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Flow Diagram of Participants in the Age-Related Eye Disease Study 2 of Lutein/Zeaxanthin Treatment for Age-Related Cataract. The World Health Organization estimates the condition is responsible for almost 50 percent of blindness worldwide. 225-578-4161 government site. There were no specific inclusion criteria regarding lens opacity status other than the need for sufficiently clear media to allow quality fundus photographs. The procedure is very safe, effective, and quick. sharing sensitive information, make sure youre on a federal The mean age of AREDS2 participants at enrollment into the follow-up study was 72 years. Professor Cristina Sabliov and assistant professor Carlos Astete in the AgCenter Department of Biological and Agricultural Engineering have found a way to use nanoparticles to efficiently deliver hydrophobic lutein and enhance its stability and antioxidant properties so it can be used effectively in eye drops. The prevalence of age-related cataract is increasing, with an estimated 30.1 million Americans likely to be affected by 2020. Professor Cristina Sabliov, left, and assistant professor Carlos Astete, of the LSU AgCenter Department of Biological and Agricultural Engineering, have formulated a nanoparticle matrix that could be used in eye drops to both prevent and treat cataracts. Duplicate gradings of the red reflex lens photographs demonstrated 93% agreement for the presence of cortical opacities and 97% agreement for the presence of PSC. Participants with previous cataract surgery were excluded only if the surgery was less than 3 months prior to enrollment. AREDS2 volunteers were generally better educated and better nourished than the general population, with higher dietary intake levels of lutein/zeaxanthin and omega-3 LCPUFAs. Cataracts usually are age-related and represent accumulated free-radical damage to the protein molecules that form the lens of the eye. Because of evidence that beta carotene may increase the risk for lung cancer in cigarette smokers and the AREDS formulation may contain more zinc than can be absorbed,26 we tested the effect of eliminating beta carotene and reducing the dosage of zinc in the AREDS formulation (not displayed in the consort diagram in Figure 1). Baseline cataract status was comparable across the 4 treatment groups. Dietary carotenoids, vitamins C and E, and risk of cataract in women: a prospective study, The use of a self-administered questionnaire to assess diet four years in the past. Information on this website is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. There is significant scientific evidence that suggests(1) that lutein helps to stave off cataracts. The key message regarding lutein itself? Supplements are available for eye health that provide optimum amounts of lutein and other key antioxidant vitamins and minerals. In the meantime, if cataracts interfere with your vision and are limiting your usual activities, I recommend surgery to replace the clouded lens in your eye with a clear artificial implant. New formulations may prove more reliable and effective. 2022 content kindly provided by SpaMedica. The .gov means its official. The severity and progression of cortical and PSC opacities on the red reflex lens photographs and the presence of pseudophakia or aphakia were graded at the reading center. Whether supplementation would be beneficial for less well-nourished populations requires further study. *AREDS2 Research Group Writing Team: The members of the writing team and their affiliations are found at the end of this article. 2013 Jul; 131(7): 843850. Baseline characteristics were comparable across the 4 treatment groups in the primary randomization (Table). Fruit, Herb, & Vegetable Infused Waters: Good Or Bad? A comparison of lutein/zeaxanthin to no lutein/zeaxanthin for progression to cataract surgery resulted in a HR of 0.96 (95% CI, 0.841.10; P = .54) (Figure 3). Participants were followed up until October 2012. Assessing nuclear opacities requires specialized slit-lamp photography, which was not readily available in a retinal practice, so that information on nuclear cataract was incomplete. The photographs were assessed by masked graders for the severity of