1
|
Kohnen T, Hammond BR. Blue Light Filtration in Intraocular Lenses: Effects on Visual Function and Systemic Health. Clin Ophthalmol 2024; 18:1575-1586. [PMID: 38835885 PMCID: PMC11149638 DOI: 10.2147/opth.s448426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 05/02/2024] [Indexed: 06/06/2024] Open
Abstract
Blue light-filtering (BLF) intraocular lenses (IOLs) are designed to mimic the healthy natural adult crystalline lens. Studies that evaluated the relative merit of ultraviolet-only IOL design (ie, blocking wavelengths <400 nm) versus BLF IOL design (ie, filtering wavelengths ~400-475 nm in addition to blocking wavelengths <400 nm) on protection and function of the visual system suggest that neither design had a deleterious impact on visual acuity or contrast sensitivity. A BLF design may reduce some aspects of glare, such as veiling and photostress. BLF has been shown in many contexts to improve visual performance under conditions that are stressed by blue light, such as distance vision impaired by short-wave dominant haze. Furthermore, some data (mostly inferential) support the notion that BLF IOLs reduce actinic stress. Biomimetic BLF IOLs represent a conservative approach to IOL design that provides no harm for visual acuity, contrast sensitivity, or color vision while improving vision under certain circumstances (eg, glare).
Collapse
Affiliation(s)
- Thomas Kohnen
- Department of Ophthalmology, Goethe University, Frankfurt, Germany
| | - Billy R Hammond
- Vision Sciences Laboratory, University of Georgia, Athens, GA, USA
| |
Collapse
|
2
|
Hu W, Seah V, Huang V, Kim JE. Effect of Antioxidant Supplementation on Macular Pigment Optical Density and Visual Functions: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2024; 15:100216. [PMID: 38582248 PMCID: PMC11052915 DOI: 10.1016/j.advnut.2024.100216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 03/14/2024] [Accepted: 03/29/2024] [Indexed: 04/08/2024] Open
Abstract
Antioxidants are bioactive molecules that function to scavenge free radicals and balance oxidative stress. Although all antioxidants can act as reactive oxygen species scavengers, their efficacy on eye health may vary. Moreover, the comparative effectiveness and potential additive effect between groups of antioxidants, hitherto, have not been systematically studied. A systematic review and network meta-analysis were conducted to investigate the comparative or additive effect of dietary antioxidant supplements on eye health. Four databases (PubMed, Embase, CINAHL, and Cochrane) were searched, and relevant randomized controlled trials were identified. Out of 60 articles selected for systematic review, 38 were included in the network meta-analysis, categorized into 8 distinct antioxidant-supplemented groups and placebo. All groups significantly increased macular pigment optical density and contrast sensitivity at low spatial frequency, whereas only the antioxidant mixture + lutein (L) + fatty acid combination exhibited significant improvements in visual acuity (hazard ratio = -0.15; 95% confidence interval: -0.28, -0.02) and L + zeaxanthin combination for photostress recovery time (hazard ratio = -5.75; 95% confidence interval: -8.80, -1.70). Especially, the L + zeaxanthin + fatty acid combination was ranked best for macular pigment optical density (surface under the cumulative ranking: 99.3%) and second best for contrast sensitivity at low spatial frequency (67.7%). However, these findings should be interpreted with caution due to low quality of evidence, primarily influenced by indirectness and potential publication bias. Overall, antioxidant supplementation was estimated to improve eye health parameters, whereas different combinations of antioxidants may also have varying effects on improving visual health from multiple perspectives. This study was registered at PROSPERO as CRD42022369250.
Collapse
Affiliation(s)
- Weili Hu
- Department of Food Science and Technology, National University of Singapore, Singapore
| | - Vernice Seah
- Department of Food Science and Technology, National University of Singapore, Singapore
| | - Vanessa Huang
- Department of Food Science and Technology, National University of Singapore, Singapore
| | - Jung Eun Kim
- Department of Food Science and Technology, National University of Singapore, Singapore.
| |
Collapse
|
3
|
Obana A, Ote K, Gohto Y, Yamada H, Hashimoto F, Okazaki S, Asaoka R. Deep learning-based correction of cataract-induced influence on macular pigment optical density measurement by autofluorescence spectroscopy. PLoS One 2024; 19:e0298132. [PMID: 38349916 PMCID: PMC10863874 DOI: 10.1371/journal.pone.0298132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/19/2024] [Indexed: 02/15/2024] Open
Abstract
PURPOSE Measurements of macular pigment optical density (MPOD) using the autofluorescence spectroscopy yield underestimations of actual values in eyes with cataracts. Previously, we proposed a correction method for this error using deep learning (DL); however, the correction performance was validated through internal cross-validation. This cross-sectional study aimed to validate this approach using an external validation dataset. METHODS MPODs at 0.25°, 0.5°, 1°, and 2° eccentricities and macular pigment optical volume (MPOV) within 9° eccentricity were measured using SPECTRALIS (Heidelberg Engineering, Heidelberg, Germany) in 197 (training dataset inherited from our previous study) and 157 eyes (validating dataset) before and after cataract surgery. A DL model was trained to predict the corrected value from the pre-operative value using the training dataset, and we measured the discrepancy between the corrected value and the actual postoperative value. Subsequently, the prediction performance was validated using a validation dataset. RESULTS Using the validation dataset, the mean absolute values of errors for MPOD and MPOV corrected using DL ranged from 8.2 to 12.4%, which were lower than values with no correction (P < 0.001, linear mixed model with Tukey's test). The error depended on the autofluorescence image quality used to calculate MPOD. The mean errors in high and moderate quality images ranged from 6.0 to 11.4%, which were lower than those of poor quality images. CONCLUSION The usefulness of the DL correction method was validated. Deep learning reduced the error for a relatively good autofluorescence image quality. Poor-quality images were not corrected.
Collapse
Affiliation(s)
- Akira Obana
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu City, Shizuoka, Japan
- Department of Medical Spectroscopy, Institute for Medical Photonics Research, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Kibo Ote
- Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Shizuoka, Japan
| | - Yuko Gohto
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu City, Shizuoka, Japan
| | - Hidenao Yamada
- Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Shizuoka, Japan
| | - Fumio Hashimoto
- Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Shizuoka, Japan
| | - Shigetoshi Okazaki
- Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Shizuoka, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu City, Shizuoka, Japan
| |
Collapse
|
4
|
Rajs P, Liehneova I, Stranak Z. Macular pigment evaluation using dual-wavelength fundus auto-fluorescence imaging. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2024. [PMID: 38214110 DOI: 10.5507/bp.2023.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024] Open
Abstract
INTRODUCTION Macular pigment plays an important role in the reduction of oxidative stress and in preventing retinal diseases. Quick and easy measurements of the macular pigment are essential in both clinical and research settings. Dual wavelength fundus auto-fluorescence seems to be the optimal method. This study aims to investigate changes in fundus autofluorescence in patients taking daily lutein oral supplements and develop image processing methods for follow-up evaluations of the images. METHODS New devices allow us to examine fundus autofluorescence using both blue and green excitation wavelengths. This allows detection of the amount of macular pigment by subtracting these two images because the yellow pigment particles absorb blue wavelengths. We determined daily dose of 25 mg of lutein and 3 mg of zeaxanthin. Patients were followed up for 15 months at 3-month intervals. RESULTS During our 15-month study, we observed a positive trend in pixel lightness values, suggesting an increase in macular pigments in the foveal area. In all patients taking daily lutein supplements, the foveal index significantly increased after six months, with a median change of 0.081. We did not observe a significant change after the first three months (0.006) and only a small change between the 6th and 12th-month visits (0.012). CONCLUSION With appropriate patients and procedures for capturing autofluorescence images, this is a valuable technique for macular pigment evaluation in follow-up examinations using software image post-processing and analysis with commonly available hardware. To put this into everyday practice, developing tools to automate the assessment is necessary.
Collapse
Affiliation(s)
- Patrik Rajs
- Department of Ophthalmology, UJEP Masaryk Hospital, Krajska zdravotni, a.s., Usti nad Labem, Czech Republic
- Department of Ophthalmology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University in Prague, Czech Republic
| | - Ivana Liehneova
- Department of Ophthalmology, UJEP Masaryk Hospital, Krajska zdravotni, a.s., Usti nad Labem, Czech Republic
| | - Zbynek Stranak
- Department of Ophthalmology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University in Prague, Czech Republic
| |
Collapse
|
5
|
Review of Evidence for the Usage of Antioxidants for Eye Aging. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5810373. [PMID: 36225983 PMCID: PMC9550496 DOI: 10.1155/2022/5810373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 06/15/2022] [Accepted: 09/22/2022] [Indexed: 11/17/2022]
Abstract
Oxidative stress is one of the common factors leading to age-related eye diseases in older adults. Factors such as high oxygen consumption, high concentration of polyunsaturated fatty acids, and cumulative exposure to high-energy visible light in the eyes, lead to excessive generation of reactive oxygen species, hence triggering apoptosis of ocular cells and giving rise to ophthalmic diseases. Dietary supplements such as carotenoids, anthocyanins, and vitamins have antioxidant properties which may be of benefit in retaining better vision or reversing vision impairment; thus, studies have been conducted to understand the role of dietary supplements in the treatment or prevention of ophthalmic diseases. While high concentration of carotenoids such as lutein and zeaxanthin decrease the risk of developing age-related macular disease, anthocyanins and vitamins play a role in the treatment and prevention of other ophthalmic diseases: saffron extract reduced intraocular pressure in glaucoma patients; bilberry extract prevented impairments in lenses and retina, as well as alleviate symptoms of dry eye disease; high concentration of beta-carotene may reduce the risk of developing cataract. Further studies with clinical measurements are required to investigate the effectiveness of antioxidants on visual function and ophthalmic diseases.
Collapse
|
6
|
Bikbov MM, Gilmanshin TR, Zainullin RM, Kazakbaeva GM, Iakupova EM, Fakhretdinova AA, Tuliakova AM, Panda‐Jonas S, Arslangareeva II, Zinnatullin AA, Gilemzianova LI, Khakimov DA, Jonas JB. Macular pigment optical density and its determinants in a Russian population: the ural eye and medical study. Acta Ophthalmol 2022; 100:e1691-e1700. [PMID: 35343640 DOI: 10.1111/aos.15131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/23/2022] [Accepted: 03/12/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To assess the macular pigment optical density (MPOD) and its associations with ocular and systemic parameters and diseases. METHODS The population-based study Ural Eye and Medical Study included 5899 (80.5%) out of 7328 eligible individuals. As part of ophthalmological and systemic examinations, MPOD was measured by reflectometry. RESULTS Macular pigment optical density (MPOD) data were available for 4889 (82.9%) individuals (mean age:57.8 ± 10.1 years;range: 40-94). Mean values for MOPD, maximal MOPD, macular pigment (MP) area and MP volume were 0.13 ± 0.04 d.u. (density units), 0.36 ± 0.09 d.u., 60 791 ± 14 826 pixel and 8033 ± 2888 d.u.pixel, respectively. A higher MP density was correlated (regression coefficient r: 0.63) with older age (standardized regression coefficient beta: 0.59; non-standardized regression coefficient B: 0.23; 95% confidence interval (CI): 0.22, 0.23; p < 0.001), female sex (beta: 0.08; B:0.63; 95%CI: 0.44, 0.83; p < 0.001), rural region of habitation (beta: 0.13; B: 1.02; 95%CI: 0.83, 1.22; p < 0.001), lower body mass index (beta: -0.04; B: -0.03; 95%CI: -0.05, 0.01; p = 0.004), lower prevalence of chronic obstructive pulmonary disorder (beta: -0.03; B: -0.43; 95%CI: -0.79, -0.08; p = 0.02), higher erythrocyte sedimentation rate (beta: 0.03; B: 0.01; 95%CI: 0.002, 0.02; p = 0.03), lower leukocyte cell count (beta: -0.04; B: -0.10; 95%CI: -0.16, -0.03; p = 0.003), thinner temporal parafoveal retinal thickness (beta: -0.06; B: -0.01;95%CI: -0.01, -0.003; p < 0.001), thinner central corneal thickness (beta: -0.06; B: -0.006; 95%CI: -0.009, -0.004; p < 0.001), higher prevalence of pseudophakia (beta: 0.09;B:2.08; 95%CI: 1.50, 2.65; p < 0.001) and reticular pseudo drusen (RPD) (beta: 0.03; B: 0.56; 95%CI: 0.13, 0.98; p = 0.01) and lower stage of open-angle glaucoma (beta: -0.03; B: -0.39; 95%CI: -0.74, -0.04; p = 0. 03). Prevalence (p = 0.44; beta: -0.01) and degree (p = 0.70; beta: -0.01) of angle-closure glaucoma, prevalence (p = 0.31; beta: 0.01) of age-related macular degeneration (AMD) without RPD and prevalence (p = 0.95; beta: 0.001) of diabetic retinopathy were not significantly associated with the mean MP density in that model. CONCLUSIONS A higher RPD prevalence and lower stage of open-angle glaucoma were ophthalmological disorders associated with a higher MPOD in a multivariable analysis, including parameters of older age, pseudophakia, female sex, rural region, lower body mass index and lower perifoveal retinal thickness.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Songhomitra Panda‐Jonas
- Privatpraxis Prof Jonas und Dr Panda‐Jonas Heidelberg Germany
- Department of Ophthalmology, Medical Faculty Mannheim Heidelberg University Mannheim Germany
- Institute of Molecular and Clinical Ophthalmology Basel Switzerland
| | | | | | | | | | - Jost B. Jonas
- Privatpraxis Prof Jonas und Dr Panda‐Jonas Heidelberg Germany
- Department of Ophthalmology, Medical Faculty Mannheim Heidelberg University Mannheim Germany
- Institute of Molecular and Clinical Ophthalmology Basel Switzerland
| |
Collapse
|
7
|
Allingham MJ, Mettu PS, Cousins SW. Phase 1 Clinical Trial of Elamipretide in Intermediate Age-Related Macular Degeneration and High-Risk Drusen. OPHTHALMOLOGY SCIENCE 2022; 2:100095. [PMID: 36246187 PMCID: PMC9560633 DOI: 10.1016/j.xops.2021.100095] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 10/29/2021] [Accepted: 12/06/2021] [Indexed: 11/25/2022]
Abstract
Purpose To assess safety, tolerability, and feasibility of subcutaneous administration of the mitochondrial-targeted drug elamipretide in patients with intermediate age-related macular degeneration (AMD) and high-risk drusen (HRD) and to perform exploratory analyses of change in visual function. Design Phase 1, single-center, open-label, 24-week clinical trial with preplanned HRD cohort. Participants Adult patients ≥55 years of age with intermediate AMD and HRD. Methods Participants received subcutaneous elamipretide 40 mg daily, with safety and tolerability assessed throughout the study. Ocular assessments included normal-luminance best-corrected visual acuity (BCVA), low-luminance best-corrected visual acuity (LLVA), normal-luminance binocular reading acuity (NLRA), low-luminance binocular reading acuity (LLRA), spectral-domain OCT, fundus autofluorescence (FAF), mesopic microperimetry, dark adaptation, and low-luminance questionnaire (LLQ). Main Outcome Measures The primary end point was safety and tolerability. Prespecified exploratory end points included changes from baseline in BCVA, LLVA, NLRA, LLRA, retinal pigment epithelium (RPE)-drusen complex (DC) volume by OCT, FAF, mesopic microperimetry, dark adaptation, and LLQ results. Results Subcutaneous administration of elamipretide was highly feasible. All participants with HRD (n = 21) experienced 1 or more adverse events (AEs), but all were mild (57%) or moderate (43%), with the most common events related to injection site reactions. No serious systemic AEs occurred. One participant discontinued because of injection site reaction, 1 participant withdrew because they did not wish to continue study visits, and 1 participant withdrew after experiencing transient visual impairment. Among the 18 participants who completed the study, mean change in BCVA from baseline to 24 weeks was +3.6 letters (P = 0.014) and LLVA was +5.6 letters (P = 0.004). Compared with baseline, mean NLRA improved by –0.11 logarithm of the minimum angle of resolution (logMAR) units (P = 0.001), and LLRA by −0.28 logMAR units (P < 0.0001). Significant improvements were found in 6 of 7 subscales of the LLQ (P<0.0015). No significant changes were observed for RPE-DC volume, FAF, mesopic microperimetry, or dark adaptation. Conclusions Elamipretide appeared to be generally safe and well tolerated in treating intermediate AMD and HRD. Exploratory analyses demonstrate a positive effect on visual function, particularly under low-luminance conditions. Further study of elamipretide for treatment of intermediate AMD with HRD is warranted.
