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AMD & Macular Pigments:

(Zeaxanthin and Lutein)

AREDS 2 Study

(Chew, MD. et. al.)

• The AREDS 1 formula plus Lutein & Zeaxanthin vs. AREDS 1 & beta-carotene:

– 18% reduction in the progression to advanced AMD

– 22% reduction in the risk of progression to neovascular AMD

• AREDS formula along with Lutein + Zeaxanthin vs. AREDS formula with no Lutein + Zeaxanthin:

– 10% additional reduction in the risk of progression to advanced AMD

– 11% reduction in the risk of progression to neovascular AMD – 26% reduction to advanced AMD in the lowest quintile – the group with the lowest dietary intake of Lutein and Zeaxanthin, which is more representative of the general population

Improvement of Retinal Function in Early Age-Related Macular Degeneration After Lutein and Zeaxanthin Supplementation: A Randomized, Double-Masked, Placebo-Controlled Trial

(Ma et. al. - American Journal of Ophthalmology, October 2012 Peking University Eye Center, Beijing, China)

• 108 subjects with early AMD supplemented with 10 mgs Lutein, 10 mgs Lutein & 10 mgs Zeaxanthin, 20 mgs Lutein, or placebo plus 36 age matched controls. (144 subjects)

• Pre and post supplementation multi-focal ERG was measured in 6 concentric annular zones around the macula

• Increased MPOD related positively to increases in N1P1 response density in ring 1 and ring 2 with little effect in ring 3 thru 6

• Improvement of N1P1 response densities was positively associated with MPOD increase, suggesting a causative effect of MPOD on retinal function and health

• Early functional abnormalities of the central retina in the early AMD patients may be improved by Lutein and Zeaxanthin supplementation

• The 10 mgs Lutein/10 mgs dietary Zeaxanthin arm had the greatest ERG documented retinal function increase in ring 1

POLA Study: Plasma Lutein and Zeaxanthin and Other Carotenoids

(Delcourt, et. al. - Investigative Ophthalmology and Visual Science 2006)

• 899 subjects

• Subjects with high plasma levels of zeaxanthin had a 93% reduction in AMD

• Subjects with high plasma levels of lutein had a 79% reduction in AMD

Rotterdam Study: Reducing the Genetic Risk of AMD

(Lintje Ho, MD et. al - Archives of Ophthalmology 2011)

• 2,167 subjects

Subjects with genetic AMD risk factors in the highest tertile of dietary zinc, ß-carotene, lutein/zeaxanthin, and EPA/DHA intake had a significant hazard ratio reduction for early AMD of approximately 40%

Serum Carotenoids and Risk of AMD

(Zhou, et. al. - Investigative Ophthalmology and Visual Science 2011)

• 263 Chinese subjects

• Serum levels of carotenoids and retinol were significantly lower in subjects with exudative AMD than in controls.

– Zeaxanthin (96% Relative Risk Reduction)

– Lycopene (78% Relative Risk Reduction)

• No significant associations between serum lutein and subjects with early or exudative AMD were observed

Blue Mountains Eye Study: Dietary Antioxidants and the Long-term Incidence of AMD

(Tan, et. al. - American Academy of Ophthalmology 2008)

• 2,454 subjects

• Higher dietary intake of zeaxanthin and lutein reduced risk of AMD by 65%

• Confirmed protective influence of zinc

• Higher beta-carotene was associated with increased risk of AMD

AREDS Report 22: The Relationship of Dietary Carotenoid and Vitamin A, E and C Intake with AMD

(Emily Chew, M.D., et. al. - Archives of Ophthalmology 2007)

• 4,757 subjects

• Participants reporting highest intake of zeaxanthin & lutein less likely to have advanced AMD (NV & GA) or intermediate drusen

Gale Study: Lutein and Zeaxanthin Status and Risk of AMD

(Gale, et. al. - Ophthalmology and Visual Science 2003)

• 380 subjects

• Low levels of zeaxanthin in plasma correlated with significantly higher AMD risk

• Did not show similar effect for lutein

• Possible studies that combine zeaxanthin & lutein may obscure protective effect of zeaxanthin

Bone & Landrum: Macular Pigment In Donor Eyes

(Bone, et. al. - Investigative Ophthalmology and Visual Science 2001)

• 112 cadaver donors, 224 eyes

• Lutein and zeaxanthin levels in all three concentric regions of the retina were less, on average, for AMD donors than controls

• Donor eyes in the highest quartile of lutein and zeaxanthin per unit area had an 82% lower prevalence of AMD compared with those in the lowest quartile

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