cortical and posterior subcapsular cataract (PSC) lens opacities at the University of Wisconsin Fundus Photograph Reading Center, Madison, Wisconsin. Centrum Silver (Pfizer Inc) was offered to all study participants to standardize multivitamin intake. A randomized, double-masked, placebo-controlled clinical trial of multivitamin supplementation for age-related lens opacities: clinical trial of nutritional supplements and age-related cataract report no. A rationale for examining the impact of lutein/zeaxanthin comes from observational data collected in AREDS, other epidemiologic studies, and animal studies.19 Lutein and zeaxanthin, xanthophylls with antioxidant capabilities, are the only carotenoids detected in the human lens.20 Observational studies have demonstrated an inverse association between dietary intake and/or blood levels of lutein/zeaxanthin and the progression of cataract, particularly the nuclear form and cataract surgery.2124 AREDS2 provided an opportunity to examine the effect that daily dietary supplementation with lutein/zeaxanthin had on age-related cataracts in a randomized clinical trial. Congdon N, OColmain B, Klaver CC, et al. will also be available for a limited time. A secondary goal was to evaluate the effect of lutein/zeaxanthin on the progression of age-related cataract. Glasses Why do I need glasses after cataract surgery? The primary outcome of the cataract clinical trial was progression to cataract surgery. A study ophthalmologist examined the anterior segment using slitlamp biomicroscopy at the annual visit to diagnose or confirm the presence of pseudophakia or aphakia. Perhaps the intervention was too late or of insufficient duration to affect the outcomes. Long-term nutrient intake and early age-related nuclear lens opacities. The nanoparticle matrix can deliver lutein to the eye efficiently as an eye drop formulation, Sabliov said. Near-sighted Does cataract surgery correct near-sightedness? Abbreviations: AREDS2, Age-Related Eye Disease Study 2; DHA, docosahexaenoic acid; EPA, eicosapentaenoic acid; IQR, interquartile range. or Healthy Lifestyle Brands. Age-related cataract, the leading cause of blindness worldwide, is a leading cause of visual impairment in the United States.13 The prevalence of age-related cataract is increasing, with an estimated 30.1 million Americans likely to be affected by 2020, escalating the already large public health and economic burden of the disease.4 Numerous observational studies have reported inverse relationships between various dietary micronutrients and the development of age-related cataract or the occurrence of cataract surgery.510 Of greatest interest have been micronutrients with antioxidant capabilities because of the importance of oxidative damage in cataract formation. Info on how to get your eyes checked with your optician. A run-in phase using study placebo and the AREDS formulation tested the participants likely ability to adhere to the study regimen. Recruitment of participants was based on retinal findings of bilateral large drusen or large drusen in 1 eye and advanced AMD in the fellow eye. Age-related cataract is a leading cause of visual impairment in the United States. Of the 6027 study eyes, 1833 (30%) had an outcome defined as any cataract. The https:// ensures that you are connecting to the Lutein and zeaxanthin and the risk of cataract: the Melbourne Visual Impairment Project, A prospective study of carotenoid intake and risk of cataract extraction in US men. 2002 global update of available data on visual impairment: a compilation of population-based prevalence studies. Median baseline serum levels of lutein in participants randomized to lutein increased by 191% to 215% at years 1, 3, and 5, while those randomized to placebo showed minimal changes. significant scientific evidence that suggests, Lutein and zeaxanthin function as blue light filters, and, as such, can help reduce the risk of cataracts, American Optometric Association (AOA): Diet and nutrition, All About Vision: Lutein and zeaxanthin: Eye and vision benefits. Exclusive Lifestyle, Nutrition & Health Advice. DHA indicates docosahexaenoic acid; EPA, eicosapentaenoic acid. Although not statistically significant, mean percentage increase in serum