Collapse
|
8
|
Lutein and Zeaxanthin Intake during Pregnancy and Visual Function in Offspring at 11–12 Years of Age. Nutrients 2022; 14:nu14040872. [PMID: 35215522 PMCID: PMC8876686 DOI: 10.3390/nu14040872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/03/2022] [Accepted: 02/16/2022] [Indexed: 02/01/2023] Open
Abstract
(1) Background: Lutein and zeaxanthin (L&Z) are essential dietary nutrients that are a crucial component of the human macula, contributing to visual functioning. They easily cross the placental barrier, so that retinal deposition commences during foetal development. This study aims to assess associations between maternal L&Z intake during pregnancy and offspring visual function at 11–12 years. (2) Methods: Using the Spanish INfancia y Medio Ambiente project (INMA) Sabadell birth cohort, 431 mother–child pairs were analysed. L&Z data were obtained from food frequency questionnaires (FFQ) at week 12 and 32 of pregnancy, alongside other nutritional and sociodemographic covariates. Contrast vision (CS) and visual acuity (VA) were assessed using the automated Freiburg Acuity and Contrast Testing (FRACT) battery. Low CS and VA were defined as being below the 20th cohort centile. Associations were explored using multiple logistic regression. (3) Results: After controlling for potential confounders, L&Z intake during the 1st and 3rd trimester did not reveal any statistically significant association with either CS or VA in offspring at age 11/12 years. (4) Conclusions: No evidence of a long-term association between L&Z intake during pregnancy and visual function in offspring was found. Further larger long-term studies including blood L&Z levels are required to confirm this result.
Collapse
|
9
|
Argiles M, Quevedo-Junyent L, Erickson G. Topical Review: Optometric Considerations in Sports vs. E-Sports. Percept Mot Skills 2022; 129:731-746. [PMID: 35084253 DOI: 10.1177/00315125211073401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Electronic sports (e-sports) have recently emerged to become a rapidly growing form of videogame competition, requiring gamers to spend many hours in front of a visual display. The nature of this new modality raises important considerations for ocular health, and visual and perceptual functioning, compared to traditional sports. In general, sports performance has been associated with open spaces, gross motor movement, and balance, while electronic sports require visual and attentional stamina at near distances with fine motor control. From an optometric viewpoint, visual perception is specific to both the sports modality and the environment where sports take place. In this topical review, we consider e-sport optometric factors such as screen time and digital eyestrain, visual skill demands, and perceptual cognitive skills such as visual attention. We compare training considerations for traditional sports and training in gaming platforms, with recommendations for future research in this growing modality. The goal of this review is to raise awareness of the various elements to consider when providing vision care to e-sport participants.
Collapse
Affiliation(s)
- Marc Argiles
- Optics and Optometry16767Universitat Politecnica de Catalunya
| | | | | |
Collapse
|
10
|
Lem DW, Davey PG, Gierhart DL, Rosen RB. A Systematic Review of Carotenoids in the Management of Age-Related Macular Degeneration. Antioxidants (Basel) 2021; 10:1255. [PMID: 34439503 PMCID: PMC8389280 DOI: 10.3390/antiox10081255] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 01/14/2023] Open
Abstract
Age-related macular degeneration (AMD) remains a leading cause of modifiable vision loss in older adults. Chronic oxidative injury and compromised antioxidant defenses represent essential drivers in the development of retinal neurodegeneration. Overwhelming free radical species formation results in mitochondrial dysfunction, as well as cellular and metabolic imbalance, which becomes exacerbated with increasing age. Thus, the depletion of systemic antioxidant capacity further proliferates oxidative stress in AMD-affected eyes, resulting in loss of photoreceptors, neuroinflammation, and ultimately atrophy within the retinal tissue. The aim of this systematic review is to examine the neuroprotective potential of the xanthophyll carotenoids lutein, zeaxanthin, and meso-zeaxanthin on retinal neurodegeneration for the purpose of adjunctive nutraceutical strategy in the management of AMD. A comprehensive literature review was performed to retrieve 55 eligible publications, using four database searches from PubMed, Embase, Cochrane Library, and the Web of Science. Epidemiology studies indicated an enhanced risk reduction against late AMD with greater dietary consumption of carotenoids, meanwhile greater concentrations in macular pigment demonstrated significant improvements in visual function among AMD patients. Collectively, evidence strongly suggests that carotenoid vitamin therapies offer remarkable synergic protection in the neurosensory retina, with the potential to serve as adjunctive nutraceutical therapy in the management of established AMD, albeit these benefits may vary among different stages of disease.
Collapse
Affiliation(s)
- Drake W. Lem
- College of Optometry, Western University of Health Sciences, Pomona, CA 91766, USA;
| | | | | | - Richard B. Rosen
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| |
Collapse
|
11
|
Arunkumar R, Gorusupudi A, Li B, Blount JD, Nwagbo U, Kim HJ, Sparrow JR, Bernstein PS. Lutein and zeaxanthin reduce A2E and iso-A2E levels and improve visual performance in Abca4 -/-/Bco2 -/- double knockout mice. Exp Eye Res 2021; 209:108680. [PMID: 34161819 PMCID: PMC8595537 DOI: 10.1016/j.exer.2021.108680] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/08/2021] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
Abstract
Accumulation of bisretinoids such as A2E and its isomer iso-A2E is thought to mediate blue light-induced oxidative damage associated with age-related macular degeneration (AMD) and autosomal recessive Stargardt disease (STGD1). We hypothesize that increasing dietary intake of the macular carotenoids lutein and zeaxanthin in individuals at risk of AMD and STGD1 can inhibit the formation of bisretinoids A2E and iso-A2E, which can potentially ameliorate macular degenerative diseases. To study the beneficial effect of macular carotenoids in a retinal degenerative diseases model, we used ATP-binding cassette, sub-family A member 4 (Abca4-/-)/β,β-carotene-9',10'-oxygenase 2 (Bco2-/-) double knockout (KO) mice that accumulate elevated levels of A2E and iso-A2E in the retinal pigment epithelium (RPE) and macular carotenoids in the retina. Abca4-/-/Bco2-/- and Abca4-/- mice were fed a lutein-supplemented chow, zeaxanthin-supplemented chow or placebo chow (~2.6 mg of carotenoid/mouse/day) for three months. Visual function and electroretinography (ERG) were measured after one month and three months of carotenoid supplementation. The lutein and zeaxanthin supplemented Abca4-/-/Bco2-/- mice had significantly lower levels of RPE/choroid A2E and iso-A2E compared to control mice fed with placebo chow and improved visual performance. Carotenoid supplementation in Abca4-/- mice minimally raised retinal carotenoid levels and did not show much difference in bisretinoid levels or visual function compared to the control diet group. There was a statistically significant inverse correlation between carotenoid levels in the retina and A2E and iso-A2E levels in the RPE/choroid. Supplementation with retinal carotenoids, especially zeaxanthin, effectively inhibits bisretinoid formation in a mouse model of STGD1 genetically enhanced to accumulate carotenoids in the retina. These results provide further impetus to pursue oral carotenoids as therapeutic interventions for STGD1 and AMD.
Collapse
Affiliation(s)
- Ranganathan Arunkumar
- Department of Ophthalmology and Visual Science, John A. Moran Eye Center, University of Utah, School of Medicine, Salt Lake City, UT, USA
| | - Aruna Gorusupudi
- Department of Ophthalmology and Visual Science, John A. Moran Eye Center, University of Utah, School of Medicine, Salt Lake City, UT, USA
| | - Binxing Li
- Department of Ophthalmology and Visual Science, John A. Moran Eye Center, University of Utah, School of Medicine, Salt Lake City, UT, USA
| | - J David Blount
- Department of Ophthalmology and Visual Science, John A. Moran Eye Center, University of Utah, School of Medicine, Salt Lake City, UT, USA
| | - Uzoamaka Nwagbo
- Department of Ophthalmology and Visual Science, John A. Moran Eye Center, University of Utah, School of Medicine, Salt Lake City, UT, USA
| | - Hye Jin Kim
- Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA; Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Janet R Sparrow
- Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA; Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Paul S Bernstein
- Department of Ophthalmology and Visual Science, John A. Moran Eye Center, University of Utah, School of Medicine, Salt Lake City, UT, USA.
| |
Collapse
|
12
|
Macular Pigment Reflectometry: Developing Clinical Protocols, Comparison with Heterochromatic Flicker Photometry and Individual Carotenoid Levels. Nutrients 2021; 13:nu13082553. [PMID: 34444721 PMCID: PMC8399813 DOI: 10.3390/nu13082553] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 12/26/2022] Open
Abstract
The study was designed to: (1) Analyze and create protocols of obtaining measurements using the Macular Pigment Reflectometry (MPR). (2) To assess the agreement of MPOD measurements obtained using the heterochromatic flicker photometry (MPS II) and MPR. (3) To obtain the lutein and zeaxanthin optical density obtained using the MPR in the central one-degree of the macula. The measurements were performed using the MPR and heterochromatic flicker photometry. The MPR measurements were performed twice without pupillary dilation and twice following pupillary dilation. The MPR measurements were performed for a 40-s period and the spectrometer signal was parsed at different time points: 10–20, 10–30, 10–40, 20–30, 20–40, and 30–40 s. The MPR analyzes the high-resolution spectrometer signal and calculates MPOD, lutein optical density and zeaxanthin optical density automatically. The MPR-MPOD data was compared with MPPS II-MPOD results. The MPR-MPOD values are highly correlated and in good agreement with the MPS II-MPOD. Of the various parsing of the data, the data 10–30 interval was the best at obtaining the MPOD, lutein, and zeaxanthin values (8–12% coefficient of repeatability). The lutein to zeaxanthin ratio in the central one-degree of the macula was 1:2.40. Dilation was not needed to obtain the MPOD values but provided better repeatability of lutein and zeaxanthin optical density. MPR generates MPOD measurements that is in good agreement with MPS II. The device can produce lutein and zeaxanthin optical density which is not available from other clinical devices.
Collapse
|
13
|
Alharbi AM, Kilani MA, Berendschot TT. Overflow phenomenon in serum lutein after supplementation: a systematic review supported with SNPs analyses. Int J Ophthalmol 2021; 14:1114-1119. [PMID: 34282399 DOI: 10.18240/ijo.2021.07.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 02/25/2021] [Indexed: 11/23/2022] Open
Abstract
Lutein, a type of carotenoids, is found to delay the onset and progression of age-related macular degeneration (AMD). Several lutein supplementation studies showed that after an initial increase, lutein serum levels demonstrated a subsequent decrease despite continuous supplementation. In this systematic literature review, this obscure phenomenon was tried to be explained. The subsequent drop in lutein levels was postulated due to down-regulation of lutein receptors scavenger receptor class B type I (SR-BI) in the gastrointestinal tract, upregulation of lutein degrading enzyme β-carotene dioxygenase (BCDO2), or perhaps a combination of both. Some single nucleotides polymorphisms (SNPs) that could have influence on the occurrence of this phenomenon. To date, an exact scientific explanation for this phenomenon has not been established. Further research is needed to investigate this phenomenon in depth to reach an irrefutable explanation, giving that lutein is proven to be effective in delaying the onset and progression of AMD and its metabolism in the human body becomes of equal importance.
