Long-term Results of Taking Anti-oxidant Nutritional Supplement in Intermediate Age-related Macular Degeneration

Seul Ki Bang; Eung Suk Kim; Jong Woo Kim; Jae Pil Shin; Ji Eun Lee; Hyeong Gon Yu; Kuhl Huh; Seung-Young Yu

doi:10.3341/jkos.2018.59.12.1152

Journal List > J Korean Ophthalmol Soc > v.59(12) > 1109302

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Bang, Kim, Kim, Shin, Lee, Yu, Huh, and Yu: Long-term Results of Taking Anti-oxidant Nutritional Supplement in Intermediate Age-related Macular Degeneration

Original Article

Journal of the Korean Ophthalmological Society 2018; 59(12): 1152-1159.

Published online: 17 December 2018

DOI: https://doi.org/10.3341/jkos.2018.59.12.1152

Long-term Results of Taking Anti-oxidant Nutritional Supplement in Intermediate Age-related Macular Degeneration

Seul Ki Bang, MD¹, Eung Suk Kim, MD, PhD¹, Jong Woo Kim, MD, PhD², Jae Pil Shin, MD, PhD³, Ji Eun Lee, MD, PhD⁴, Hyeong Gon Yu, MD, PhD⁵, Kuhl Huh, MD, PhD⁶, Seung-Young Yu, MD, PhD¹

¹Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea.

²Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea.

³Department of Ophthalmology, Kyungpook National University School of Medicine, Daegu, Korea.

⁴Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.

⁵Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.

⁶Blue Eye Center, Seoul, Korea.

Address reprint requests to Seung-Young Yu, MD, PhD. Department of Ophthalmology, Kyung Hee University Hospital, #23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea. Tel: 82-2-958-8451, Fax: 82-2-966-7340, syyu@khu.ac.kr

Received 21 June 2018 Revised 2 October 2018 Accepted 23 November 2018

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We prospectively investigated clinical changes and long-term outcomes after administration of the drugs recommended by the Age-Related Eye Disease Study-2 to patients with intermediate age-related macular degeneration (AMD).

Methods

This prospective multicenter study enrolled 79 eyes of 55 patients taking lutein and zeaxanthin. The primary endpoint was contrast sensitivity; this was checked every 12 months for a total of 36 months after treatment commenced. The secondary endpoints were visual acuity, central macular thickness, and drusen volume; the latter two parameters were assessed using spectral domain optical coherence tomography.

Results

The mean patient age was 72.46 ± 7.16 years. Contrast sensitivity gradually improved at both three and six cycles per degree. The corrected visual acuity was 0.13 ± 0.14 logMAR and did not change significantly over the 36 months. Neither the central macular thickness nor drusen volume changed significantly.

Conclusions

Contrast sensitivity markedly improved after treatment, improving vision and patient satisfaction. Visual acuity, central retinal thickness, and drusen volume did not deteriorate. Therefore, progression of AMD and visual function deterioration were halted.

Keywords: Age-Related Eye Disease Study (AREDS)-2 formula, Contrast sensitivity, Drusen volume, Intermediate age-related macular degeneration (AMD)

Figures and Tables

Figure 1

Bar graph showing the results of contrast sensitivity at each spatial frequency. Changing of contrast sensitivity during the follow-up period. ^*Significantly different than the baseline.

Figure 2

Changing of variables during the follow-up period. (A) Best-corrected visual acuity (BCVA). (B) Mean central macular thickness. (C) Mean drusen volume. (D) Area of hypo-fluorescence region. ^*Significantly different than the baseline.

Figure 3

A case of progression to advanced age-related macular degeneration. (A) Baseline. (B) After 36 months of administration of Age-Related Eye Disease Study-2 formula. FAF = fundus autofluorescence; OCT = optical coherence tomography; FA = fluorescein angiography; ICGA = indocyanine green angiography.

Table 1

Baseline demographics and descriptive data

Values are presented as mean ± standard deviation or number (%).

AMD = age-related macular degeneration.

Table 2

Baseline characteristics and changes of variables during the follow-up period

Values are presented as mean ± standard deviation unless otherwise indicated.

CPD = cycles per degree; BCVA = best-corrected visual acuity; CMT = central macular thickness; MDV = mean drusen volume.

^*Significant differences during the follow-up period compared to baseline using a paired t-test.

Table 3

Changes of contrast sensitivity during the follow-up period according to cataract status

Values are presented as mean ± standard deviation unless otherwise indicated.

CPD = cycles per degree.

^*Significant differences during the follow-up period compared to baseline using a paired t-test.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

References

1. Vingerling JR, Dielemans I, Hofman A, et al. The prevalence of age-related maculopathy in the Rotterdam study. Ophthalmology. 1995; 102:205–210.

2. Klein R, Chou CF, Klein BE, et al. Prevalence of age-related macular degeneration in the US population. Arch Ophthalmol. 2011; 129:75–80.

3. Klein R, Klein BE, Linton KL. Prevalence of age-related maculopathy. The beaver dam eye study. Ophthalmology. 1992; 99:933–943.

4. Krishnaiah S, Das TP, Kovai V, Rao GN. Associated factors for Age-related maculopathy in the adult population in southern India: the Andhra Pradesh eye disease study. Br J Ophthalmol. 2009; 93:1146–1150.

5. Miyazaki M, Nakamura H, Kubo M, et al. Risk factors for age related maculopathy in a Japanese population: the Hisayama study. Br J Ophthalmol. 2003; 87:469–472.

6. Song SJ, Youm DJ, Chang Y, Yu HG. Age-related macular degeneration in a screened South Korean population: prevalence, risk factors, and subtypes. Ophthalmic Epidemiol. 2009; 16:304–310.