levels of lutein/zeaxanthin in those randomized to lutein/zeaxanthin and beta carotene were lower than those randomized to lutein/zeaxanthin alone at year 5 (171% vs 270%, respectively; P = .08). You can get sulfur from onions, garlic, shallots and capers and can boost your intake with supplements of alpha-lipoic acid (ALA) (250 mg twice a day) and N-acetylcysteine (600 mg twice a day). N01-EY-50007). A test of interaction between treatment and the quintile groups showed a P value of .006. Dr. Weil's FREE health living advice delivered to you! Institutional review boards at the clinical sites approved the AREDS2 research protocol, and participants provided written informed consent. All rights reserved. Resnikoff S, Pascolini D, Etyaale D, et al. Although there was no scientific rationale to consider omega-3 LCPUFAs to be important in reducing the progression to cataract surgery, this analysis was conducted for completeness. Cataracts are a common condition in older adults that causes the lens of the eye to become cloudy and block light from the retina. Causes and prevalence of visual impairment among adults in the United States. Surgery How is a cataract operation performed? For participants in the lowest quintile of dietary intake of lutein/zeaxanthin, the hazard ratio comparing lutein/zeaxanthin vs no lutein/zeaxanthin for progression to cataract surgery was 0.68 (95% CI, 0.480.96; P = .03). About 3% of participants began taking lutein/zeaxanthin in both treatment arms; approximately 19% of these participants stopped their study medications permanently. Group Information: The AREDS2 Research Group is found online in the Supplement (eAppendix). For the same outcome, in subgroup analyses by quintiles of lutein/zeaxanthin intake, a comparison of lutein/zeaxanthin vs no lutein/zeaxanthin resulted in HRs of 0.64 (95% CI, 0.460.89; P = .008) and 1.26 (95% CI, 0.911.75; P = .17) for the lowest and highest quintiles of dietary lutein/zeaxanthin, respectively. Pascolini D, Mariotti SP, Pokharel GP, et al. Competitive inhibition of carotenoid transport and tissue concentrations by high dose supplements of lutein, zeaxanthin and beta-carotene, Prevalence of lens opacities in surgical and general populations, Cataract surgery and subtype in a defined, older population: the SEECAT Project, Cataract: relationship between nutrition and oxidation. Of these, 777 eyes were phakic. Dietary modulation of lens zeaxanthin in quail, Measurement of carotenoids, retinoids, and tocopherols in human lenses. A healthy, nutritious and varied diet, consisting of substantial amounts of fruit and vegetables, as well as nuts, seeds, fish and meat will, without a shadow of a doubt, help you to maintain not just healthy eyes, but general health as well. The results for quintiles 2 through 4 were in between the values for quintiles 1 and 5. National Library of Medicine The antioxidant glutathione can also help, but it doesnt come directly from foods the liver manufacturers it after you consume sulfur or certain amino acids. The median follow-up duration was 4.7 years (inter-quartile range, 4.45.1 years). Components of the AREDS2 formulation, donated by DSM Nutritional Products, include lutein/zeaxanthin supplied as water soluble triglyceride compounds and omega-3 LCPUFA formulation supplied in ethyl ester form as Ropufa 75 n-33 EE. Good sources are kale, spinach, collard greens, other leafy greens and eggs (choose organic eggs fortified with omega-3 fatty acid, which contains DHA, another nutrient that is good for the eyes). The possible effect of competitive absorption of carotenoids, which has been demonstrated in other human studies31,32 and in animal studies,33 also needs consideration. At least 1 eye of each participant was free of advanced AMD. AREDS2 participants in the lowest quintile of dietary intake of lutein/zeaxanthin showed some evidence of a beneficial effect of lutein/zeaxanthin supplementation on the progression to the cataract outcomes. The mean difference between the 2 grades was 0.03 mm2 (95% CI, 5.31 to 5.25) for cortical and 0.03 mm2 (95% CI, 0.7 to 0.81) for PSC opacities. The Age-Related Eye Disease Study 2 (AREDS2): study design and baseline characteristics (AREDS2 report number 1), Underwood Memorial