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Health News Archive 51 - Vision (con't)
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Lutein Increases Macular Pigment Density

Supplementation with lutein esters increased macular pigment density and serum lutein levels in patients with early and late-stage age-related macular degeneration (AMD), according to a study published in the July issue of Experimental Eye Research (79, 1:21-27, 2004) (www.sciencedirect.com/science/journal/00144835).

In the study, researchers in Waterford, Ireland evaluated the effect of a daily 20 mg lutein ester supplement (equivalent of 10 mg/day free lutein) in patients with early AMD, in terms of macular pigment optical density (MPOD) and plasma concentrations of lutein. MPOD was measured using a flicker photometric technique in seven AMD patients and six age-matched controls over a period of 18 to 20 weeks. Plasma lutein increased from a mean baseline concentration of 182 (127) ng ml-1 to a peak of 1077 (165) ng ml-1 in AMD patients, and from 152 (57) to 1110 (605) ng ml-1 in control subjects. Mean MPOD increased significantly from a baseline of 0•24 to a peak of 0•31 in AMD sufferers. This mean increment of 0•07 was the same for the age-matched controls (baseline: 0•20; peak: 0•27).

The researchers concluded the results of the study demonstrate for the first time that AMD is not associated with intestinal malabsorption of the relevant macular carotenoids, and that a diseased macula can accumulate and stabilize lutein and/or zeaxanthin. Moreover, the beneficial effects of lutein supplementation, if any, may be extended to subjects with established AMD, the researchers added.

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Lutein Supplementation May Improve Vision for People with Dry AMD

According to a study published in Optometry - Journal of the American Optometric Association, in April 2004, lutein supplementation may help improve vision for people who have "dry" age-related macular degeneration - the most prevalent form of the disease. The LAST (Lutein Antioxidant Supplementation Trial) study is the first to record actual improvement in several key visual functions among patients with AMD.

The LAST study - which was randomized, double-masked and placebo-controlled -- was conducted at Veterans Administration Hospital in Chicago, Illinois, from August 1999 to May 2001. The study involved ninety dry AMD participants, who were referred by ophthalmologists in the Chicago area.  The participants were randomly assigned to 3 groups: lutein only, lutein plus antioxidants, and placebo. The participants received serial eye examinations after 4, 8, and 12 months.

The two groups taking Lutein displayed documented levels of improved vision in a variety of areas, including improvement for near visual acuity and contrast sensitivity function, glare recovery - which is how fast normal vision returns after you see a glare, and macular pigment optical density.  Macular pigment optical density (MPOD) increased 36 - 43% in the two lutein groups.  MPOD is the amount of lutein and zeaxanthin in the macula, and is one of the most accurate signals of AMD risk.  Improvements in distortions and blind spots were noted among the groups taking lutein.  Additionally, improvements noted in the lutein groups in regards to scotomas (missing areas within the visual field) and metamorphopsias (distortions of visual images within the visual field) may have been due to the presence of mesozeaxanthin, a chemical compound of lutein.  The placebo group experienced no improvement in vision.

"The findings strongly indicate the need for larger studies involving more participants over a longer period to ascertain more definitive findings. However, we encourage people with AMD to discuss nutrition strategies with their doctor now and consider whether taking a vitamin supplement containing lutein might be right for them," said Gerrard Grace, Chair AMD Alliance International. "This is important because although further study about lutein will take place, we do know from the Age Related Eye Disease Study (AREDS) conducted by the National Eye Institute, that there is a beneficial effect of supplementation with vitamins C, E, beta-carotene and zinc. This study demonstrated a 25% reduction in progression of AMD over 5 years."

AMD can make seniors lose their independence by making everyday activities, such as reading, driving and seeing loved ones, difficult or impossible. As many as six million Americans have vision loss because of age-related macular degeneration (AMD), and worldwide as many as 30 million people have AMD. The number of people with this untreatable disease is expected to double by 2030.

The exact cause of AMD is unknown, but risk factors for the disease include age, blue eyes and light hair/skin, high fat diets, and smoking. The symptoms for people with advanced AMD include:

  • straight lines in the field of vision, such as telephone poles, appear wavy;

  • type in books, magazines and newspapers appears blurry; and

  • dark or empty spaces may block the center of vision.

Lutein is a naturally occurring antioxidant found in dark green leafy vegetables such as spinach, kale and collard greens. In the LAST study, 90 AMD patients were supplemented daily with a capsule containing 10 mg of crystalline FloraGLO lutein, a Lutein supplement of 10 mg crystalline lutein plus a mixed antioxidant formula, or placebo for 12 months.

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C-reactive Protein Levels Linked with Macular Degeneration

The February 11, 2004 issue of the Journal of the American Medical Association published a report that establishes a link between elevated levels of the inflammatory marker C-reactive protein (CRP) and age-related macular degeneration (AMD), a disease of the eye which affects older individuals and is the leading cause of vision loss in this age group. The investigation involved participants in the Age-Related Eye Disease Study (AREDS), a multicenter study that was designed to assess the incidence, prognosis and risk factors in the development of age-related macular degeneration and cataract.

The current study involved 930 participants from two AREDS study sites. Blood samples were analyzed for levels of C-reactive protein. The participants were divided into four groups according to the severity of macular degeneration, or its absence.

C-reactive protein levels were significantly higher in the group diagnosed with advanced macular degeneration than in those in whom the disease was absent. Analysis of the results found CRP levels to be significantly associated with the presence of both intermediate and advanced stages of AMD. Those whose CRP levels were in the highest one-fourth had a 65 percent increased risk of macular degeneration compared to those in the lowest one-fourth of participants.

This study is the first to establish an association between C-reactive protein levels and age-related macular degeneration in a large population. The finding may implicate inflammation in the development of age-related macular degeneration, adding to the number of conditions for which inflammation has recently emerged as a causative factor. The authors suggest that, “Anti-inflammatory agents might have a role in preventing AMD, and inflammatory biomarkers such as CRP may provide a method of identifying individuals for whom these agents and other therapies would be more or less effective.”

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