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Health News Archive 2 - Vision
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Lutein Supplementation Prevents Age-related Macular Degeneration (AMD)

According to a study from England, "age-related macular degeneration (AMD) is the leading cause of severe vision loss in the developed world. The lack of effective treatment modalities, coupled with evidence supporting an oxidative pathogenesis, has increased interest in the potential preventative role of nutritional supplementation. This article reviews seven randomized controlled trials that have investigated the role of nutritional supplementation in AMD."

"Three of these trials reported a positive effect of nutritional supplementation on AMD: the Age-related eye study (AREDS), the Lutein Antioxidant Supplementation Trial (LAST), and the oral zinc trial. However, the oral zinc trial was unlikely to detect any difference between treatments smaller than 72%, and the AREDS results were based on a subgroup of their study population," wrote H. Bartlett and colleagues, Aston University, School of Life & Health Sciences.

"Lutein was considered for the AREDS formulation, but was not commercially available at that time. The findings of the LAST support a possible therapeutic role of lutein in AMD," scientists concluded.

Bartlett and colleagues published their study titled Age-related macular degeneration and nutritional supplementation: a review of randomized controlled trials in the journal Ophthalmic and Physiological Optics.   

Source: Age-related macular degeneration and nutritional supplementation: a review of randomized controlled trials. Ophthal Physiol Optics, 2003;23(5):383-399

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Lutein Supplements Associated with 63% Increase in Visual Acuity

Research: In a randomized, double-blind study, groups of five patients diagnosed with age-related cataracts took 15 mg of lutein from a lutein ester supplement, 100 mg vitamin E, or a placebo capsule three times per week for up to two years. The subjects' visual acuity was measured with several standard eye tests at the beginning of the study and then every three months.

Results: As a group, subjects taking the lutein ester supplements had significant improvements in visual acuity -- approximately 63% -- and glare sensitivity also improved. Those taking vitamin E showed a trend toward maintaining their acuity. The opposite effect was seen among those taking placebos; there was a trend toward decreased visual acuity in these subjects. During the supplementation period, cataracts did not progress in four patients in the lutein group, three patients in the vitamin E group and one patient in the placebo group.

Source: Nutrition, 2003;19:21-24.

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Low Levels of Lutein and Zeaxanthin Associated with Vision Loss (AMD)

A research report in the journal Ophthalmology reports that supplementation with Lutein and Zeaxanthin is associated with a 32% higher level of pigment in the eyes of age-related macular degeneration (AMD) patients. 

"These results taken together lead us to believe that low macular levels of lutein and zeaxanthin represent a pathogenic risk factor for the development of AMD,"1-6 Bernstein said. "As a safeguard, patients at risk for visual loss from AMD should consider supplementing their diets with at least 4 mg. of lutein each day along with other antioxidant nutrients."

The study was based on the hypothesis that the levels of Lutein in the eyes of people with age-related macular degeneration (AMD) would be lower than the levels of Lutein found in the normal, healthy eyes of elderly people without AMD.  For the first time, researchers were able to use objective, non-invasive technology to measure Lutein and zeaxanthin levels in the eyes of living people in a large-scale clinical study.  Researchers measured macular carotenoids levels in 93 eyes from 63 patients with AMD and in 220 normal eyes from 138 volunteers.  The macula was illuminated with a low-power argon laser spot for less than a second and measured backscattered light using a Raman spectograph to determine macular levels of Lutein and zeaxanthin with high sensitivity specifically. 

Researchers found that macular carotenoid levels decline with age, reaching a stable low level after age 60, the age when AMD incidence begins to rise dramatically.  They also found that macular pigment levels in the eyes of AMD patients not consuming high-dose Lutein supplements are 32% lower than elderly normal eyes. The research shows that AMD patients who had begun taking high-dose lutein supplements (4 milligrams or more per day) regularly after their initial diagnosis of AMD were able return those levels back to normal.

The research was led by Paul S. Bernstein, M.D., Ph.D., at the Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine in Salt Lake City. It was published in the October 2002 issue of Ophthalmology (volume 109, pages 1780-1787), the peer-reviewed medical journal of the American Academy of Ophthalmology (AAO). Bernstein is a Research to Prevent Blindness Sybil B. Harrington Scholar in macular degeneration research.

Ophthalmology, 2002;109:1780-1787

1. Snodderly DM, Brown PK, Delori FC, Auran JD. The macular pigment. Absorbance spectra, localization, and discrimination from other yellow pigments in primate retinas. Investigative Ophthalmology and Visual Science, 1984;25:660-73.