7. Park SJ, Lee JH, Woo SJ, et al. Epidemiologic Survey Committee of the Korean Ophthalmologic Society; Age-related macular degeneration: prevalence and risk factors from Korean National Health and Nutrition Examination Survey, 2008 through 2011. Ophthalmology. 2014; 121:1756–1765.

8. Dimitrov PN, Mukesh BN, McCarty CA, Taylor HR. Five-year incidence of bilateral cause-specific visual impairment in the Melbourne visual impairment project. Invest Ophthalmol Vis Sci. 2003; 44:5075–5081.

9. Domalpally A, Danis R, Agrón E, et al. Evaluation of geographic atrophy from color photographs and fundus autofluorescence images: age-related eye disease study 2 report number 11. Ophthalmology. 2016; 123:2401–2407.

10. Ding X, Patel M, Chan CC. Molecular pathology of age-related macular degeneration. Prog Retin Eye Res. 2009; 28:1–18.

11. Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8. Arch Ophthalmol. 2001; 119:1417–1436.

12. Faria BM, Duman F, Zheng CX, et al. Evaluating contrast sensitivity in age-related macular degeneration using a novel computer-based test, the SPAETH/RICHMAN contrast sensitivity test. Retina. 2015; 35:1465–1473.

13. Maynard ML, Zele AJ, Feigl B. Mesopic Pelli-Robson contrast sensitivity and MP-1 microperimetry in healthy ageing and age-related macular degeneration. Acta Ophthalmol. 2016; 94:e772–e778.

14. Richman J, Spaeth GL, Wirostko B. Contrast sensitivity basics and a critique of currently available tests. J Cataract Refract Surg. 2013; 39:1100–1106.

15. Hammond BR, Fletcher LM, Roos F, et al. A double-blind, placebo-controlled study on the effects of lutein and zeaxanthin on photostress recovery, glare disability, and chromatic contrast. Invest Ophthalmol Vis Sci. 2014; 55:8583–8589.

16. Nolan JM, Power R, Stringham J, et al. Enrichment of macular pigment enhances contrast sensitivity in subjects free of retinal disease: central retinal enrichment supplementation trials - report 1. Invest Ophthalmol Vis Sci. 2016; 57:3429–3439.

17. Kvansakul J, Rodriguez-Carmona M, Edgar DF, et al. Supplementation with the carotenoids lutein or zeaxanthin improves human visual performance. Ophthalmic Physiol Opt. 2006; 26:362–371.

18. Loughman J, Nolan JM, Howard AN, et al. The impact of macular pigment augmentation on visual performance using different carotenoid formulations. Invest Ophthalmol Vis Sci. 2012; 53:7871–7880.

19. Nolan JM, Loughman J, Akkali MC, et al. The impact of macular pigment augmentation on visual performance in normal subjects: COMPASS. Vision Res. 2011; 51:459–469.

20. Olmedilla B, Granado F, Blanco I, Vaquero M. Lutein, but not alpha-tocopherol, supplementation improves visual function in patients with age-related cataracts: a 2-y double-blind, placebo-controlled pilot study. Nutrition. 2003; 19:21–24.

21. Ma L, Lin XM, Zou ZY, et al. A 12-week lutein supplementation improves visual function in Chinese people with long-term computer display light exposure. Br J Nutr. 2009; 102:186–190.

22. Bartlett HE, Eperjesi F. Effect of lutein and antioxidant dietary supplementation on contrast sensitivity in age-related macular disease: a randomized controlled trial. Eur J Clin Nutr. 2007; 61:1121–1127.

23. Woods RL, Wood JM. The role of contrast sensitivity charts and contrast letter charts in clinical practice. Clin Exp Optom. 1995; 78:43–57.

24. Legge GE, Rubin GS, Pelli DG, Schleske MM. Psychophysics of reading--II. Low vision. Vision Res. 1985; 25:253–265.

25. Lovie-Kitchin JE, Mainstone JC, Robinson J, Brown B. What areas of the visual field are important for mobility in low vision patients. Vision Res. 1990; 5:249–263.

TOOLS

Similar articles

Long-term Results of Taking Anti-oxidant Nutritional Supplement in Intermediate Age-related Macular Degeneration

Abstract

Purpose

Methods

Results

Conclusions

Figures and Tables

Figure 1

Bar graph showing the results of contrast sensitivity at each spatial frequency. Changing of contrast sensitivity during the follow-up period. *Significantly different than the baseline.

Figure 2

Changing of variables during the follow-up period. (A) Best-corrected visual acuity (BCVA). (B) Mean central macular thickness. (C) Mean drusen volume. (D) Area of hypo-fluorescence region. *Significantly different than the baseline.

Figure 3

A case of progression to advanced age-related macular degeneration. (A) Baseline. (B) After 36 months of administration of Age-Related Eye Disease Study-2 formula. FAF = fundus autofluorescence; OCT = optical coherence tomography; FA = fluorescein angiography; ICGA = indocyanine green angiography.

Table 1

Baseline demographics and descriptive data

Table 2

Baseline characteristics and changes of variables during the follow-up period

Table 3

Changes of contrast sensitivity during the follow-up period according to cataract status

Notes

References

Bar graph showing the results of contrast sensitivity at each spatial frequency. Changing of contrast sensitivity during the follow-up period. ^*Significantly different than the baseline.

Changing of variables during the follow-up period. (A) Best-corrected visual acuity (BCVA). (B) Mean central macular thickness. (C) Mean drusen volume. (D) Area of hypo-fluorescence region. ^*Significantly different than the baseline.