Collapse
Affiliation(s)
- Abdulrahman M Alharbi
- Clinical Biochemistry Unit, Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | | | - Tos Tjm Berendschot
- University Eye Clinic, Maastricht University Medical Center, Maastricht 6229HX, The Netherlands
| |
Collapse
|
14
|
Green-Gomez M, Moran R, Stringham J, Hernández-Alcaraz C, Mendoza-Herrera K, Fromow-Guerra JJ, Prado-Cabrero A, Nolan J. Environmental and Nutritional Determinants of Macular Pigment in a Mexican Population. Invest Ophthalmol Vis Sci 2021; 62:18. [PMID: 34241622 PMCID: PMC8288050 DOI: 10.1167/iovs.62.9.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/21/2021] [Indexed: 01/23/2023] Open
Abstract
Purpose The carotenoids lutein (L), zeaxanthin (Z), and meso-zeaxanthin deposit at the macula as macular pigment (MP) and provide visual benefits and protection against macular diseases. The present study investigated MP, its nutritional and environmental determinants, and its constituent carotenoids in serum from a Mexican sample, in healthy participants and with metabolic diseases. Additionally, we compared these variables with an Irish sample. Methods MP was measured in 215 subjects from a rural community in Mexico with dual-wavelength autofluorescence imaging reported as MP optical volume (MPOV). Dietary intake and serum concentrations of L and Z were evaluated. Results The mean MPOV was 8429 (95% confidence interval, 8060-8797); range. 1171-15,976. The mean L and Z serum concentrations were 0.25 ± 0.15 µmol/L and 0.09 ± 0.04 µmol/L, respectively. The MPOV was positively correlated with L and Z serum concentrations (r = 0.347; P < 0.001 and r = 0.311; P < 0.001, respectively), but not with L + Z dietary estimates. Subjects with daily sunlight exposure of more than 50% were found to have significantly higher MPOV than those with less than 50% (P = 0.005). MPOV and serum concentrations of L and Z were significantly higher in the Mexican sample compared with the Irish sample, but this difference was not reflected in dietary analysis. Conclusions These new data from a Mexican sample provide evidence of the multifactorial interactions and environmental determinants of MP such as sunlight exposure and dietary patterns. These findings will be essential for future studies in Mexico for eye health, visual function, and ocular pathology.
Collapse
Affiliation(s)
- Marina Green-Gomez
- Nutrition Research Centre Ireland, School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | - Rachel Moran
- Nutrition Research Centre Ireland, School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | - James Stringham
- Nutrition Research Centre Ireland, School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | - Cesar Hernández-Alcaraz
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Kenny Mendoza-Herrera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - J Jans Fromow-Guerra
- Retina Division, Asociación Para Evitar la Ceguera en México I.A.P., México City, México
| | - Alfonso Prado-Cabrero
- Nutrition Research Centre Ireland, School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | - John Nolan
- Nutrition Research Centre Ireland, School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| |
Collapse
|
15
|
Obana A, Ote K, Hashimoto F, Asaoka R, Gohto Y, Okazaki S, Yamada H. Correction for the Influence of Cataract on Macular Pigment Measurement by Autofluorescence Technique Using Deep Learning. Transl Vis Sci Technol 2021; 10:18. [PMID: 34003903 PMCID: PMC7884288 DOI: 10.1167/tvst.10.2.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Measurements of macular pigment optical density (MPOD) by the autofluorescence technique yield underestimations of actual values in eyes with cataract. We applied deep learning (DL) to correct this error. Subjects and Methods MPOD was measured by SPECTRALIS (Heidelberg Engineering, Heidelberg, Germany) in 197 eyes before and after cataract surgery. The nominal MPOD values (= preoperative value) were corrected by three methods: the regression equation (RE) method, subjective classification (SC) method (described in our previous study), and DL method. The errors between the corrected and true values (= postoperative value) were calculated for local MPODs at 0.25°, 0.5°, 1°, and 2° eccentricities and macular pigment optical volume (MPOV) within 9° eccentricity. Results The mean error for MPODs at four eccentricities was 32% without any correction, 15% with correction by RE, 16% with correction by SC, and 14% with correction by DL. The mean error for MPOV was 21% without correction and 14%, 10%, and 10%, respectively, with correction by the same methods. The errors with any correction were significantly lower than those without correction (P < 0.001, linear mixed model with Tukey's test). The errors with DL correction were significantly lower than those with RE correction in MPOD at 1° eccentricity and MPOV (P < 0.001) and were equivalent to those with SC correction. Conclusions The objective method using DL was useful to correct MPOD values measured in aged people. Translational Relevance MPOD can be obtained with small errors in eyes with cataract using DL.
Collapse
Affiliation(s)
- Akira Obana
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu City, Shizuoka, Japan.,Department of Medical Spectroscopy, Institute for Medical Photonics Research, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Kibo Ote
- Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Shizuoka, Japan
| | - Fumio Hashimoto
- Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Shizuoka, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu City, Shizuoka, Japan
| | - Yuko Gohto
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu City, Shizuoka, Japan
| | - Shigetoshi Okazaki
- Department of Medical Spectroscopy, Institute for Medical Photonics Research, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Hidenao Yamada
- Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Shizuoka, Japan
| |
Collapse
|
16
|
Wilson LM, Tharmarajah S, Jia Y, Semba RD, Schaumberg DA, Robinson KA. The Effect of Lutein/Zeaxanthin Intake on Human Macular Pigment Optical Density: A Systematic Review and Meta-Analysis. Adv Nutr 2021; 12:2244-2254. [PMID: 34157098 PMCID: PMC8634499 DOI: 10.1093/advances/nmab071] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/15/2021] [Accepted: 05/11/2021] [Indexed: 01/05/2023] Open
Abstract
Lutein, zeaxanthin, and meso-zeaxanthin are the only carotenoids found in the human macula and may have a role in visual function. These carotenoids are reported to protect the retina, and thus vision, as antioxidants and by acting as a blue light filter. Our objective was to determine a minimum concentration of lutein/zeaxanthin intake that is associated with a statistically significant and/or clinically important change in macular pigment optical density (MPOD) among adults with healthy eyes. We searched Ovid MEDLINE, CENTRAL, and the Commonwealth of Agriculture Bureau for English-language studies through to July 2020. Two reviewers screened results to identify studies that evaluated supplements or dietary sources of lutein/zeaxanthin on MPOD among adults with healthy eyes. One reviewer extracted data and assessed strength of evidence, which was confirmed by a second reviewer. Two independent reviewers assessed the risk of bias. Meta-analyses were stratified by total lutein/zeaxanthin dose. We included 46 studies (N = 3189 participants; mean age = 43 y; 42% male). There was no statistically significant change in MPOD among studies evaluating <5 mg/d of total lutein/zeaxanthin intake which primarily assessed dietary interventions for 3-6 mo (pooled mean difference, 0.02; 95% CI: -0.01 to 0.05). The pooled mean increase in MPOD was 0.04 units (95% CI: 0.02 to 0.07) among studies evaluating 5 to <20 mg/d of lutein/zeaxanthin and was 0.11 units (95% CI: 0.06 to 0.16) among studies evaluating ≥20 mg/d of lutein/zeaxanthin for 3-12 mo. MPOD increased with lutein/zeaxanthin intake, particularly at higher doses, among adults with healthy eyes. The effects of lutein/zeaxanthin intake at doses <5 mg/d or from dietary sources is less clear. Increased lutein/zeaxanthin intake can help with maintaining ocular health. Future research is needed to determine the minimum dose and duration of lutein/zeaxanthin intake that is associated with a clinically important change in MPOD or visual function.
Collapse
Affiliation(s)
| | - Saraniya Tharmarajah
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yuanxi Jia
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Richard D Semba
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Debra A Schaumberg
- Department of Ophthalmology & Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA,Evidera, Inc., Bethesda, MD, USA
| | - Karen A Robinson
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| |
Collapse
|
17
|
Lem DW, Gierhart DL, Davey PG. Carotenoids in the Management of Glaucoma: A Systematic Review of the Evidence. Nutrients 2021; 13:nu13061949. [PMID: 34204051 PMCID: PMC8228567 DOI: 10.3390/nu13061949] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 12/23/2022] Open
Abstract
Primary open-angle glaucoma (POAG) remains a leading cause of irreversible blindness globally. Recent evidence further substantiates sustained oxidative stress, and compromised antioxidant defenses are key drivers in the onset of glaucomatous neurodegeneration. Overwhelming oxidative injury is likely attributed to compounding mitochondrial dysfunction that worsens with age-related processes, causing aberrant formation of free radical species. Thus, a compromised systemic antioxidant capacity exacerbates further oxidative insult in glaucoma, leading to apoptosis, neuroinflammation, and subsequent tissue injury. The purpose of this systematic review is to investigate the neuroprotective benefits of the macular carotenoids lutein, zeaxanthin, and meso-zeaxanthin on glaucomatous neurodegeneration for the purpose of adjunctive nutraceutical treatment in glaucoma. A comprehensive literature search was conducted in three databases (PubMed, Cochrane Library, and Web of Science) and 20 records were identified for screening. Lutein demonstrated enhanced neuroprotection on retinal ganglion cell survival and preserved synaptic activity. In clinical studies, a protective trend was seen with greater dietary consumption of carotenoids and risk of glaucoma, while greater carotenoid levels in macular pigment were largely associated with improved visual performance in glaucomatous eyes. The data suggest that carotenoid vitamin therapy exerts synergic neuroprotective benefits and has the capacity to serve adjunctive therapy in the management of glaucoma.
Collapse
Affiliation(s)
- Drake W. Lem
- College of Optometry, Western University of Health Sciences, 309 E Second St, Pomona, CA 91766, USA;
| | | | - Pinakin Gunvant Davey
- College of Optometry, Western University of Health Sciences, 309 E Second St, Pomona, CA 91766, USA;
- Correspondence: ; Tel.: +1-909-469-8473
| |
Collapse
|
18
|
Różanowska MB, Czuba-Pelech B, Landrum JT, Różanowski B. Comparison of Antioxidant Properties of Dehydrolutein with Lutein and Zeaxanthin, and their Effects on Cultured Retinal Pigment Epithelial Cells. Antioxidants (Basel) 2021; 10:antiox10050753. [PMID: 34068492 PMCID: PMC8151661 DOI: 10.3390/antiox10050753] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/01/2021] [Accepted: 05/07/2021] [Indexed: 12/14/2022] Open
Abstract
Dehydrolutein accumulates in substantial concentrations in the retina. The aim of this study was to compare antioxidant properties of dehydrolutein with other retinal carotenoids, lutein, and zeaxanthin, and their effects on ARPE-19 cells. The time-resolved detection of characteristic singlet oxygen phosphorescence was used to compare the singlet oxygen quenching rate constants of dehydrolutein, lutein, and zeaxanthin. The effects of these carotenoids on photosensitized oxidation were tested in liposomes, where photo-oxidation was induced by light in the presence of photosensitizers, and monitored by oximetry. To compare the uptake of dehydrolutein, lutein, and zeaxanthin, ARPE-19 cells were incubated with carotenoids for up to 19 days, and carotenoid contents were determined by spectrophotometry in cell extracts. To investigate the effects of carotenoids on photocytotoxicity, cells were exposed to light in the presence of rose bengal or all-trans-retinal. The results demonstrate that the rate constants for singlet oxygen quenching are 0.77 × 1010, 0.55 × 1010, and 1.23 × 1010 M-1s-1 for dehydrolutein, lutein, and zeaxanthin, respectively. Overall, dehydrolutein is similar to lutein or zeaxanthin in the protection of lipids against photosensitized oxidation. ARPE-19 cells accumulate substantial amounts of both zeaxanthin and lutein, but no detectable amounts of dehydrolutein. Cells pre-incubated with carotenoids are equally susceptible to photosensitized damage as cells without carotenoids. Carotenoids provided to cells together with the extracellular photosensitizers offer partial protection against photodamage. In conclusion, the antioxidant properties of dehydrolutein are similar to lutein and zeaxanthin. The mechanism responsible for its lack of accumulation in ARPE-19 cells deserves further investigation.