2. Bone RA, Landrum JT, Fernandez L, Tarsis SL. Analysis of the macular pigment by HPLC: Retinal distribution and age study. Investigative Ophthalmology and Visual Science, 1988;29:843-9.

3. Landrum JT, Bone RA. Lutein, zeaxanthin, and the macular pigment. Archives of Biochemistry and Biophysics, 2001; 385:28-40.

4. Bernstein PS, Katz NB. The role of ocular free radicals in age-related macular degeneration. In: Fuchs J, Packer L, eds, Environmental Stressors in Health and Disease, New York: Marcel Decker, 2001:423-56.

5. Beatty S, Koh HH, Henson D, Boulton M. The role of oxidative stress in the pathogenesis of age-related macular degeneration. Survey of Ophthalmology 2000;45;115-34.

6. Beatty S, Murray IJ, Henson DB, et al. Macular pigment and risk for age-related macular degeneration in subjects from a northern European population. Investigative Ophthalmology and Visual Science 2001;42:439-46.

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Antioxidant Nutrients - Lutein and Zeaxanthin - May Prevent Age-Related Eye Diseases: Vitamin C Plays A Starring Role in Cataract Prevention

NEW YORK, Oct. 23, 2001 -- The following release was issued today by the Vitamin Nutrition Information Service (VNIS):

Vitamins C and E and two carotenoids, lutein and zeaxanthin, may play a role in preventing cataracts, according to a study published in the July issue of The Archives of Ophthalmology.1 Researchers found that individuals with the highest intakes of vitamin C, vitamin E, and lutein/zeaxanthin had significantly lower rates of cataracts. Of all the nutrients, vitamin C showed the strongest relationship between increased intake levels and a lower incidence of cataracts.

Study Findings

The researchers also found that subjects who used vitamin C (140-300 mg/daily) for 10 or more years had significantly lower rates of cataracts than women who were non-supplement users. The Tufts University researchers noted that women with lutein/zeaxanthin intakes above 2.4 mg per day may have a lower risk of cataracts. The study, led by Allen Taylor, Ph.D. of Tufts University, followed 478 women, aged 53 to 73 years, without previously diagnosed cataracts for a 13 - 15 year period.

Taylor's study is one of the latest studies to highlight the role that vitamin C, lutein and zeaxanthin play in preventing cataracts. His research supports findings from NHANES II (Second National Health and Nutrition Examination Study) and the Beaver Dam Eye study. An analysis of NHANES II data found that higher blood levels of vitamin C were associated with a lower risk of cataracts.2

The Beaver Dam Eye Study showed a strong inverse association between lutein intake and incidence of nuclear cataracts -- a 30 percent to 40 percent risk reduction of cataracts for persons with the highest lutein intakes.3

Related Information

More than half of all Americans aged 65 and older have some evidence of cataracts.4 Cataract extractions are the most common surgical procedure performed in the U.S., accounting for more than 2 million procedures each year.5 Epidemiologists at the National Eye Institute have estimated that if the progression of cataracts could be delayed by 10 years, the number of cataract extraction surgeries per year would be reduced by 45 percent.6

Given wise choices of fruits and vegetables, the 5 A Day pattern of eating, currently recommended by the U.S. Department of Agriculture, will provide about 225-250 mg of vitamin C and about 5-6 mg of carotenoids. However, the majority of people in the U.S. are not presently meeting the 5 A Day guidelines. Current intake levels of vitamin C average 90mg/day while lutein/zeaxanthin intakes average 2-4 mg per day.

  1. Taylor, et al. Long-term nutrient intake and early age-related nuclear lens opacities. "Arch Ophthalmol." 119:1009-1019, 2001.

  2. Mares-Perlman et al. Association of zinc and antioxidant nutrients with age-related maculopathy. "Arch Ophthalmol." 114(8):991-997,1996.

  3. Simon et al. Serum ascorbic acid and other correlates of self-reported cataract among older Americans. "J Clin Epidemiol." 52(12):207-211, 1999.

  4. National Eye Institute. http://www.nei.nih.gov

  5. Ruthow et al. Surgical operations in the United States: Then (1983) and Now (1994). "Arch Surg." 132:983-990, 1997.

  6. Kupfer et al. National Eye Institute, NIH, Bethesda, MD. The Conquest of Cataract: A Global Challenge. "Trans Ophthalmol"

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Carotenoids Associated with Lower Risk of Cataracts

Researchers studied 372 men and women, ranging in age from 66 to 75 years.  Of these people, 245 had at least one of several common types of cataracts.  The researchers measured blood levels of antioxidant carotenoids and Vitamins E and C.

