Akuffo K O, Nolan J M, Howard A N, Moran R, Stack J, Klein R, Klein B E, Meuer S M, Sabour-Pickett S, Thurnham D I, Beatty S
Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland.
Howard Foundation, Cambridge, UK.
Eye (Lond). 2015 Jul;29(7):902-12. doi: 10.1038/eye.2015.64. Epub 2015 May 15.
To compare the impact of sustained supplementation using different macular carotenoid formulations on macular pigment (MP) and visual function in early age-related macular degeneration (AMD).
Sixty-seven subjects with early AMD were randomly assigned to: Group 1 (20 mg per day lutein (L), 0.86 mg per day zeaxanthin (Z); Ultra Lutein), Group 2 (10 mg per day meso-zeaxanthin (MZ), 10 mg per day L, 2 mg per day Z; Macushield; Macuhealth), Group 3 (17 mg per day MZ, 3 mg per day L, 2 mg per day Z). MP was measured using customised heterochromatic flicker photometry and visual function was assessed by measuring contrast sensitivity (CS) and best-corrected visual acuity (BCVA). AMD was graded using the Wisconsin Age-Related Maculopathy Grading System (AREDS 11-step severity scale).
At 3 years, a significant increase in MP from baseline was observed in all groups at each eccentricity (P<0.05), except at 1.75° in Group 1 (P=0.160). Between 24 and 36 months, significant increases in MP at each eccentricity were seen in Group 3 (P<0.05 for all), and at 0.50° in Group 2 (P<0.05), whereas no significant increases were seen in Group 1 (P>0.05 for all). At 36 months, compared with baseline, the following significant improvements (P<0.05) in CS were observed: Group 2-1.2, 6, and 9.6 cycles per degree (c.p.d.); Group 1-15.15 c.p.d.; and Group 3-6, 9.6, and 15.15 c.p.d. No significant changes in BCVA, or progression to advanced AMD, were observed.
In early AMD, MP can be augmented with a variety of supplements, although the inclusion of MZ may confer benefits in terms of panprofile augmentation and in terms of CS enhancement.
比较使用不同黄斑类胡萝卜素制剂持续补充对早期年龄相关性黄斑变性（AMD）患者黄斑色素（MP）及视觉功能的影响。
67例早期AMD患者被随机分为：第1组（每天20毫克叶黄素（L），每天0.86毫克玉米黄质（Z）；超级叶黄素），第2组（每天10毫克内消旋玉米黄质（MZ），每天10毫克L，每天2毫克Z；Macushield；Macuhealth），第3组（每天17毫克MZ，每天3毫克L，每天2毫克Z）。使用定制的异色闪烁光度法测量MP，并通过测量对比敏感度（CS）和最佳矫正视力（BCVA）评估视觉功能。采用威斯康星年龄相关性黄斑病变分级系统（AREDS 11步严重程度量表）对AMD进行分级。
3年时，除第1组在1.75°处（P = 0.160）外，所有组在各偏心度下MP均较基线有显著增加（P < 0.05）。在24至36个月之间，第3组在各偏心度下MP均有显著增加（所有P < 0.05），第2组在0.50°处MP有显著增加（P < 0.05），而第1组无显著增加（所有P > 0.05）。在36个月时，与基线相比，观察到CS有以下显著改善（P < 0.05）：第2组-每度1.2、6和9.6周/度（c.p.d.）；第1组-15.15 c.p.d.；第3组-6、9.6和15.15 c.p.d.。未观察到BCVA有显著变化，也未观察到进展为晚期AMD。
在早期AMD中，多种补充剂均可增加MP，尽管包含MZ在全轮廓增加和CS增强方面可能更有益。
