Choi Rene Y, Gorusupudi Aruna, Wegner Kimberley, Sharifzadeh Mohsen, Gellermann Werner, Bernstein Paul S
Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah.
Department of Physics and Astronomy, University of Utah, Salt Lake City, Utah.
Retina. 2017 Dec;37(12):2238-2247. doi: 10.1097/IAE.0000000000001450.
To analyze macular pigment (MP) amount and distribution in patients with macular telangiectasia Type 2 receiving oral zeaxanthin supplementation in a randomized, open-label, interventional trial.
Eight macular telangiectasia Type 2 patients were randomized to 10 mg or 20 mg of zeaxanthin per day. At each visit, best-corrected visual acuity, contrast sensitivity, fundus biomicroscopy, color fundus photography, autofluorescence imaging, optical coherence tomography, and serum carotenoid levels were tested. Patients were assessed at baseline and after 6, 12, 18, and 24 months of zeaxanthin supplementation. Concentration of MP was analyzed and calculated from autofluorescence imaging obtained at 488-nm excitation wavelength. Serum carotenoid levels were obtained using high-performance liquid chromatography.
The majority of patients had definite increases in the intensity of hypofluorescent ring of MP, but none of them deposited MP centrally at the fovea. Although some patients noted subjective improvements in vision, no objective improvements could be documented, and there were no changes in foveal optical coherence tomographic features. Yellowish, hypofluorescent crystals appeared in one patient's macular region with no change in visual acuity. These inner retinal crystals disappeared several months after discontinuing her 20-mg zeaxanthin supplement.
Based on the current study, zeaxanthin supplementation does not result in any visual benefit in patients with macular telangiectasia Type 2 and does not reestablish a normal peaked distribution of MP in the fovea. One patient developed a novel, reversible, crystalline maculopathy in response to zeaxanthin supplementation that was reminiscent of canthaxanthin crystalline maculopathy.
在一项随机、开放标签的干预试验中，分析接受口服玉米黄质补充剂的2型黄斑毛细血管扩张症患者的黄斑色素（MP）含量和分布情况。
8例2型黄斑毛细血管扩张症患者被随机分为每日服用10毫克或20毫克玉米黄质两组。每次就诊时，检测最佳矫正视力、对比敏感度、眼底生物显微镜检查、彩色眼底照相、自发荧光成像、光学相干断层扫描和血清类胡萝卜素水平。在基线以及补充玉米黄质6、12、18和24个月后对患者进行评估。根据在488纳米激发波长下获得的自发荧光成像分析并计算MP浓度。使用高效液相色谱法测定血清类胡萝卜素水平。
大多数患者MP低荧光环强度有明显增加，但无一例在中央凹处中央沉积MP。尽管一些患者表示主观上视力有所改善，但未记录到客观改善，且中央凹光学相干断层扫描特征无变化。一名患者黄斑区出现淡黄色低荧光晶体，视力无变化。停用20毫克玉米黄质补充剂数月后，这些视网膜内晶体消失。
基于当前研究，补充玉米黄质对2型黄斑毛细血管扩张症患者没有任何视觉益处，也不会在中央凹重新建立正常的MP峰值分布。一名患者在补充玉米黄质后出现了一种新型的、可逆的结晶性黄斑病变，类似于角黄素结晶性黄斑病变。
