to-head randomized clinical trial
AU - Akuffo, Kwadwo Owusu
AU - Beatty, Stephen
AU - Peto, Tunde
AU - Stack, Jim
AU - Stringham, Jim
AU - Kelly, David
AU - Leung, Irene
AU - Corcoran, Laura
AU - Nolan, John M.
N1 - Funding Information:
The authors thank the Whitfield Clinic Pharmacy, Waterford, Ireland, for their support with randomization and intervention assignment (Catherine Kelly [Chief Pharmacist] and Lisa O’Brien [Pharmacy Technician]). They also thank Moorfields Eye Hospital Reading Centre, London, United Kingdom, for retinal photograph grading where Tunde Peto and Irene Leung have been funded by the National Institute of Health Research Biomedical Research Centre at Moorfields Eye Hospital and University College London Institute of Ophthalmology. They also thank Elizabeth Johnson from Tufts University, Boston, Massachusetts, United States, for permission to use the ‘‘L/Z screener’’ for estimating dietary intake of lutein and zeaxanthin in this study. They also thank the CREST Data Safety and Monitoring Committee (James Loughman [Chairperson and Vision Scientist], Ailbhe Whyte [Medical Ophthalmologist], Michael Harrison [Research Ethics Committee member], and Frank Leonard [Statistician]) for their support and guidance during the Central Retinal Enrichment Supplementation Trials study. Supported by the European Research Council Grant 281096.
Publisher Copyright:
© 2017 The Authors.
PY - 2017/10
Y1 - 2017/10
N2 - PURPOSE. The purpose of this study was to evaluate the impact of supplemental macular carotenoids (including versus not including meso-zeaxanthin) in combination with coantioxidants on visual function in patients with nonadvanced age-related macular degeneration. METHODS. In this study, 121 participants were randomly assigned to group 1 (Age-Related Eye Disease Study 2 formulation with a low dose [25 mg] of zinc and an addition of 10 mg mesozeaxanthin; n = 60) or group 2 (Age-Related Eye Disease Study 2 formulation with a low dose [25 mg] of zinc; n = 61). Visual function was assessed using best-corrected visual acuity, contrast sensitivity (CS), glare disability, retinal straylight, photostress recovery time, reading performance, and the National Eye Institute Visual Function Questionnaire-25. Macular pigment was measured using customized heterochromatic flicker photometry. RESULTS. There was a statistically significant improvement in the primary outcome measure (letter CS at 6 cycles per degree [6 cpd]) over time (P = 0.013), and this observed improvement was statistically comparable between interventions (P = 0.881). Statistically significant improvements in several secondary outcome visual function measures (letter CS at 1.2 and 2.4 cpd; mesopic and photopic CS at all spatial frequencies; mesopic glare disability at 1.5, 3, and 6 cpd; photopic glare disability at 1.5, 3, 6, and 12 cpd; photostress recovery time; retinal straylight; mean and maximum reading speed) were also observed over time (P < 0.05, for all), and were statistically comparable between interventions (P > 0.05, for all). Statistically significant increases in macular pigment at all eccentricities were observed over time (P < 0.0005, for all), and the degree of augmentation was statistically comparable between interventions (P > 0.05). CONCLUSIONS. Antioxidant supplementation in patients with nonadvanced age-related macular degeneration results in significant increases in macular pigment and improvements in CS and other measures of visual function. (Clinical trial, http://www.isrctn.com/ISRCTN13894787).
AB - PURPOSE. The purpose of this study was to evaluate the impact of supplemental macular carotenoids (including versus not including meso-zeaxanthin) in combination with coantioxidants on visual function in patients with nonadvanced age-related macular degeneration. METHODS. In this study, 121 participants were randomly assigned to group 1 (Age-Related Eye Disease Study 2 formulation with a low dose [25 mg] of zinc and an addition of 10 mg mesozeaxanthin; n = 60) or group 2 (Age-Related Eye Disease Study 2 formulation with a low dose [25 mg] of zinc; n = 61). Visual function was assessed using best-corrected visual acuity, contrast sensitivity (CS), glare disability, retinal straylight, photostress recovery time, reading performance, and the National Eye Institute Visual Function Questionnaire-25. Macular pigment was measured using customized heterochromatic flicker photometry. RESULTS. There was a statistically significant improvement in the primary outcome measure (letter CS at 6 cycles per degree [6 cpd]) over time (P = 0.013), and this observed improvement was statistically comparable between interventions (P = 0.881). Statistically significant improvements in several secondary outcome visual function measures (letter CS at 1.2 and 2.4 cpd; mesopic and photopic CS at all spatial frequencies; mesopic glare disability at 1.5, 3, and 6 cpd; photopic glare disability at 1.5, 3, 6, and 12 cpd; photostress recovery time; retinal straylight; mean and maximum reading speed) were also observed over time (P < 0.05, for all), and were statistically comparable between interventions (P > 0.05, for all). Statistically significant increases in macular pigment at all eccentricities were observed over time (P < 0.0005, for all), and the degree of augmentation was statistically comparable between interventions (P > 0.05). CONCLUSIONS. Antioxidant supplementation in patients with nonadvanced age-related macular degeneration results in significant increases in macular pigment and improvements in CS and other measures of visual function. (Clinical trial, http://www.isrctn.com/ISRCTN13894787).
KW - Age-related macular degeneration
KW - Contrast sensitivity
KW - Glare disability
KW - Lutein
KW - Macular pigment
KW - Macular pigment
KW - Meso-zeaxanthin
KW - NEI VFQ-25
KW - Photostress recovery time
KW - Randomized clinical trial
KW - Reading performance
KW - Retinal straylight
KW - Visual acuity
KW - Visual function
KW - Zeaxanthin
UR - http://www.scopus.com/inward/record.url?scp=85032143463&partnerID=8YFLogxK
U2 - 10.1167/iovs.16-21192
DO - 10.1167/iovs.16-21192
M3 - Article
C2 - 29053808
AN - SCOPUS:85032143463
SN - 0146-0404
VL - 58
SP - 5347
EP - 5360
JO - Investigative Ophthalmology and Visual Science
JF - Investigative Ophthalmology and Visual Science
IS - 12
ER -