Collapse
Affiliation(s)
- Małgorzata B. Różanowska
- School of Optometry and Vision Sciences, Cardiff University, Cardiff CF24 4HQ, Wales, UK
- Cardiff Institute for Tissue Engineering and Repair (CITER), Cardiff University, Cardiff CF24 4HQ, Wales, UK
- Correspondence: ; Tel.: +44-292-087-5057
| | - Barbara Czuba-Pelech
- Department of Biophysics, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, 30-387 Kraków, Poland;
| | - John T. Landrum
- Department of Chemistry and Biochemistry, Florida International University, Miami, FL 33199, USA;
| | | |
Collapse
|
19
|
Factors Differentiating the Antioxidant Activity of Macular Xanthophylls in the Human Eye Retina. Antioxidants (Basel) 2021; 10:antiox10040601. [PMID: 33919673 PMCID: PMC8070478 DOI: 10.3390/antiox10040601] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/01/2021] [Accepted: 04/07/2021] [Indexed: 02/06/2023] Open
Abstract
Macular xanthophylls, which are absorbed from the human diet, accumulate in high concentrations in the human retina, where they efficiently protect against oxidative stress that may lead to retinal damage. In addition, macular xanthophylls are uniquely spatially distributed in the retina. The zeaxanthin concentration (including the lutein metabolite meso-zeaxanthin) is ~9-fold greater than lutein concentration in the central fovea. These numbers do not correlate at all with the dietary intake of xanthophylls, for which there is a dietary zeaxanthin-to-lutein molar ratio of 1:12 to 1:5. The unique spatial distributions of macular xanthophylls—lutein, zeaxanthin, and meso-zeaxanthin—in the retina, which developed during evolution, maximize the protection of the retina provided by these xanthophylls. We will correlate the differences in the spatial distributions of macular xanthophylls with their different antioxidant activities in the retina. Can the major protective function of macular xanthophylls in the retina, namely antioxidant actions, explain their evolutionarily determined, unique spatial distributions? In this review, we will address this question.
Collapse
|
20
|
Böhm V, Lietz G, Olmedilla-Alonso B, Phelan D, Reboul E, Bánati D, Borel P, Corte-Real J, de Lera AR, Desmarchelier C, Dulinska-Litewka J, Landrier JF, Milisav I, Nolan J, Porrini M, Riso P, Roob JM, Valanou E, Wawrzyniak A, Winklhofer-Roob BM, Rühl R, Bohn T. From carotenoid intake to carotenoid blood and tissue concentrations - implications for dietary intake recommendations. Nutr Rev 2021; 79:544-573. [PMID: 32766681 PMCID: PMC8025354 DOI: 10.1093/nutrit/nuaa008] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
There is uncertainty regarding carotenoid intake recommendations, because positive and negative health effects have been found or are correlated with carotenoid intake and tissue levels (including blood, adipose tissue, and the macula), depending on the type of study (epidemiological vs intervention), the dose (physiological vs supraphysiological) and the matrix (foods vs supplements, isolated or used in combination). All these factors, combined with interindividual response variations (eg, depending on age, sex, disease state, genetic makeup), make the relationship between carotenoid intake and their blood/tissue concentrations often unclear and highly variable. Although blood total carotenoid concentrations <1000 nmol/L have been related to increased chronic disease risk, no dietary reference intakes (DRIs) exist. Although high total plasma/serum carotenoid concentrations of up to 7500 nmol/L are achievable after supplementation, a plateauing effect for higher doses and prolonged intake is apparent. In this review and position paper, the current knowledge on carotenoids in serum/plasma and tissues and their relationship to dietary intake and health status is summarized with the aim of proposing suggestions for a "normal," safe, and desirable range of concentrations that presumably are beneficial for health. Existing recommendations are likewise evaluated and practical dietary suggestions are included.
Collapse
Affiliation(s)
- Volker Böhm
- Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, Germany
| | - Georg Lietz
- Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Begoña Olmedilla-Alonso
- Institute of Food Science, Technology and Nutrition, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - David Phelan
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, Waterford, Ireland
| | | | | | - Patrick Borel
- C2VN, INRAE, INSERM, Aix Marseille Univ, Marseille, France
| | - Joana Corte-Real
- Population Health Department, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Angel R de Lera
- Departmento de Química Orgánica, Centro De Investigaciones Biomédicas and Instituto de Investigación Biomédica de Vigo, Universidade de Vigo, Vigo, Spain
| | | | | | | | - Irina Milisav
- University of Ljubljana, Ljubljana, Slovenia
- University of Ljubljana, Faculty of Health Sciences, Ljubljana, Slovenia and with University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
| | - John Nolan
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, Waterford, Ireland
| | - Marisa Porrini
- Universitàdegli Studi di Milano, Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, Milan, Italy
| | - Patrizia Riso
- Universitàdegli Studi di Milano, Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, Milan, Italy
| | - Johannes M Roob
- Research Unit Chronic Inflammation in Nephrology, Clinical Division of Nephrology, Department of Internal Medicine, Medical University, Graz, Austria
| | | | - Agata Wawrzyniak
- Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Brigitte M Winklhofer-Roob
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University, Graz, Austria
| | - Ralph Rühl
- Paprika Bioanalytics BT, Debrecen, Hungary and with CISCAREX UG, Berlin, Germany
| | - Torsten Bohn
- Population Health Department, Luxembourg Institute of Health, Strassen, Luxembourg
| |
Collapse
|
21
|
Bernstein PS, Arunkumar R. The emerging roles of the macular pigment carotenoids throughout the lifespan and in prenatal supplementation. J Lipid Res 2021; 62:100038. [PMID: 32709621 PMCID: PMC7933486 DOI: 10.1194/jlr.tr120000956] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/17/2020] [Indexed: 02/06/2023] Open
Abstract
Since the publication of the Age-Related Eye Disease Study 2 (AREDS2) in 2013, the macular pigment carotenoids lutein (L) and zeaxanthin (Z) have become well known to both the eye care community and the public. It is a fascinating aspect of evolution that primates have repurposed photoprotective pigments and binding proteins from plants and insects to protect and enhance visual acuity. Moreover, utilization of these plant-derived nutrients has been widely embraced for preventing vision loss from age-related macular degeneration. More recently, there has been growing awareness that these nutrients can also play a role in improving visual performance in adults. On the other hand, the potential benefits of L and Z supplementation at very young ages have been underappreciated. In this review, we examine the biochemical mechanisms and supportive data for L and Z supplementation throughout the lifespan, with particular emphasis on prenatal supplementation. We propose that prenatal nutritional recommendations may aim at improving maternal and infant carotenoid status. Prenatal supplementation with L and Z might enhance infant visual development and performance and may even prevent retinopathy of prematurity, possibilities that should be examined in future clinical studies.
Collapse
Affiliation(s)
- Paul S Bernstein
- Department of Ophthalmology and Visual Science, Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA.
| | - Ranganathan Arunkumar
- Department of Ophthalmology and Visual Science, Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA
| |
Collapse
|
22
|
Banerjee M, Chawla R, Kumar A. Antioxidant supplements in age-related macular degeneration: are they actually beneficial? Ther Adv Ophthalmol 2021; 13:25158414211030418. [PMID: 34471798 PMCID: PMC8404659 DOI: 10.1177/25158414211030418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 06/16/2021] [Indexed: 11/17/2022] Open
Abstract
Age-related macular degeneration (ARMD) is one of the prominent causes of central visual loss in the older age group in the urbanized, industrialized world. In recent years, many epidemiological studies and clinical trials have evaluated the role of antioxidants and micronutrients to prevent the progression of ARMD. In this article, we review some of these major studies. In addition, we review the absorption and bioavailability and possible undesirable effects of these nutrients after ingestion. The role of genotypes and inappropriate use of these supplements are also discussed. From all the above evidence, we conclude that it may not be prudent to prescribe these formulations without a proper assessment of the individual's health and dietary status. The effectiveness of all the components in antioxidant formulations is controversial. Thus, these supplements should not be prescribed just for the purpose of providing patients some kind of therapy, which may give a false sense of mental satisfaction.
Collapse
Affiliation(s)
- Mousumi Banerjee
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rohan Chawla
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Atul Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
23
|
Dekker TM, Farahbakhsh M, Atkinson J, Braddick OJ, Jones PR. Development of the spatial contrast sensitivity function (CSF) during childhood: Analysis of previous findings and new psychophysical data. J Vis 2020; 20:4. [PMID: 33275663 PMCID: PMC7718811 DOI: 10.1167/jov.20.13.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Although the contrast sensitivity function (CSF) changes markedly during infancy, there is no consensus regarding whether, how, and why it continues to develop in later childhood. Here, we analyzed previously published data (N = 1928 CSFs), and present new psychophysical findings from 98 children (4.7–14.8 years) and 50 adults (18.1–29.7 years), in order to answer the following questions: (1) Does the CSF change during childhood? (2) How large is the developmental effect size? (3) Are any changes uniform across the CSF, or frequency-specific? and (4) Can some or all of the changes be explained by “non-visual” (i.e. procedural/cognitive) factors, such as boredom or inattentiveness? The new data were collected using a four-alternative forced-choice (4AFC) Gabor-detection task, with two different psychophysical procedures (Weighted Staircase; QUEST+), and suprathreshold (false-negative) catch trials to quantify lapse rates. It is shown that from ages 4 to 18 years, the CSF improves (at an exponentially decaying rate) by approximately 0.3 log10 units (a doubling of contrast sensitivity [CS]), with 90% of this change complete by 12 years of age. The size of the effect was small relative to individual variability, with age alone explaining less than one sixth of variability (16%), and most children performing as well as some adults (i.e. falling within the 90% population limits for adults). Development was frequency-specific, with changes occurring primarily around or below the CSF peak (≤ 4 cpd). At least half — and potentially all — of the changes observed could be explained by non-visual factors (e.g. lapses in concentration), although possible biological mechanisms are discussed.
Collapse
Affiliation(s)
- Tessa M Dekker
- Child Vision Lab, Institute of Ophthalmology, University College London (UCL), London, UK.,Division of Psychology and Language Sciences, University College London (UCL), London, UK.,
| | - Mahtab Farahbakhsh
- Child Vision Lab, Institute of Ophthalmology, University College London (UCL), London, UK.,
| | - Janette Atkinson
- Faculty of Brain Sciences, University College London (UCL), London, UK.,
| | - Oliver J Braddick
- Department of Experimental Psychology, University of Oxford, Oxford, UK.,
| | - Pete R Jones
- Child Vision Lab, Institute of Ophthalmology, University College London (UCL), London, UK.,NIHR Moorfields Biomedical Research Centre, London, UK.,Division of Optometry and Visual Science, City, University of London, London, UK.,
| |
Collapse
|
24
|
Davey PG, Henderson T, Lem DW, Weis R, Amonoo-Monney S, Evans DW. Visual Function and Macular Carotenoid Changes in Eyes with Retinal Drusen-An Open Label Randomized Controlled Trial to Compare a Micronized Lipid-Based Carotenoid Liquid Supplementation and AREDS-2 Formula. Nutrients 2020; 12:nu12113271. [PMID: 33114566 PMCID: PMC7693149 DOI: 10.3390/nu12113271] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/22/2020] [Accepted: 10/22/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose: To compare the changes in visual and ocular parameters in individuals with retinal drusen who were treated with two commercially available nutritional supplements. Methods: An open-label, single-center, randomized, parallel-treatment with an observational control group design was utilized. The treatment groups included individuals with fine retinal drusen sub-clinical age-related macular degeneration (AMD), while the control group consisted of ocular normal individuals. The treatment groups were randomly assigned to the micronized lipid-based carotenoid supplement, Lumega-Z (LM), or the PreserVision Age-Related Eye Disease Study 2 (AREDS-2) soft gel (PV). Visual performance was evaluated using the techniques of visual acuity, dark adaptation recovery and contrast sensitivity, at baseline, three months, and six months. Additionally, the macular pigment optical density (MPOD) was measured. The control group was not assigned any carotenoid supplement. The right eye and left eye results were analyzed separately. Results: Seventy-nine participants were recruited for this study, of which 68 qualified and 56 participants had useable reliable data. Of the individuals who completed this study, 25 participants belonged to the LM group, 16 belonged to the PV group, and 15 to the control group. The LM group demonstrated statistically significant improvements in contrast sensitivity function (CSF) in both eyes at six months (p < 0.001). The LM group displayed a positive linear trend with treatment time in CSF (p < 0.001), with benefits visible after just three months of supplementation. Although there was a trend showing improvement in CSF in the PV group, the change was not significant after a Bonferroni-corrected p-value of p < 0.00625. Visual acuity, dark adaptation recovery and MPOD did not significantly improve in either treatment groups. Conclusion: The LM group demonstrated greater and faster benefits in visual performance as measured by CSF when compared to the PV group. This trial has been registered at clinicaltrials.gov (NCT03946085).
Collapse
Affiliation(s)
- Pinakin Gunvant Davey
- College of Optometry, Western University of Health Sciences, Pomona, CA 91766, USA; (D.W.L.); (S.A.-M.)
- Correspondence: ; Tel.: +1-909-469-8473
| | | | - Drake W. Lem
- College of Optometry, Western University of Health Sciences, Pomona, CA 91766, USA; (D.W.L.); (S.A.-M.)
| | - Rebecca Weis
- Eye Clinic of Austin, Austin, TX 78731, USA; (T.H.); (R.W.)
| | - Stephanie Amonoo-Monney
- College of Optometry, Western University of Health Sciences, Pomona, CA 91766, USA; (D.W.L.); (S.A.-M.)
| | - David W. Evans
- VectorVision/Guardion Health Sciences, San Diego, CA 92128, USA;
| |
Collapse
|
25
|
Clinical Effects of Dietary Supplementation of Lutein with High Bio-Accessibility on Macular Pigment Optical Density and Contrast Sensitivity: A Randomized Double-Blind Placebo-Controlled Parallel-Group Comparison Trial. Nutrients 2020; 12:nu12102966. [PMID: 32998324 PMCID: PMC7600844 DOI: 10.3390/nu12102966] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 11/17/2022] Open
Abstract
Improvements in macular pigment optical density (MPOD) and contrast sensitivity after administration of 12 mg lutein alone and the timing at which efficacy is observed remain unknown. Therefore, lutein (12 mg), a crystalline formulation, was used in this study, considering its bioaccessibility. This study aimed to determine the effects of lutein administration for 16 weeks on MPOD, contrast sensitivity, and glare sensitivity, and changes in serum lutein levels were determined. The study subjects comprised 59 healthy male and female adults aged 20–69 years. The study diet included a placebo (placebo group) or a diet supplemented with 12 mg of lutein (lutein group). Each study diet was continuously administered for 16 weeks. At weeks 8 and 16, MPOD, contrast sensitivity, glare sensitivity, and serum lutein levels were evaluated. Compared with the placebo group, the lutein group showed significantly improved MPOD, contrast sensitivity, and glare sensitivity at week 16 and significantly increased serum lutein levels at weeks 8 and 16. Continuous administration of lutein for 16 weeks, considering its bioaccessibility, increased MPOD; it made the outlines of visible objects clearer and was effective in inhibiting decreases in visual function caused by glare from light.
