The Impact of Supplemental Antioxidants on Visual Function in Nonadvanced Age-Related Macular Degeneration: A Head-to-Head Randomized Clinical Trial

Invest Ophthalmol Vis Sci. 2017 Oct 1;58(12):5347-5360. doi: 10.1167/iovs.16-21192.

Abstract

Purpose: The purpose of this study was to evaluate the impact of supplemental macular carotenoids (including versus not including meso-zeaxanthin) in combination with coantioxidants on visual function in patients with nonadvanced age-related macular degeneration.

Methods: In this study, 121 participants were randomly assigned to group 1 (Age-Related Eye Disease Study 2 formulation with a low dose [25 mg] of zinc and an addition of 10 mg meso-zeaxanthin; n = 60) or group 2 (Age-Related Eye Disease Study 2 formulation with a low dose [25 mg] of zinc; n = 61). Visual function was assessed using best-corrected visual acuity, contrast sensitivity (CS), glare disability, retinal straylight, photostress recovery time, reading performance, and the National Eye Institute Visual Function Questionnaire-25. Macular pigment was measured using customized heterochromatic flicker photometry.

Results: There was a statistically significant improvement in the primary outcome measure (letter CS at 6 cycles per degree [6 cpd]) over time (P = 0.013), and this observed improvement was statistically comparable between interventions (P = 0.881). Statistically significant improvements in several secondary outcome visual function measures (letter CS at 1.2 and 2.4 cpd; mesopic and photopic CS at all spatial frequencies; mesopic glare disability at 1.5, 3, and 6 cpd; photopic glare disability at 1.5, 3, 6, and 12 cpd; photostress recovery time; retinal straylight; mean and maximum reading speed) were also observed over time (P < 0.05, for all), and were statistically comparable between interventions (P > 0.05, for all). Statistically significant increases in macular pigment at all eccentricities were observed over time (P < 0.0005, for all), and the degree of augmentation was statistically comparable between interventions (P > 0.05).

Conclusions: Antioxidant supplementation in patients with nonadvanced age-related macular degeneration results in significant increases in macular pigment and improvements in CS and other measures of visual function. (Clinical trial, http://www.isrctn.com/ISRCTN13894787).

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Antioxidants / administration & dosage*
  • Ascorbic Acid / administration & dosage
  • Contrast Sensitivity / physiology
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Glare
  • Humans
  • Lutein / therapeutic use*
  • Macular Degeneration / drug therapy*
  • Macular Degeneration / physiopathology
  • Macular Pigment / therapeutic use*
  • Male
  • Middle Aged
  • Photometry / methods
  • Reading
  • Trace Elements / administration & dosage
  • Visual Acuity / physiology*
  • Vitamin E / administration & dosage
  • Zeaxanthins / therapeutic use
  • Zinc / administration & dosage

Substances

  • Antioxidants
  • Macular Pigment
  • Trace Elements
  • Zeaxanthins
  • Vitamin E
  • meso-zeaxanthin
  • Zinc
  • Ascorbic Acid
  • Lutein

Associated data

  • ISRCTN/ISRCTN13894787