Nutraceuticals, Supplements & Vitamins - Michigan Optometric ...

Age Related Macular Degeneration
Taurine, Omega-3 fatty acid, Zinc, Antioxidant,
Lutein Study (TOZAL) – trial examined effects
of omega-3 fatty acids and other nutrients on
reducing the progression of ARMD
Nutritional Supplements for Prevention
of ARMD
Carotenoids
• Lutein - primary macular pigment with antioxidant
activity, increased intake (10-30 mg/day) increases
accumulation in macula
– Some studies found 6 mg/day initially, 2 mg/day
maintenance reduced risk
– More recent study – no increase in MPOD with 6
mg/day lutein, need at least 10 mg
• Zeaxanthin - primary macular pigment with antioxidant
activity, increased intake (2-6 mg/day) increases
accumulation in macula
• Elevated intakes reduce risks of ARMD
• Yellow xanthophyll plant pigments
Nutritional Supplements for Prevention of
ARMD
• Macular pigment decreased in smokers,
females > males, light color iris
• Macular pigment may result directly from
dietary origins with healthy and diseased
macula capable of accumulating and
stabilizing both lutein and zeaxanthin
Age Related Macular Degeneration
• Age Related Eye Disease Study 2 (AREDS 2) – broad
based study similar design to AREDS to investigate
effects of lutein, zeaxanthin and omega-3 fatty acid
(EPA, DHA) supplementation on ARMD disease
progression
• Patients with intermediate or advanced ARMD
• AREDS 2 to refine original AREDS formula
• AREDS 2 to assess the effects of reducing zinc and
eliminating beta-carotene on progression of ARMD
Nutritional Supplements for Prevention
of ARMD
• Lutein - concentrated in the macula lutea, acts as
antioxidant, also found in the aqueous
• Zeaxanthin - primary macular pigment, acts as
antioxidant, predominant pigment in central fovea
• Zeaxanthin – 11 double bonds compared to 10 for
lutein, possibly greater protection against blue and
near ultraviolet light
• Pigments also found in inner layers of retina, may
protect against photo-induced (blue light) retinal
damage, increased pigment concentrations
associated with higher visual sensitivity
Nutritional Supplements for Prevention of
ARMD
Lutein Antioxidant Supplementation Trial
• 15mg lutein, 20 mg vitamin E
• Positive effect on macular function
AREDS Report 22 – Higher dietary intake of
lutein/zeaxanthin independently associated with
decreased likelihood of having neovascular ARMD,
geographic atrophy, and large or extensive
intermediate drusen
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