Collapse
|
26
|
Doğan M, Kutluksaman B. Macular pigment optical density after panretinal photocoagulation. Clin Exp Optom 2020; 104:187-193. [PMID: 32869395 DOI: 10.1111/cxo.13126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
CLINICAL RELEVANCE Panretinal photocoagulation, an important treatment method in diabetic retinopathy, can affect macular pigment optical density, which has protective and antioxidant properties. As a result of this effect, the retina may become more sensitive to high-energy visible light. BACKGROUND The current study assesses the effect of panretinal photocoagulation treatment on macular pigment optical density, which has essential functions for the retina. METHODS In this prospective clinical study, the colour perimetry method was used to measure macular pigment optical density. Thirty-six eyes of 36 participants with severe non-proliferative diabetic retinopathy without macular involvement were included in the study. Conventional panretinal photocoagulation treatments were applied at baseline, one month, two months, and at three months to the participants who clinically required this treatment. Macular pigment optical density and retinal thickness measurements were performed at baseline, months one, two, three and six. RESULTS The mean macular pigment optical density reduction in the fovea over the six-months was 0.02 ± 0.02 logarithmic units (p < 0.001). Similarly, the pericentral areas declined by 0.04 ± 0.03 logarithmic units (p < 0.001). Mean central macular thickness and foveal thickness increased by 5.03 ± 5.02 μm and 2.78 (interquartile range 2-4) μm, respectively. In this study, correlation analysis shows that the laser energy applied was significantly and strongly correlated with reductions in macular pigment optical density (for the fovea and pericentral area respectively: r = -0.855, p < 0.001; r = -0.895, p < 0.001). Further, there were significant and strong correlations between the applied laser energy, and central macular thickness and fovea thickness (r = 0.751, p < 0.001; ρ = 0.718, p < 0.001, respectively). CONCLUSION Panretinal photocoagulation may potentially cause a decrease in macular pigment density in proportion to the laser energy applied.
Collapse
Affiliation(s)
- Mustafa Doğan
- Department of Ophthalmology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Bünyamin Kutluksaman
- Department of Ophthalmology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras, Turkey
| |
Collapse
|
27
|
Green-Gomez M, Prado-Cabrero A, Moran R, Power T, Gómez-Mascaraque LG, Stack J, Nolan JM. The Impact of Formulation on Lutein, Zeaxanthin, and meso-Zeaxanthin Bioavailability: A Randomised Double-Blind Placebo-Controlled Study. Antioxidants (Basel) 2020; 9:E767. [PMID: 32824736 PMCID: PMC7463514 DOI: 10.3390/antiox9080767] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/14/2020] [Accepted: 08/15/2020] [Indexed: 12/31/2022] Open
Abstract
Lutein (L), zeaxanthin (Z), and meso-zeaxanthin (MZ) have been the focus of research and commercial interest for their applications in human health. Research into formulations to enhance their bioavailability is merited. This 6 month randomised placebo-controlled trial involving 81 healthy volunteers compared the bioavailability of different formulations of free L, Z, and MZ in sunflower or omega-3 oil versus L, Z, and MZ diacetates (Ld, Zd, and MZd) in a micromicellar formulation. Fasting serum carotenoids, macular pigment, and skin carotenoid score were analysed at baseline and 6 months. Serum L, Z, and MZ concentrations increased in all active interventions compared to placebo (p < 0.001 to p = 0.008). The diacetate micromicelle formulation exhibited a significantly higher mean response in serum concentrations of Z and MZ compared to the other active interventions (p = 0.002 to 0.019). A micromicellar formulation with solubilised Z and MZ diacetates is a promising technology advancement that enhances the bioavailability of these carotenoids when compared to traditional carotenoid formulations (ISRCTN clinical trial registration number: ISRCTN18206561).
Collapse
Affiliation(s)
- Marina Green-Gomez
- Nutrition Research Centre Ireland, School of Health Sciences, Carriganore House, Waterford Institute of Technology West Campus, X91 X236 Waterford, Ireland; (M.G.-G.); (A.P.-C.); (R.M.); (T.P.); (J.S.)
| | - Alfonso Prado-Cabrero
- Nutrition Research Centre Ireland, School of Health Sciences, Carriganore House, Waterford Institute of Technology West Campus, X91 X236 Waterford, Ireland; (M.G.-G.); (A.P.-C.); (R.M.); (T.P.); (J.S.)
| | - Rachel Moran
- Nutrition Research Centre Ireland, School of Health Sciences, Carriganore House, Waterford Institute of Technology West Campus, X91 X236 Waterford, Ireland; (M.G.-G.); (A.P.-C.); (R.M.); (T.P.); (J.S.)
| | - Tommy Power
- Nutrition Research Centre Ireland, School of Health Sciences, Carriganore House, Waterford Institute of Technology West Campus, X91 X236 Waterford, Ireland; (M.G.-G.); (A.P.-C.); (R.M.); (T.P.); (J.S.)
| | | | - Jim Stack
- Nutrition Research Centre Ireland, School of Health Sciences, Carriganore House, Waterford Institute of Technology West Campus, X91 X236 Waterford, Ireland; (M.G.-G.); (A.P.-C.); (R.M.); (T.P.); (J.S.)
| | - John M. Nolan
- Nutrition Research Centre Ireland, School of Health Sciences, Carriganore House, Waterford Institute of Technology West Campus, X91 X236 Waterford, Ireland; (M.G.-G.); (A.P.-C.); (R.M.); (T.P.); (J.S.)
| |
Collapse
|
28
|
The association between macular pigment optical density and visual function outcomes: a systematic review and meta-analysis. Eye (Lond) 2020; 35:1620-1628. [PMID: 32792595 DOI: 10.1038/s41433-020-01124-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 07/30/2020] [Accepted: 07/30/2020] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To conduct a systematic review and meta-analysis on data related to macular pigment optical density (MPOD) and visual function in adults with healthy eyes. METHODS MEDLINE®, Cochrane, and Commonwealth of Agriculture Bureau abstracts databases were searched for English-language publications between 1946 and August 2018. Included studies examined correlation of MPOD and visual function in adults with healthy eyes at all timepoints and all designs, except for case-control, case reports, and reviews. Visual function outcomes of interest included photostress recovery, contrast sensitivity, visual acuity, glare sensitivity/disability, and dark adaptation. Random effects model meta-analyses combined study-level correlation (r). RESULTS Twenty-two publications were included. In meta-analysis MPOD was found to be significantly correlated with contrast sensitivity at 30' (two studies, summary r: 0.37; 95% CI 0.15, 0.56), and at 1° eccentricity with a spatial frequency of 7, 11, and 21 cpd (three studies, summary r: 0.31; 95% CI 0.06, 0.52), with photostress recovery at a 1° eccentricity with a moderate background, 10 cpd, and 16% contrast (two studies, summary r: -0.17; 95% CI -0.31, -0.02), and at 30' (four studies, summary r: -0.57; 95% CI -0.78, -0.24), and with glare disability at 30' eccentricity with a log scale at 460 nm (three studies, summary r = 0.47; 95% CI 0.32; 0.59). There were insufficient data for meta-analysis for other visual functions. CONCLUSIONS Our review identifies a link between MPOD and visual function with significant correlations with photostress recovery, glare disability, and contrast sensitivity.
Collapse
|
29
|
Kan J, Wang M, Liu Y, Liu H, Chen L, Zhang X, Huang C, Liu BY, Gu Z, Du J. A novel botanical formula improves eye fatigue and dry eye: a randomized, double-blind, placebo-controlled study. Am J Clin Nutr 2020; 112:334-342. [PMID: 32542334 DOI: 10.1093/ajcn/nqaa139] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 05/15/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND With the frequent use of video display units, eye fatigue is becoming more common globally. An alternative nutritional strategy is needed to prevent the aggravation of eye fatigue symptoms. OBJECTIVES The objective was to evaluate the protective effect of a novel botanical combination of lutein ester, zeaxanthin, and extracts of blackcurrant, chrysanthemum, and goji berry on adults with eye fatigue in a randomized, double-blind, placebo-controlled clinical trial. METHODS We randomly allocated 360 participants into 4 groups to receive placebo and 3 doses of our formula (chewable tablets, containing 6 mg, 10 mg, or 14 mg of lutein) once daily for 90 d. Each participant had 3 visits at baseline (V1), 45 d (V2), and 90 d (V3) during the study. RESULTS Intervention with the formula improved individual scores of eye fatigue symptoms, including eye soreness, blurred vision, dry eye, foreign body sensation, and tearing. Compared with placebo, the formula at all 3 doses significantly decreased the total score of eye fatigue symptoms and increased the visuognosis persistence time at both V2 and V3. According to the Schirmer test, both 10-mg and 14-mg lutein formula groups had improved tear secretion at V3 compared with the placebo. The keratography results indicated that the first tear break-up time, average tear break-up time, and tear meniscus height were significantly increased after formula intervention. The formula at all 3 doses significantly increased the macular pigment optical density at V2 and V3 compared with the placebo, whereas optical coherence tomography showed no significant difference in retinal thickness and retinal volume across all groups at both visits. CONCLUSIONS Our botanical formula improves eye fatigue, dry eye, and macular function without changing the retinal structure, and thus it could serve as an effective nutritional strategy in improving eye fatigue without causing serious side effects.Clinical Trial Registry: chictr.org.cn (ChiCTR1800018987).
Collapse
Affiliation(s)
- Juntao Kan
- Nutrilite Health Institute, Shanghai, China
| | - Min Wang
- Department of Ophthalmology, Aier Eye Hospital, Shanghai, China
| | - Ying Liu
- Vanderbilt Epidemiology Center, Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Liang Chen
- Nutrilite Health Institute, Shanghai, China
| | - Xue Zhang
- Nutrilite Health Institute, Shanghai, China
| | | | - Bryan Y Liu
- College of Biotechnology, East China University of Science and Technology, Shanghai, China
| | - Zhensheng Gu
- Department of Ophthalmology, Xinhua Hospital, Shanghai, China
| | - Jun Du
- Nutrilite Health Institute, Shanghai, China
| |
Collapse
|
30
|
Paulsen AJ, Pinto A, Fischer ME, Chen Y, Huang GH, Klein BEK, Klein R, Cruickshanks KJ. Generational Differences in the 10-year Incidence of Impaired Contrast Sensitivity. Ophthalmic Epidemiol 2020; 28:175-182. [PMID: 32693658 DOI: 10.1080/09286586.2020.1791909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To determine if incidence of contrast sensitivity (CS) impairment differs by generation and identify factors to explain these differences. METHODS The Beaver Dam Eye Study (BDES) and Beaver Dam Offspring Study (BOSS) are cohort studies of aging adults in Beaver Dam, Wisconsin. Baseline examinations occurred from 1993 to 1995 (BDES) and 2005-2008 (BOSS). Follow-up examinations occurred in five-year intervals. CS testing was conducted with Pelli-Robson letter sensitivity charts; Incident impairment was a log CS score <1.55 in either eye at follow-up. Associations of incidence with generation were investigated using estimated hazard ratios (HR) with 95% confidence intervals (CI). RESULTS Participants (N = 3185) had a mean age of 51.9 years at baseline (standard deviation = 9.9) and 51.9% were female. Ten-year cumulative incidence of CS impairment was 40.1%, was higher among women (41.7%) than men (38.8%), and increased by age group. The risk of incident CS impairment decreased by 39% per generation. In multivariable models, the Baby Boom Generation (HR = 0.42, 95%CI = 0.31, 0.58) and Generation X (HR = 0.56, 95%CI = 0.34, 0.91) had a significantly decreased risk of CS impairment compared to the Greatest Generation. Results were similar in sensitivity analyses excluding those with cataract, age-related macular degeneration, or visual acuity impairment. CONCLUSION The risk of incident CS impairment decreased by birth cohort, with the greatest reduction in the Baby Boom Generation. The difference in risk suggests that there are unknown modifiable risk factors that may help to further explain the etiology of CS impairment and provide potential pathways for prevention in the future.
