Lutein Supplementation Research Articles

No Effect of Carotenoid Supplementation on Phytohemagglutinin Response or Body Condition of Nestling House Wrens

Carotenoids are an essential and often limiting resource in animals and play important roles in immune system function. In birds, the period shortly after hatching is an energetically demanding stage characterized by rapid growth in body size and organ systems, including the immune system. Availability of carotenoids for the growing nestlings may be of particular importance and potentially limiting at this stage of development. We tested the hypothesis that the availability of carotenoids for the embryo in the egg and in the diet of nestlings limits the condition and immune responses of nestling house wrens (Troglodytes aedon Vieillot 1809), a species with melanin-based plumage pigments. In one experiment, nestlings within females' second broods were randomly assigned to receive either a control or a lutein supplement (2008); in a second experiment, females, before their first broods, were either induced to lay additional eggs or not induced, and nestlings within both kinds of broods were supplemented as in the first experiment (2009). There were no significant effects of lutein supplementation on nestling condition or phytohemagglutinin response. There was a significant effect of lutein supplementation on nestling mass in 2008, but the difference was opposite to that predicted. Moreover, even when breeding females were stressed by inducing them to lay supernumerary eggs, lutein supplementation of nestlings had no effect on the size or condition of nestlings hatching from these eggs. These results suggest that maternally derived lutein in the egg and that provided in the diet of nestlings are not limiting to normal development and to the components of the immune system involved in the phytohemagglutinin response of nestling house wrens.

Lutein and zeaxanthin supplementation in preterm infants to prevent retinopathy of prematurity: a randomized controlled study

Objectives: Lutein and its isomer zeaxanthin (L/Z) function in the eye as antioxidant agents and blue-light filters. Our aim was to evaluate whether their administration could help decrease the occurrence of retinopathy of prematurity (ROP) in preterm infants. Methods: Infants with gestational age ≤32 weeks were randomly assigned to receive a daily dose of L/Z (0.14 + 0.006 mg) or placebo until discharge. Results: ROP occurrence was similar in the L/Z (11/58; 19%) and placebo (15/56; 27%) groups, as the occurrence of ROP at each stage and the need of eye surgery. Conclusion: L/Z supplementation was ineffective in preventing ROP in preterm infants and did not affect the outcome at discharge of our patients.

Effects of Lutein Supplementation on Macular Pigment Optical Density and Visual Acuity in Patients with Age-Related Macular Degeneration

There is evidence from several large-scale clinical trials that reduced intake of lutein, a major component of the macular pigment, is a risk factor for the development of AMD. In the present study (LISA; Lutein Intervention Study Austria) it was hypothesized that lutein supplementation increases macular pigment optical density (MPOD). In addition, an investigation was conducted into whether lutein supplementation improves visual acuity (VA) and macular function (mean differential light threshold; MDLT), as assessed with microperimetry. One hundred twenty-six patients with AMD (AREDS [Age-related Eye Disease Study] stages 2, 3, and 4) were included in this randomized (2:1), placebo-controlled, double-masked parallel group study. Lutein or placebo was administered for 6 months. MPOD was measured with a custom-built reflectometer. VA was assessed with ETDRS (Early Treatment Diabetic Retinopathy Study) charts, and MDLT was assessed with a microperimeter. Lutein significantly increased MPOD by 27.9% ± 2.9% (P < 0.001 versus placebo). No significant effect of lutein supplementation on MDLT or VA was seen, although a tendency toward an increase was seen for both parameters (MDLT, P = 0.096 versus placebo; VA, P = 0.070 versus placebo). A significant correlation was found, however, between the increase in MPOD after 6 months and the increase in MDLT after 6 months (r = 0.25, P = 0.027), as well as between the increase in MPOD after 6 months and the increase in VA after 6 months (r = 0.27, P = 0.013). The present study demonstrates that lutein supplementation increases MPOD, as assessed with an objective The correlation between the change in MPOD and the change in VA and MDLT indicates that patients who show a pronounced increase in MPOD also benefit in terms of visual function. (ClinicalTrials.gov number, NCT00879671.).