Lecture: human zinc homeostasis: good but not perfect, Regression analysis of multivariate incomplete failure time data by modeling marginal distributions. Plasma lutein and zeaxanthin and other carotenoids as modifiable risk factors for age-related maculopathy and cataract: the POLA Study. Maraini G, Williams SL, Sperduto RD, et al. By clicking "Subscribe," you agree to the DrWeil.com Some participants received both beta carotene and lutein/zeaxanthin, while others received lutein/zeaxanthin alone. Any third party offering or advertising on this website does not constitute an endorsement by Andrew Weil, M.D. out of DrWeil.com subscriptions at any time. Jacques PF, Chylack LT Jr, Hankinson SE, et al. You may be able to avoid cataracts or slow their growth by not smoking, wearing UV protective sunglasses and keeping your blood sugar under control (type 2 diabetes is a leading cause of vision loss). Clinical trial results for the AMD component of AREDS2 are presented elsewhere. A second randomization was conducted for the AMD component of the trial. HHS-N-2602005-00007-C and ADB contract No. For lutein/zeaxanthin vs no lutein/zeaxanthin, the hazard ratios for progression to cataract surgery was 0.96 (95% CI, 0.841.10; P = .54). In subgroup analyses restricted to quintiles of dietary lutein/zeaxanthin intake, HRs for the first and fifth quintiles were 0.70 (95% CI, 0.530.94; P = .02) and 1.15 (95% CI, 0.861.54; P = .36), respectively, for the lutein/zeaxanthin vs no lutein/zeaxanthin comparison (Figure 4). A total of 3159 AREDS2 participants were phakic in at least 1 eye and 1389 of 6027 study eyes underwent cataract surgery during the study, with median follow-up of 4.7 years. Of the 3159 randomized participants, 104 (3%) were lost to follow-up and 204 (6%) died. The number of eyes and Kaplan-Meier probabilities (N[%]) of progression to cataract surgery by 5 years for study eyes randomized to lutein/zeaxanthin or no lutein/zeaxanthin were 681 eyes (24%) and 708 eyes (24%), respectively (Figure 2). Patients lost to follow-up or who died during the course of the study were censored at the time of the last contact. Baton Rouge, LA 70803, There were more than 24 million cases of cataracts in the U.S. in 2010, according to the, LSU AgCenter scientists develop cataract-reducing eye drops. The nanoparticle matrix may enhance the benefits of lutein by preventing it from disintegrating before it collects in the eye lens, where cataracts occur, Sabliov said. The unit of analysis for ophthalmic outcomes was by eye. These nutrients were considered only important for the treatment of AMD but they need to be considered for potential interaction with the primary randomization. The hazard ratio for 3 or more lines of vision loss was 1.03 (95% CI, 0.931.13; P = .61 for lutein/zeaxanthin vs no lutein/zeaxanthin). Wang Y, Roger Illingworth D, Connor SL, Barton Duell P, Connor WE. Adherence to the treatment regimen was assessed by pill count at each annual study visit. Study participants were randomly assigned to take 1 of the following supplements daily: (1) placebo; (2) lutein/zeaxanthin; (3) DHA/EPA; or (4) lutein/zeaxanthin and DHA/EPA. Kuzniarz M, Mitchell P, Cumming RG, Flood VM. A secondary outcome of AREDS2 was to evaluate the effects of lutein/zeaxanthin on the subsequent need for cataract surgery. 9. Long-term supplementation with alpha-tocopherol and beta-carotene and age-related cataract, A randomized trial of beta carotene and age-related cataract in US physicians, The Linxian cataract studies: two nutrition intervention trials. A test of interaction between treatment and the quintile groups showed a P value of .01. 8600 Rockville Pike Accessibility The lens efficacy outcome, the time to progression to cataract surgery, was assessed with a Cox proportional hazards model using the Wei, Lin, and Weissfeld method for obtaining robust variance estimates, allowing for dependence among multiple event times (1 or 2 study eyes).27 The models were run with and without stratification by the secondary randomization. Site by EQ. No clinically or statistically significant serious adverse effect was associated with the treatments. You also agree to receive emails from DrWeil.com, and you may opt Baton Rouge, LA 70803