Collapse
Affiliation(s)
- Adam J Paulsen
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Alex Pinto
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Mary E Fischer
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Yanjun Chen
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Guan-Hua Huang
- Institute of Statistics, National Chiao Tung University, Hsinchu, Taiwan
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Karen J Cruickshanks
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.,Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| |
Collapse
|
31
|
Kar D, Clark ME, Swain TA, McGwin G, Crosson JN, Owsley C, Sloan KR, Curcio CA. Local Abundance of Macular Xanthophyll Pigment Is Associated with Rod- and Cone-Mediated Vision in Aging and Age-Related Macular Degeneration. Invest Ophthalmol Vis Sci 2020; 61:46. [PMID: 32729911 PMCID: PMC7425747 DOI: 10.1167/iovs.61.8.46] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Purpose We assessed the association between the abundance of macular xanthophyll carotenoid pigment using dual-wavelength autofluorescence and multimodal vision testing including rod-mediated dark adaptation (RMDA), a measure of retinoid re-supply, in adults ≥60 years old with and without age-related macular degeneration (AMD). Methods AMD severity was determined using the nine-step Age-Related Eye Disease Study grading. Tests probed cones (best-corrected visual acuity, contrast sensitivity), cones and rods (low-luminance visual acuity, low-luminance deficit, mesopic light sensitivity), or rods only (scotopic light sensitivity, RMDA). Signal attenuation by macular pigment optical density (MPOD) was estimated using a ratio of blue and green autofluorescence signal to yield mean MPOD in a 1°-diameter fovea-centered disk, mean MPOD in a 2°-diameter disk centered on a perifoveal RMDA test location, and macular pigment optical volume (MPOV, or integrated MPOD) in a 4°-diameter fovea-centered disk. Age-adjusted associations between vision and imaging measures were determined. Results In 88 eyes of 88 subjects (age, 74.9 ± 5.8 years) with normal eyes (n = 32), early AMD (n = 23), or intermediate AMD (n = 33), foveal and perifoveal MPOD and MPOV were higher in the AMD eyes than in the normal eyes. At the RMDA test location, higher MPOD was unrelated to AMD severity but was associated with faster RMDA. Conclusions In older adults with and without AMD, higher macular xanthophyll concentrations are associated with better best-corrected visual acuity and RMDA. Data are consistent with a model of cone resilience and rod vulnerability in aging and AMD and can be further explored in a larger sample study.
Collapse
|
32
|
Effect of an antioxidant supplement containing high dose lutein and zeaxanthin on macular pigment and skin carotenoid levels. Sci Rep 2020; 10:10262. [PMID: 32581313 PMCID: PMC7314813 DOI: 10.1038/s41598-020-66962-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 05/27/2020] [Indexed: 12/18/2022] Open
Abstract
The effect of a high dose lutein/zeaxanthin supplement on macular pigment optical density (MPOD) and skin carotenoid (SC) levels in healthy subjects was investigated. This is a prospective, single-arm, open-label study. Subjects were 16 Japanese, age 26-57 years. Subjects took a supplement containing 20 mg/day of lutein, 4 mg/day of zeaxanthin, and other antioxidants (vitamin C, vitamin E, zinc, copper) for 16 weeks. MPOD levels were measured by a two-wavelength autofluorescence imaging technique. SC levels were measured by reflection spectroscopy. Total volume of MPOD within 9° eccentricity significantly increased by week 8 and continued to increase until week 16 (p < 0.0001, two-way factorial ANOVA). The increase rate of MPOD was significantly higher in subjects with body mass index (BMI) less than 25 kg/m2 (n = 13) compared to those of 25 kg/m2 and higher (n = 3). SC levels increased significantly by week 4 and continued to increase until week 16 (p < 0.0001, two-way factorial ANOVA). All subjects completed the study without any serious adverse events. These results demonstrated the effectiveness of a high dose lutein/zeaxanthin supplement for MPOD volume and SC levels without serious adverse events.
Collapse
|
33
|
Curcio CA, McGwin G, Sadda SR, Hu Z, Clark ME, Sloan KR, Swain T, Crosson JN, Owsley C. Functionally validated imaging endpoints in the Alabama study on early age-related macular degeneration 2 (ALSTAR2): design and methods. BMC Ophthalmol 2020; 20:196. [PMID: 32429847 PMCID: PMC7236516 DOI: 10.1186/s12886-020-01467-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/08/2020] [Indexed: 12/29/2022] Open
Abstract
Background Age-related macular degeneration (AMD), a leading cause of irreversible vision impairment in the United States and globally, is a disease of the photoreceptor support system involving the retinal pigment epithelium (RPE), Bruch’s membrane, and the choriocapillaris in the setting of characteristic extracellular deposits between outer retinal cells and their blood supply. Research has clearly documented the selective vulnerability of rod photoreceptors and rod-mediated (scotopic) vision in early AMD, including delayed rod-mediated dark adaptation (RMDA) and impaired rod-mediated light and pattern sensitivity. The unifying hypothesis of the Alabama Study on Early Macular Degeneration (ALSTAR2) is that early AMD is a disease of micronutrient deficiency and vascular insufficiency, due to detectable structural changes in the retinoid re-supply route from the choriocapillaris to the photoreceptors. Functionally this is manifest as delayed rod-mediated dark adaptation and eventually as rod-mediated visual dysfunction in general. Methods A cohort of 480 older adults either in normal macular health or with early AMD will be enrolled and followed for 3 years to examine cross-sectional and longitudinal associations between structural and functional characteristics of AMD. Using spectral domain optical coherence tomography, the association between (1) subretinal drusenoid deposits and drusen, (2) RPE cell bodies, and (3) the choriocapillaris’ vascular density and rod- and cone-mediated vision will be examined. An accurate map and timeline of structure-function relationships in aging and early AMD gained from ALSTAR2, especially the critical transition from aging to disease, will identify major characteristics relevant to future treatments and preventative measures. Discussion A major barrier to developing treatments and prevention strategies for early AMD is a limited understanding of the temporal interrelationships among structural and functional characteristics while transitioning from aging to early AMD. ALSTAR2 will enable the development of functionally valid, structural biomarkers for early AMD, suitable for use in forthcoming clinical trials as endpoint/outcome measures. The comprehensive dataset will also allow hypothesis-testing for mechanisms that underlie the transition from aging to AMD, one of which is a newly developed Center-Surround model of cone resilience and rod vulnerability. Trial registration ClinicalTrials.gov Identifier NCT04112667, October 7, 2019.
Collapse
Affiliation(s)
- Christine A Curcio
- Department of Ophthalmology and Visual Sciences, Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, 1720 University Blvd., Suite 609, Birmingham, AL, 35294-0009, USA
| | - Gerald McGwin
- Department of Ophthalmology and Visual Sciences, Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, 1720 University Blvd., Suite 609, Birmingham, AL, 35294-0009, USA.,Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Srinivas R Sadda
- Doheny Eye Institute, P.O. Box 86228, Los Angeles, CA, 90033, USA
| | - Zhihong Hu
- Doheny Eye Institute, P.O. Box 86228, Los Angeles, CA, 90033, USA
| | - Mark E Clark
- Department of Ophthalmology and Visual Sciences, Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, 1720 University Blvd., Suite 609, Birmingham, AL, 35294-0009, USA
| | - Kenneth R Sloan
- Department of Ophthalmology and Visual Sciences, Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, 1720 University Blvd., Suite 609, Birmingham, AL, 35294-0009, USA.,Department of Computer Science, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Thomas Swain
- Department of Ophthalmology and Visual Sciences, Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, 1720 University Blvd., Suite 609, Birmingham, AL, 35294-0009, USA
| | - Jason N Crosson
- Department of Ophthalmology and Visual Sciences, Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, 1720 University Blvd., Suite 609, Birmingham, AL, 35294-0009, USA.,Retina Consultants of Alabama, Birmingham, AL, 35233, USA
| | - Cynthia Owsley
- Department of Ophthalmology and Visual Sciences, Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, 1720 University Blvd., Suite 609, Birmingham, AL, 35294-0009, USA.
| |
Collapse
|
34
|
de Mejia EG, Zhang Q, Penta K, Eroglu A, Lila MA. The Colors of Health: Chemistry, Bioactivity, and Market Demand for Colorful Foods and Natural Food Sources of Colorants. Annu Rev Food Sci Technol 2020; 11:145-182. [PMID: 32126181 DOI: 10.1146/annurev-food-032519-051729] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is an increasing consumer demand for natural colors in foods. However, there is a limited number of available natural food sources for use by the food industry because of technical and regulatory limitations. Natural colors are less stable and have less vibrant hues compared to their synthetic color counterparts. Natural pigments also have known health benefits that are seldom leveraged by the food industry. Betalains, carotenoids, phycocyanins, and anthocyanins are major food colorants used in the food industry that have documented biological effects, particularly in the prevention and management of chronic diseases such as diabetes, obesity, and cardiovascular disease. The color industry needs new sources of stable, functional, and safe natural food colorants. New opportunities include sourcing new colors from microbial sources and via the use of genetic biotechnology. In all cases, there is an imperative need for toxicological evaluation to pave the way for their regulatory approval.
Collapse
Affiliation(s)
- Elvira Gonzalez de Mejia
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, Illinois 61801, USA;
| | - Qiaozhi Zhang
- College of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou 310018, China
| | - Kayla Penta
- Department of Molecular and Structural Biochemistry and Plants for Human Health Institute, North Carolina Research Campus, North Carolina State University, Kannapolis, North Carolina 28081, USA
| | - Abdulkerim Eroglu
- Department of Molecular and Structural Biochemistry and Plants for Human Health Institute, North Carolina Research Campus, North Carolina State University, Kannapolis, North Carolina 28081, USA
| | - Mary Ann Lila
- Department of Food, Bioprocessing & Nutrition Sciences and Plants for Human Health Institute, North Carolina Research Campus, North Carolina State University, Kannapolis, North Carolina 28081, USA
| |
Collapse
|
35
|
Obana A, Gohto Y, Sasano H, Gellermann W, Sharifzadeh M, Seto T, Bernstein PS. Spatial distribution of macular pigment estimated by autofluorescence imaging in elderly Japanese individuals. Jpn J Ophthalmol 2020; 64:160-170. [PMID: 31989400 DOI: 10.1007/s10384-020-00716-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 10/31/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine the spatial distribution types of macular pigment (MP) in elderly Japanese individuals and to consider their origin. STUDY DESIGN Observational case series. METHODS Local MP optical density (MPOD) at some eccentricities and MP volume were measured using the MPOD module of a MultiColor Spectralis in 96 pseudophakic eyes of 96 participants (age range, 52-86 years; mean age, 72.8 ± 8.3 years). The MP distribution types were determined from the MP spatial profiles. The retinal thickness (RT) at the foveal center, at both 0.5° and 0.9° eccentricities, and the foveal width were measured using optical coherence tomography. RESULTS The mean local MPOD at the foveal center was 0.79. Spatial distribution was classified into four types: central peak (24.0%), ring-like (40.6%), intermediate (22.9%), and central dip (12.5%). The ring-like type was the most frequent in these Japanese participants. The central-peak type showed lower MPOD than did the other types in the area outside 0.9°. The ring-like type occurred frequently in eyes with small RT at 0.5° and wider foveal width. A rough contour of the Müller cell cone was found more frequently in the central-dip type than in the other types. CONCLUSIONS The present characteristics of the different distribution patterns could be explained by the hypothesis that MP presents mainly in the Müller cell cone within 0.5° and in Müller cells in the outer and inner plexiform layers in the area outside 0.5°. The anatomic characteristics of Müller cells at the fovea and parafovea likely affect the MP distribution.
Collapse
Affiliation(s)
- Akira Obana
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka, 430-8558, Japan. .,Hamamatsu BioPhotonics Innovation Chair, Institute for Medical Photonics Research, Preeminent Medical Photonics Education and Research Center, Hamamatsu University School of Medicine, Hamamatsu, Japan.
| | - Yuko Gohto
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka, 430-8558, Japan
| | - Hiroyuki Sasano
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka, 430-8558, Japan
| | | | | | - Takahiko Seto
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka, 430-8558, Japan
| | - Paul S Bernstein
- Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, Salt Lake City, USA
| |
Collapse
|
36
|
Green-Gomez M, Bernstein PS, Curcio CA, Moran R, Roche W, Nolan JM. Standardizing the Assessment of Macular Pigment Using a Dual-Wavelength Autofluorescence Technique. Transl Vis Sci Technol 2019; 8:41. [PMID: 31867142 PMCID: PMC6922273 DOI: 10.1167/tvst.8.6.41] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/03/2019] [Indexed: 12/24/2022] Open
Abstract
PURPOSE It is essential to have an appropriate measure to assess macular pigment (MP) that can provide an accurate, valid, and reliable representation of the MP within the macula. The aim of this study was to describe and introduce MP optical volume (MPOV) as an optimal value for reporting MP. METHODS Three hundred ninety-three subjects were analyzed using the Heidelberg Spectralis with the investigational MP optical density (MPOD) module to measure MPOV and MPOD at four foveal eccentricities (0.23°, 0.51°, 0.98°, 1.76° [7° as reference point]). Lutein (L) and zeaxanthin (Z) dietary intake and serum concentrations were evaluated. RESULTS MPOV mean was 5094 (95%CI, 4877-5310); range: 527 to 10,652. MPOV was inversely correlated with body mass index and positively correlated with education (r = -0.156, P = 0.002 and r = 0.124, P = 0.014, respectively). Serum concentrations of L and Z were positively correlated with MPOV (r = 0.422, P < 0.001 and r = 0.285, P < 0.001, respectively). MPOV was positively correlated to MPOD at all measured eccentricities, with the strongest agreement at 1.76° (r = 0.906, P < 0.001). Serum concentrations of L and Z, BMI, education, and age (P < 0.001) were found to be significant predictors of MPOV. CONCLUSIONS The Spectralis MPOV measurement provided a comprehensive and detailed evaluation of the MP profile. The Spectralis MPOV should be considered a preferred metric for the assessment of MP. TRANSLATIONAL RELEVANCE Applying a standardized method for the assessment and report of MP will allow to fully derive meaning from observational studies and to successfully implement this MP measurement technique in research and clinical settings.