A prospective, randomized, double blind study comparing lutein to placebo for reducing occurrence and severity of retinopathy of prematurity

Lutein has been shown to have antioxidant functions in newborns and with zeaxantin selectively taken up into the macula of the eye. We hypothesize that lutein administration may contribute to reducing the incidence of Retinopathy of Prematurity (ROP). This was a single center, double-blind randomized controlled study. Preterm infants with gestational age (GA) ≤32 weeks able to tolerate minimal enteral feeding before the seventh day of life (DOL) were enrolled; lutein and zeaxantin plasma concentrations and ROP occurrence and severity were evaluated. Sixty-three newborns were enrolled, 31 in the lutein group and 32 in the placebo group (one died before ROP assessment). The mean GA was 29.9 (±1.9) weeks and the mean birth weight was 1331 (±415) grams. There were no differences in the incidence of ROP at any stage between groups. Oxidative injury is probably an additional mechanism of damage of the developing retinal vessels, and it probably plays only a minor role in the pathogenesis of ROP. Supplementation with antioxidant substances might have beneficial effects noticeable only on larger samples of high risk neonates or at very high dosage. Further investigations would be needed to evaluate whether lutein supplementation can influence functional rather than anatomical outcomes in preterm infants.

Effect of 1-year lutein supplementation on macular pigment optical density and visual function

Although it is known that antioxidants including lutein can affect macular pigment optical density (MPOD) and visual function, we still have much to learn about their effect. Our aim was to assess the 1-year changes in MPOD and visual function in response to supplementation containing lutein. We prospectively measured the MPOD level of those who received a supplement containing 6mg of lutein daily for 1year. MPOD level was measured every 3months by using autofluorescence spectrometry with the two-wavelength method. Other examinations, including contrast sensitivity and retinal sensitivity were also measured every 3 or 6months. Stepwise regression analysis was performed to determine the factors that correlated with the changes observed in those examinations. Forty-three eyes of 43 Japanese subjects, including five normal eyes, five fellow eyes with central serous chorioretinopathy (CSC), and 33 fellow eyes with age-related macular degeneration (AMD) were enrolled. The higher baseline MPOD level was correlated with the eye with a clear intraocular lens (IOL). Although no time-dependent changes in the MPOD level were obtained in any area, subjects without cardiovascular diseases showed higher increase in the MPOD level. We observed significant increases in the contrast sensitivity at 1year (p = 0.0124) and in the retinal sensitivity at 6months (p < 0.0001) and 1year (p < 0.0001). Stepwise regression analysis showed that nonsmokers had increased contrast sensitivity (p = 0.0173), and the fellow eye of those with CSC had less of an increase in retinal sensitivity (p = 0.0491). Daily supplementation with 6mg of lutein did not affect the MPOD level for 1year, suggesting that 6mg of lutein may be insufficient to increase the MPOD level. However, supplementation seems to improve visual functions such as contrast sensitivity and retinal sensitivity.

Lutein supplementation alters inflammatory cytokine production and antioxidant status in F-line turkeys

Effect of dietary lutein supplementation on turkey production parameters, cytokine production, and oxidative status during an acute phase response following lipopolysaccharide (LPS) injection was studied. One-day-old chicks were fed a basal diet supplemented with 3 levels (0, 25, or 50 mg/kg of feed) of lutein. At 50 d of dietary lutein supplementation, turkeys were injected or not injected with LPS. Increasing dietary lutein increased the liver and plasma lutein content in both LPS injected and uninjected groups. In the groups fed 50 mg of lutein, LPS treatment decreased the lutein content of both the liver and the plasma at 48 h post-LPS injection. In the groups fed 0 mg of lutein, LPS treatment decreased the BW gain and feed consumption at 24 and 48 h post-LPS injection. The feed intake and BW gain of the group fed 50 mg of lutein in the LPS injected groups were comparable to those of the group with no LPS injection at both 24 and 48 h post-LPS injection. Treatment with LPS increased IL-1β mRNA content (P = 0.01) in the group fed 0 mg of lutein. In the LPS injected groups, increasing dietary lutein to 50 mg decreased the IL-1β mRNA amount compared with the group fed 0 mg of lutein. In the LPS injected groups, increasing dietary lutein to 50 mg increased IL-10 mRNA content compared with the group fed 0 mg of lutein. Injection of LPS increased the thiobarbituric reactive substances content of the liver in the group fed 0 mg of lutein. Increasing dietary lutein to 50 mg decreased the thiobarbituric reactive substances content of the liver in the LPS injected groups. Dietary lutein supplementation decreased oxidative damage and inflammatory responses post-LPS injection by decreasing IL-1β production and increasing IL-10 production in turkeys.

