Abstract
Lutein, zeaxanthin, and meso-zeaxanthin are xanthophyll carotenoids found within the retina and throughout the visual system. The retina is one of the most metabolically active tissues in the body. The highest concentration of xanthophylls is found within the retina, and this selective presence has generated many theories regarding their role in supporting retinal function. Subsequently, the effect of xanthophylls in the prevention and treatment of various eye diseases has been examined through epidemiological studies, animal studies, and clinical trials. This paper attempts to review the epidemiological studies and clinical trials investigating the effects of xanthophylls on the incidence and progression of various eye diseases. Observational studies have reported that increased dietary intake and higher serum levels of lutein and zeaxanthin are associated with lower risk of age-related macular degeneration (AMD), especially late AMD. Randomized, placebo-controlled clinical trials have demonstrated that xanthophyll supplementation increases macular pigment levels, improves visual function, and decreases the risk of progression to late AMD, especially neovascular AMD. Current publications on the preventive and therapeutic effects of lutein and zeaxanthin on cataracts, diabetic retinopathy, and retinopathy of prematurity have reported encouraging results.
Highlights
Macular pigments are xanthophyll carotenoids that provide the macula lutea with its yellow appearance
Dietary L/Z intake was inversely associated with neovascular age-related macular degeneration (AMD) (odds ratio (OR), 0.65; 95% confidence intervals (CI): 0.45–0.93), geographic atrophy (OR, 0.45; 95% CI: 0.24–0.86), and large or extensive intermediate drusen (OR, 0.73; 95% CI, 0.56–0.96), comparing the highest versus lowest quintiles of intake, after adjustment for total energy intake and nonnutrient-based covariates
Epidemiological studies have revealed that low macular pigment levels are associated with higher risk of AMD
Summary
Macular pigments are xanthophyll carotenoids that provide the macula lutea with its yellow appearance. Supplementation trials involving L, MZ, and Z suggest that MZ may be absorbed and converted in the retina, as supplementation with high dosages of MZ (10 mg MZ, 10 mg L, and 2 mg Z or 17 mg MZ, 3 mg L, and 2 mg Z) resulted in higher macular pigment levels and higher MZ serum levels than supplementing without MZ (20 mg L and 0.86 mg Z) [12]. L has a greater filtering efficacy, and Z is superior in preventing lipid peroxidation induced by UV light [32, 33] These essential functions of macular pigment decrease oxidative stress in the retina and enhance vision in both normal and diseased retinas
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