Collapse
Affiliation(s)
- Marina Green-Gomez
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland
| | | | - Christine A. Curcio
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rachel Moran
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland
| | - Warren Roche
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland
| | - John M. Nolan
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland
| |
Collapse
|
37
|
Loladze I, Nolan JM, Ziska LH, Knobbe AR. Rising Atmospheric CO2Lowers Concentrations of Plant Carotenoids Essential to Human Health: A Meta‐Analysis. Mol Nutr Food Res 2019; 63:e1801047. [DOI: 10.1002/mnfr.201801047] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 05/07/2019] [Indexed: 01/27/2023]
Affiliation(s)
- Irakli Loladze
- Bryan College of Health SciencesBryan Medical Center Lincoln NE 68506 USA
- School of Mathematical and Statistical SciencesArizona State University Temple AZ 85281 USA
| | - John M. Nolan
- Nutrition Research Centre Ireland, School of Health Science, Carriganore HouseWaterford Institute of Technology West Campus Waterford Ireland
| | - Lewis H. Ziska
- USDA‐ARSAdaptive Cropping Systems Laboratory Beltsville MD 20705 USA
- Mailman School of Public HealthColumbia University New York NY 10025 USA
| | - Amy R. Knobbe
- Bryan College of Health SciencesBryan Medical Center Lincoln NE 68506 USA
| |
Collapse
|
38
|
Roark MW, Stringham JM. Visual Performance in the "Real World": Contrast Sensitivity, Visual Acuity, and Effects of Macular Carotenoids. Mol Nutr Food Res 2019; 63:e1801053. [PMID: 31116474 DOI: 10.1002/mnfr.201801053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 04/30/2019] [Indexed: 11/10/2022]
Abstract
Visual acuity (VA) is compared to contrast sensitivity (CS) testing in assessing "real-world" visual performance, and it is recommended that both should be measured routinely in the clinic. The role of nutritional intervention in improving visual performance is reviewed and emphasized. A brief history and illustration of both VA and CS, within the scope of visual performance, is presented. Parameters for effective CS testing in the clinic, and guidelines for interpretation of results, including a new model for understanding the visual impact of changes in CS, are also presented. Relevant research that supports the use of the macular carotenoids lutein, zeaxanthin, and meso-zeaxanthin to enhance visual performance is reviewed with suggested guidelines for supplementation. CS testing is easily performed at a single intermediate target size and is an excellent tool for the accurate assessment of a patient's overall visual experience. Research continues to uncover the strong link between nutrition and visual performance; the macular carotenoids appear to be especially effective in this regard, and their benefits to visual performance now importantly include contrast sensitivity. Clinicians can provide an improved level of care by incorporating into the examination protocol CS testing and, where appropriate, nutritional counseling and intervention.
Collapse
Affiliation(s)
- Mark W Roark
- Allisonville Eye Care Center, 10967 Allisonville Rd #120, Fishers, IN, 46038, USA
| | - James M Stringham
- Duke Eye Center, Visual Performance Laboratory, 2351 Erwin Road, Durham, NC, 27710, USA
| |
Collapse
|
39
|
Stringham JM, Johnson EJ, Hammond BR. Lutein across the Lifespan: From Childhood Cognitive Performance to the Aging Eye and Brain. Curr Dev Nutr 2019; 3:nzz066. [PMID: 31321376 PMCID: PMC6629295 DOI: 10.1093/cdn/nzz066] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/05/2019] [Accepted: 05/30/2019] [Indexed: 12/21/2022] Open
Abstract
Lutein is a non-provitamin A dietary carotenoid found in dark green leafy vegetables, corn, eggs, and avocados. Among the carotenoids, lutein and its isomer, zeaxanthin, are the only 2 that cross the blood-retina barrier to form macular pigment in the retina. Lutein also preferentially accumulates in the human brain across multiple life stages. A variety of scientific evidence supports a role for lutein in visual as well as cognitive function across the lifespan. The purpose of this review is to summarize the latest science on lutein's role in the eye and the brain across different ages.
Collapse
Affiliation(s)
| | | | - B Randy Hammond
- Department of Psychology, University of Georgia-Athens, Athens, GA, USA
| |
Collapse
|
40
|
Abstract
Carotenoids are anti-oxidative agents. Human skin and eyes contain specific carotenoid species known to prevent various pathologies caused by oxidative stress. We quantified skin and eye carotenoid levels and investigated their potential correlation in a population including 985 Japanese patients and staff members of an ophthalmology clinic (577 men, 408 women, mean age of 69.7 ± 13.6 [SD]). Skin carotenoid (SC) and macular pigment (MP) levels were measured with reflection spectroscopy and autofluorescence imaging methods, respectively. The mean SC index was 343.1 ± 142.1 (SD). SC indices for women were higher than for men (382 vs 315, p < 0.001). Smokers and overweight subjects (BMI ≥ 25) had lower SC indices. Subjects taking lutein supplements had higher SC indices than non-supplementing subjects (415 vs 325, p < 0.001). SC and MP indices were significantly correlated. The obtained data set can be used for reference purposes by Japanese subjects and researchers interested in tissue responses to diets high in carotenoids and lutein supplementation.
Collapse
|
41
|
Daga FB, Ogata NG, Medeiros FA, Moran R, Morris J, Zangwill LM, Weinreb RN, Nolan JM. Macular Pigment and Visual Function in Patients With Glaucoma: The San Diego Macular Pigment Study. Invest Ophthalmol Vis Sci 2019; 59:4471-4476. [PMID: 30193322 PMCID: PMC6133244 DOI: 10.1167/iovs.18-24170] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose Although recent studies have shown that macular pigment (MP) is significantly lower in glaucoma patients, this relationship merits further investigation. Methods This cross-sectional study included 85 glaucoma patients and 22 controls. All subjects had standard automated perimetry (SAP) and retinal nerve fiber layer (RNFL) thickness measurements. Intake of lutein (L) and zeaxanthin (Z) was estimated using a novel dietary screener. The Heidelberg Spectralis dual-wavelength autofluorescence (AF) technology was employed to study the relationship between MP and glaucoma. The association between MP volume and glaucoma was investigated using linear regression models accounting for potential confounding factors. Results Glaucoma patients had significantly worse SAP mean deviation (MD) and lower RNFL thickness in the study eye compared to control subjects (P < 0.001 for both). MP (volume) was comparable between groups (P = 0.436). In the univariable model, diagnosis of glaucoma was not associated with MP volume (R2 = 1.22%; P = 0.257). Dietary intake of L and Z was positively and significantly related to MP in the univariable (P = 0.022) and multivariable (P = 0.020) models. Conclusions These results challenge previous studies that reported that glaucoma is associated with low MP. Dietary habits were found to be the main predictor of MP in this sample. Further research is merited to better understand the relationship between glaucoma, MP, and visual performance in these patients.
Collapse
Affiliation(s)
- Fábio B Daga
- Hamilton Glaucoma Center and Shiley Eye Institute and Department of Ophthalmology, University of California San Diego, La Jolla, California, United States.,Department of Ophthalmology, Duke Eye Center, Duke University, Durham, North Carolina, United States
| | - Nara G Ogata
- Hamilton Glaucoma Center and Shiley Eye Institute and Department of Ophthalmology, University of California San Diego, La Jolla, California, United States.,Department of Ophthalmology, Duke Eye Center, Duke University, Durham, North Carolina, United States
| | - Felipe A Medeiros
- Hamilton Glaucoma Center and Shiley Eye Institute and Department of Ophthalmology, University of California San Diego, La Jolla, California, United States.,Department of Ophthalmology, Duke Eye Center, Duke University, Durham, North Carolina, United States
| | - Rachel Moran
- Nutrition Research Centre Ireland, School of Health Sciences, Carriganore House, Waterford Institute of Technology, West Campus, Carriganore, Waterford, Ireland
| | - Jeffrey Morris
- Morris Eye Group, Encinitas, Vista, California, United States
| | - Linda M Zangwill
- Hamilton Glaucoma Center and Shiley Eye Institute and Department of Ophthalmology, University of California San Diego, La Jolla, California, United States
| | - Robert N Weinreb
- Hamilton Glaucoma Center and Shiley Eye Institute and Department of Ophthalmology, University of California San Diego, La Jolla, California, United States
| | - John M Nolan
- Hamilton Glaucoma Center and Shiley Eye Institute and Department of Ophthalmology, University of California San Diego, La Jolla, California, United States.,Nutrition Research Centre Ireland, School of Health Sciences, Carriganore House, Waterford Institute of Technology, West Campus, Carriganore, Waterford, Ireland
| |
Collapse
|
42
|
Waugh N, Loveman E, Colquitt J, Royle P, Yeong JL, Hoad G, Lois N. Treatments for dry age-related macular degeneration and Stargardt disease: a systematic review. Health Technol Assess 2019; 22:1-168. [PMID: 29846169 DOI: 10.3310/hta22270] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Age-related macular degeneration (AMD) is the leading cause of visual loss in older people. Advanced AMD takes two forms, neovascular (wet) and atrophic (dry). Stargardt disease (STGD) is the commonest form of inherited macular dystrophy. OBJECTIVE To carry out a systematic review of treatments for dry AMD and STGD, and to identify emerging treatments where future NIHR research might be commissioned. DESIGN Systematic review. METHODS We searched MEDLINE, EMBASE, Web of Science and The Cochrane Library from 2005 to 13 July 2017 for reviews, journal articles and meeting abstracts. We looked for studies of interventions that aim to preserve or restore vision in people with dry AMD or STGD. The most important outcomes are those that matter to patients: visual acuity (VA), contrast sensitivity, reading speed, ability to drive, adverse effects of treatment, quality of life, progression of disease and patient preference. However, visual loss is a late event and intermediate predictors of future decline were accepted if there was good evidence that they are strong predictors of subsequent visual outcomes. These include changes detectable by investigation, but not necessarily noticed by people with AMD or STGD. ClinicalTrials.gov, the World Health Organization search portal and the UK Clinical Trials gateway were searched for ongoing and recently completed clinical trials. RESULTS The titles and abstracts of 7948 articles were screened for inclusion. The full text of 398 articles were obtained for further screening and checking of references and 112 articles were included in the final report. Overall, there were disappointingly few good-quality studies (including of sufficient size and duration) reporting useful outcomes, particularly in STGD. However we did identify a number of promising research topics, including drug treatments, stem cells, new forms of laser treatment, and implantable intraocular lens telescopes. In many cases, research is already under way, funded by industry or governments. LIMITATIONS In AMD, the main limitation came from the poor quality of much of the evidence. Many studies used VA as their main outcome despite not having sufficient duration to observe changes. The evidence on treatments for STGD is sparse. Most studies tested interventions with no comparison group, were far too short term, and the quality of some studies was poor. FUTURE WORK We think that the topics on which the Health Technology Assessment (HTA) and Efficacy Mechanism and Evaluation (EME) programmes might consider commissioning primary research are in STGD, a HTA trial of fenretinide (ReVision Therapeutics, San Diego, CA, USA), a visual cycle inhibitor, and EME research into the value of lutein and zeaxanthin supplements, using short-term measures of retinal function. In AMD, we suggest trials of fenretinide and of a potent statin. There is epidemiological evidence from the USA that the drug, levodopa, used for treating Parkinson's disease, may reduce the incidence of AMD. We suggest that similar research should be carried out using the large general practice databases in the UK. Ideally, future research should be at earlier stages in both diseases, before vision is impaired, using sensitive measures of macular function. This may require early detection of AMD by screening. STUDY REGISTRATION This study is registered as PROSPERO CRD42016038708. FUNDING The National Institute for Health Research HTA programme.
Collapse
Affiliation(s)
- Norman Waugh
- Division of Health Sciences, University of Warwick, Coventry, UK
| | | | | | - Pamela Royle
- Division of Health Sciences, University of Warwick, Coventry, UK
| | | | | | - Noemi Lois
- Ophthalmology, Royal Victoria Hospital, Belfast, UK.,Wellcome-Wolfson Centre for Experimental Medicine, Queens University, Belfast, UK
| |
Collapse
|
43
|
Nutrients for Prevention of Macular Degeneration and Eye-Related Diseases. Antioxidants (Basel) 2019; 8:antiox8040085. [PMID: 30986936 PMCID: PMC6523787 DOI: 10.3390/antiox8040085] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 03/18/2019] [Accepted: 03/25/2019] [Indexed: 12/28/2022] Open
Abstract
The risk of macular degeneration can be reduced through the consumption of antioxidant-rich foods, supplements, and nutraceutical formulas. This review focuses on the antioxidants, vitamins, and minerals that have been reported for reducing the risk of macular degeneration and other eye-related diseases. Antioxidants including anthocyanins, carotenoids, flavonoids, and vitamins have been shown to reduce the risk of eye-related diseases. Anthocyanins extracted from berries are powerful antioxidants. Cyanidin, delphinidin, malvidin, pelargonidin, peonidin, and petunidin are anthocyanin aglycones detected in berries, currants, and other colored fruits and vegetables. β-Carotene, as well as xanthophyll lutein and zeaxanthin, have been reported to reduce the risk of macular degeneration. Flavonoids from plants help in the prevention of eye-related diseases through anti-inflammatory mechanisms. A combination of these antioxidants, vitamins, and minerals possess a synergistic effect on the prevention or risk reduction of macular degeneration. Formulas have been developed as dietary supplements to cater to the high demand from consumers and patients with eye problems. Many of the formulated dietary supplements that are sold in the market have been clinically proven for their efficacy to treat eye diseases. Although the bioactivities in the supplement capsules or tablets have been scientifically established for reducing risks of several diseases, which include macular degeneration and other eye-related diseases, knowledge on the right dosage, efficacy, and bioavailability of antioxidants, vitamins, and minerals is important for consumers. The information may help them make the best decision in choosing the right dietary supplements and nutraceuticals following the evidence-based recommended dosages and reference intakes for improving general health and preventing eye-related diseases. This review covers the potential causal factors involved in eye diseases, clinically proven treatments, and controversial findings on the antioxidants in the prevention of macular degeneration. Future studies should consider multiethnic and multicenter trials for eliminating potential bias in research.