Results: In this study, the lowest risk of nuclear cataracts (cataracts located in the central part of the lens) was in people with the highest blood levels of either alpha-carotene or beta-carotene.  Specifically, people with high levels of alpha-carotene and beta-carotene were 50% and 30% respectively, less likely to develop nuclear cataracts.  In addition, people with high Lycopene levels were 60% less likely to develop cortical cataracts (in the outer layer of the lens).  Finally, people with the highest Lutein levels were 50% less likely to develop posterior subcapsular cataracts (located toward the bottom back of the lens). High plasma concentrations of vitamins C and E or carotenoids zeaxanthin and beta-cryptoxanthin were not associated with decreased risk of cataracts. 

Ophthalmology, 2001;108:1992-1998

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Pycnogenol® Shown to Improve Eyesight in Diabetics

In a clinical study published in the May 2001 journal Phytotherapy Research the antioxidant, Pycnogenol® helped 30 diabetics ward off one of the most debilitating affects of the diabetes - diabetic retinopathy. Diabetic retinopathy involves bleeding in the eye, which can lead to blindness. The study concluded that Pycnogenol® helped slow progression of diabetic retinopathy (blindness) by sealing the leaky capillaries that cause the condition.
 
The placebo controlled clinical study at the Italian University of Aquila was carried out with 40 patients suffering from various forms of retinopathies. Most patients were diabetics, others suffered from hypertensive and atherosclerotic retinopathy.  During the two-month clinical study, the 30 participants taking Pycnogenol® showed no deterioration of retinal function and some showed a significant recovery of visual acuity in comparison to the progressively worsened condition of the ten patient placebo-treated group.

Whereas the retinopathy progressively reduced the visual acuity in the placebo treated patients, treatment with 150 mg Pycnogenol® daily for 2 months significantly slowed down the deterioration of visual acuity and, in some cases even improved the recovery.

Study Procedure
In the Pycnogenol® treated group, the significant reduction of retinal blood capillary leakage was demonstrated by injecting a fluorescent dye into the blood of patients, allowing to trace blood leakage into the retina.  The retina was scanned after light-stimulation in a checkerboard pattern by measuring electric responsiveness, a method termed electroretinography. This method provides an objective measure for the integrity and function of the retina. Pycnogenol® treated patients showed a clear and significant improvement, whereas placebo treated patients remained unaffected.

The physicians scored the efficacy of Pycnogenol® as "good" to "very good" in 53% of the patients. The tolerabilty was very good in all patients.
 
Diabetic Retinopathy
Particularly for diabetics, this condition represents a serious threat. After 20 years from the onset of diabetes, over 90% of the people with type 1 diabetes and more than 60% of people with type 2 diabetes will have diabetic retinopathy.1 Unfortunately, there are hardly any warning signs, the condition causes no symptoms until it is relatively advanced. Therefore, regular screening for retinopathy is most important for diabetics.

Diabetic retinopathy is the leading form of blindness in people under the age of 60 in the US and affects more than 5.3 million Americans. Some diabetics are looking to natural sources to keep their eyes healthy. Pycnogenol® has shown a positive affect in five clinical studies, including more than 1,000 diabetics, in strengthening the tiny capillaries in the eye. Researchers conducted the studies because Pycnogenol® has been shown to strengthen the circulatory system in dozens of studies over the last two decades.
  
Other Pycnogenol® Benefits
In addition to the extensive research in diabetic retinopathy, Pycnogenol® has been studied in connection with other complications associated with diabetes. Diabetes increases the production of free radicals, which damage the body by increasing the risk of heart attack, nerve damage, cataracts, blindness and stroke.
  
While Pycnogenol® helps guard against health risks linked to diabetes, the antioxidant also increases the body’s defenses, like Vitamin C and E, to maintain general health. Most importantly, Pycnogenol® has been extensively researched for its safety and can be taken continuously without side effects.

Source: Spadea L, Balestrazzi E. Treatment of vascular retinopathies with Pycnogenol®. Phytother Res, Issue May 2001. 15: 219-223.

  1. Klein R, Klein B, Moss S, Davis MD, DeMets DL. The Wisconsin epidemiological study of diabetic retinopathy. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years. Arch Ophtalmol 102: 520-532, 1984.

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