Collapse
|
44
|
Temple SE, Roberts NW, Misson GP. Haidinger's brushes elicited at varying degrees of polarization rapidly and easily assesses total macular pigmentation. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2019; 36:B123-B131. [PMID: 31044990 DOI: 10.1364/josaa.36.00b123] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 03/07/2019] [Indexed: 06/09/2023]
Abstract
Macular pigments (MPs), by absorbing potentially toxic short-wavelength (400-500 nm) visible light, provide protection against photo-chemical damage thought to be relevant in the pathogenesis of age-related macular degeneration (AMD). A method of screening for low levels of MPs could be part of a prevention strategy for helping people to delay the onset of AMD. We introduce a new method for assessing MP density that takes advantage of the polarization-dependent absorption of blue light by MPs, which results in the entoptic phenomenon called Haidinger's brushes (HB). Subjects were asked to identify the direction of rotation of HB when presented with a circular stimulus illuminated with an even intensity of polarized white light in which the electric field vector was rotating either clockwise or anti-clockwise. By reducing the degree of polarization of the stimulus light, a threshold for perceiving HB (degree of polarization threshold) was determined and correlated (r2=0.66) to macular pigment optical density assessed using dual-wavelength fundus autofluoresence. The speed and ease of measurement of degree of polarization threshold makes it well suited for large-scale screening of macular pigmentation.
Collapse
|
45
|
Obana A, Gohto Y, Sasano H, Gellermann W, Sharifzadeh M, Seto T, Bernstein PS. Grade of Cataract and Its Influence on Measurement of Macular Pigment Optical Density Using Autofluorescence Imaging. Invest Ophthalmol Vis Sci 2019; 59:3011-3019. [PMID: 30025122 PMCID: PMC5995481 DOI: 10.1167/iovs.17-23699] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Purpose To evaluate the influence of cataracts on measuring macular pigment optical density (MPOD) using a dual-wavelength confocal scanning autofluorescence imaging technique and to establish methods to compensate for the influence of cataracts. Methods This prospective case series comprised 100 eyes that underwent cataract surgery. Cataracts were graded based on the World Health Organization classification. MPOD levels were measured with the MPOD module of the Spectralis MultiColor instrument (Spectralis-MP), pre- and postoperatively. We investigated the relationship between change in MPOD values and age, cataract grade, and quality of autofluorescence images. Local MPOD levels were evaluated for four strategically chosen eccentricities within the macular region, and the total MPOD volume was evaluated within 8.98° eccentricity from the center. Results MPOD levels could be obtained in 67 eyes before surgery. Local and volume MPOD levels were higher postoperatively relative to preoperatively in all eyes. The mean ratio of local MPOD levels after and before surgery (correction factor, CF) ranged from 1.42 to 1.77, with larger CFs required for eccentricities closer to the foveal center. The CF for the MPOD volume was 1.31. Age, grade of nuclear cataract (NUC), posterior subcapsular opacity, and image quality index (IQI) significantly contributed to CFs. For example, regression equation for CF at 0.23° = 0.17 + 0.16 × IQI + 0.29 × NUC grade + 0.01 × age (P < 0.001). Conclusions Cataracts affected MPOD measurements with the Spectralis-MP, but corrected MPOD results could be obtained via regression equations.
Collapse
Affiliation(s)
- Akira Obana
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu City, Shizuoka, Japan.,Department of Medical Spectroscopy, Institute for Medical Photonics Research, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Yuko Gohto
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu City, Shizuoka, Japan
| | - Hiroyuki Sasano
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu City, Shizuoka, Japan
| | | | | | - Takahiko Seto
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu City, Shizuoka, Japan
| | - Paul S Bernstein
- Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, Salt Lake City, Utah, United States
| |
Collapse
|
46
|
Curcio CA. Soft Drusen in Age-Related Macular Degeneration: Biology and Targeting Via the Oil Spill Strategies. Invest Ophthalmol Vis Sci 2018; 59:AMD160-AMD181. [PMID: 30357336 PMCID: PMC6733535 DOI: 10.1167/iovs.18-24882] [Citation(s) in RCA: 173] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
AMD is a major cause of legal blindness in older adults approachable through multidisciplinary research involving human tissues and patients. AMD is a vascular-metabolic-inflammatory disease, in which two sets of extracellular deposits, soft drusen/basal linear deposit (BLinD) and subretinal drusenoid deposit (SDD), confer risk for end-stages of atrophy and neovascularization. Understanding how deposits form can lead to insights for new preventions and therapy. The topographic correspondence of BLinD and SDD with cones and rods, respectively, suggest newly realized exchange pathways among outer retinal cells and across Bruch's membrane and the subretinal space, in service of highly evolved, eye-specific physiology. This review focuses on soft drusen/BLinD, summarizing evidence that a major ultrastructural component is large apolipoprotein B,E-containing, cholesterol-rich lipoproteins secreted by the retinal pigment epithelium (RPE) that offload unneeded lipids of dietary and outer segment origin to create an atherosclerosis-like progression in the subRPE-basal lamina space. Clinical observations and an RPE cell culture system combine to suggest that soft drusen/BLinD form when secretions of functional RPE back up in the subRPE-basal lamina space by impaired egress across aged Bruch's membrane-choriocapillary endothelium. The soft drusen lifecycle includes growth, anterior migration of RPE atop drusen, then collapse, and atrophy. Proof-of-concept studies in humans and animal models suggest that targeting the “Oil Spill in Bruch's membrane” offers promise of treating a process in early AMD that underlies progression to both end-stages. A companion article addresses the antecedents of soft drusen within the biology of the macula.
Collapse
Affiliation(s)
- Christine A Curcio
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| |
Collapse
|
47
|
Curcio CA. Antecedents of Soft Drusen, the Specific Deposits of Age-Related Macular Degeneration, in the Biology of Human Macula. Invest Ophthalmol Vis Sci 2018; 59:AMD182-AMD194. [PMID: 30357337 PMCID: PMC6733529 DOI: 10.1167/iovs.18-24883] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AMD pathobiology was irreversibly changed by the recent discovery of extracellular cholesterol-containing deposits in the subretinal space, between the photoreceptors and retinal pigment epithelium (RPE), called subretinal drusenoid deposits (SDDs). SDDs strikingly mirror the topography of rod photoreceptors in human macula, raising the question of whether an equivalent process results in a deposition related to foveal cones. Herein we propose that AMD's pathognomonic lesion-soft drusen and basal linear deposit (BLinD, same material, diffusely distributed)-is the leading candidate. Epidemiologic, clinical, and histologic data suggest that these deposits are most abundant in the central macula, under the fovea. Strong evidence presented in a companion article supports the idea that the dominant ultrastructural component is large apolipoprotein B,E-containing lipoproteins, constitutively secreted by RPE. Lipoprotein fatty acids are dominated by linoleate (implicating diet) rather than docosahexaenoate (implicating photoreceptors); we seek within the retina cellular relationships and dietary drivers to explain soft druse topography. The delivery of xanthophyll pigments to highly evolved and numerous Müller cells in the human fovea, through RPE, is one strong candidate, because Müller cells are the main reservoir of these pigments, which replenish from diet. We propose that the evolution of neuroglial relations and xanthophyll delivery that underlie exquisite human foveal vision came with a price, that is, soft drusen and sequela, long after our reproductive years.
Collapse
Affiliation(s)
- Christine A Curcio
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| |
Collapse
|
48
|
Rinninella E, Mele MC, Merendino N, Cintoni M, Anselmi G, Caporossi A, Gasbarrini A, Minnella AM. The Role of Diet, Micronutrients and the Gut Microbiota in Age-Related Macular Degeneration: New Perspectives from the Gut⁻Retina Axis. Nutrients 2018; 10:nu10111677. [PMID: 30400586 PMCID: PMC6267253 DOI: 10.3390/nu10111677] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 10/25/2018] [Accepted: 10/31/2018] [Indexed: 12/13/2022] Open
Abstract
Age-related macular degeneration (AMD) is a complex multifactorial disease and the primary cause of legal and irreversible blindness among individuals aged ≥65 years in developed countries. Globally, it affects 30–50 million individuals, with an estimated increase of approximately 200 million by 2020 and approximately 300 million by 2040. Currently, the neovascular form may be able to be treated with the use of anti-VEGF drugs, while no effective treatments are available for the dry form. Many studies, such as the randomized controlled trials (RCTs) Age-Related Eye Disease Study (AREDS) and AREDS 2, have shown a potential role of micronutrient supplementation in lowering the risk of progression of the early stages of AMD. Recently, low-grade inflammation, sustained by dysbiosis and a leaky gut, has been shown to contribute to the development of AMD. Given the ascertained influence of the gut microbiota in systemic low-grade inflammation and its potential modulation by macro- and micro-nutrients, a potential role of diet in AMD has been proposed. This review discusses the role of the gut microbiota in the development of AMD. Using PubMed, Web of Science and Scopus, we searched for recent scientific evidence discussing the impact of dietary habits (high-fat and high-glucose or -fructose diets), micronutrients (vitamins C, E, and D, zinc, beta-carotene, lutein and zeaxanthin) and omega-3 fatty acids on the modulation of the gut microbiota and their relationship with AMD risk and progression.
Collapse
Affiliation(s)
- Emanuele Rinninella
- UOC di Nutrizione Clinica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy.
- Istituto di Patologia Speciale Medica, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy.
| | - Maria Cristina Mele
- UOC di Nutrizione Clinica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy.
- Istituto di Patologia Speciale Medica, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy.
| | - Nicolò Merendino
- Laboratorio di Nutrizione Cellulare e Molecolare, Dipartimento di Scienze Ecologiche e Biologiche (DEB), Università della Tuscia, Largo dell'Università snc, 01100 Viterbo, Italy.
| | - Marco Cintoni
- Scuola di Specializzazione in Scienza dell'Alimentazione, Università di Roma Tor Vergata, Via Montpellier 1, 00133 Rome, Italy.
| | - Gaia Anselmi
- UOC di Nutrizione Clinica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy.
| | - Aldo Caporossi
- UOC di Oculistica, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy.
- Istituto di Oftalmologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy.
| | - Antonio Gasbarrini
- UOC di Nutrizione Clinica, Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy.
- Istituto di Patologia Speciale Medica, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy.
| | - Angelo Maria Minnella
- UOC di Oculistica, Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy.
- Istituto di Oftalmologia, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy.
| |
Collapse
|
49
|
The clinical relevance of visualising the peripheral retina. Prog Retin Eye Res 2018; 68:83-109. [PMID: 30316018 DOI: 10.1016/j.preteyeres.2018.10.001] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 10/01/2018] [Accepted: 10/07/2018] [Indexed: 01/04/2023]
Abstract
Recent developments in imaging technologies now allow the documentation, qualitative and quantitative evaluation of peripheral retinal lesions. As wide field retinal imaging, capturing both the central and peripheral retina up to 200° eccentricity, is becoming readily available the question is: what is it that we gain by imaging the periphery? Based on accumulating evidence it is clear that findings in the periphery do not always associate to those observed in the posterior pole. However, the newly acquired information may provide useful clues to previously unrecognised disease features and may facilitate more accurate disease prognostication. In this review, we explore the anatomy and physiology of the peripheral retina, focusing on how it differs from the posterior pole, recount the history of peripheral retinal imaging, describe various peripheral retinal lesions and evaluate the overall relevance of peripheral retinal findings to different diseases.
Collapse
|
50
|
Sasano H, Obana A, Sharifzadeh M, Bernstein PS, Okazaki S, Gohto Y, Seto T, Gellermann W. Optical Detection of Macular Pigment Formation in Premature Infants. Transl Vis Sci Technol 2018; 7:3. [PMID: 30002950 PMCID: PMC6038830 DOI: 10.1167/tvst.7.4.3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/06/2018] [Indexed: 12/14/2022] Open
Abstract
Purpose To demonstrate the presence of macular pigment in the retina of premature infants, and to examine its changes with age. Methods The participants included 40 premature infants. Infants who had received laser photocoagulation for retinopathy of prematurity were excluded. Macular pigment optical density (MPOD) was measured by fundus reflectometry using RetCam3, a digital fundus camera. The reflection imaging was performed for ROP screening. The imaging time points were from a post menstrual age (PMA) of 29 weeks 0 days to 46 weeks 5 days. Results The MPOD levels could be obtained from 39 premature infants. The levels at the first measurement ranged from 0 to 0.18 (mean 0.076, SD 0.044). The earliest time, when a nonvanishing MPOD level was obtained, was at a PMA of 33 weeks and 2 days, and that level was 0.05. The initial examination MPOD levels showed a moderate correlation with age (R2 = 0.32, P < 0.00017). The mean MPOD levels measured each week during the follow-up period showed a very strong correlation with age (R2 = 0.91, P < 0.0001). A regression line of MPOD = 0.0069 × age − 0.1783 was derived, where age is counted in PMA days. Conclusions The MPOD levels of premature infants were for the first time measured in living eyes. Macular pigment increased linearly with age. Translational Relevance Macular pigment increased with the development of macular morphology. This result suggested the importance of nutritional management of infants and mothers during perinatal period.
Collapse
Affiliation(s)
- Hiroyuki Sasano
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan.,Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan
| | - Akira Obana
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan.,Department of Medical Spectroscopy, Institute for Medical Photonics Research, Preeminent Medical Photonics Education and Research Center, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | | | - Paul S Bernstein
- Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Shigetoshi Okazaki
- Department of Medical Spectroscopy, Institute for Medical Photonics Research, Preeminent Medical Photonics Education and Research Center, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Yuko Gohto
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Takahiko Seto
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | | |
Collapse
|