Serum carotenoids as a biomarker for carotenoid concentrations in the brain

Carotenoids, specifically lutein and zeaxanthin, cross the blood brain barrier to form macular pigment in the eye. Macular pigment has been related to serum lutein and zeaxanthin. Lutein supplementation was shown to improve cognitive function in older adults possibly due to increase in brain lutein. The objective was to evaluate if serum carotenoids are related to brain carotenoids in older adults. Brain tissues (cerebellum, temporal, frontal and occipital cortices) from decedents older than 98 years who had participated in the Georgia Centenarian Study were used. Subjects (n=49) had agreed to donate their brain after death. Serum and brains were extracted and analyzed using RP-HPLC. Age-adjusted partial correlation was done using SPSS. P values < 0.05 were considered significant. Among all the carotenoids and in all sampled brain regions, lutein concentrations were the highest (P< 0.0001). Serum lutein, zeaxanthin, cryptoxanthin, lycopene and β-carotene were positively associated with brain lutein (0.283, P<0.0001), zeaxanthin (0.503, P< 0.0001), cryptoxanthin (0.468, P<0.0001), lycopene (0.348, P<0.0001) and β-carotene (0.515, P<0.0001), respectively in all regions of the brain combined. Serum carotenoid concentrations can be used as a biomarker to predict brain carotenoid concentrations. Support:USDA#581950-7-07; DSM, NIH 1P01-AG17553 (L. Poon, PI)

Lutein and Zeaxanthin Supplementation Suppresses Ocular and Systemic Inflammatory Response

Lutein and Zeaxanthin Supplementation Suppresses Ocular and Systemic Inflammatory Response

Xanthophylls protect against induced oxidation in cultured human retinal pigment epithelial cells

Lutein and zeaxanthin are dietary carotenoids which accumulate in human retina, including the retinal pigment epithelial (RPE) cells. Oxidative damage of RPE cells is involved in the pathogenesis age related macular degeneration (AMD). The purpose of this study was to evaluate the potential protective effect of lutein and zeaxanthin against hydrogen peroxide induced oxidative stress in cultured human RPE cells. Human D407 RPE cells were pretreated with lutein and zeaxanthin (10μM) for 24h, and exposed for 1h to 500μM hydrogen peroxide. Cell viability, reactive oxygen species (ROS), the lipid peroxidation and the activity of antioxidant enzymes were determined in basal and oxidative stress conditions. Lutein and zeaxanthin pretreatment protected RPE cells against hydrogen peroxide induced cytoxicity, and inhibited the intracellular ROS generation and lipid peroxidation. Xanthophylls induced a significant increase of superoxide dismutase and glutathione peroxidase activity and of the level of reduced glutathione, but did not significantly modify the catalase activity. These results suggest that lutein and zeaxanthin supplementation can contribute to the prevention of age-related macular degeneration, not only by increasing the macular pigment density, but also by protecting retinal pigment epithelium against oxidative stress.

Lutein and zeaxanthin supplementation in preterm VLBW neonates in NICU: A multicentre RCT

Lutein and zeaxanthin supplementation in preterm VLBW neonates in NICU: A multicentre RCT

Enhancement of Yolk Color in Raw and Boiled Egg Yolk with Lutein from Marigold Flower Meal and Marigold Flower Extract

The effects of non-saponified lutein from marigold flower meal (MFM) and saponified lutein from marigold flower extract (MFE) on chicken egg yolk coloration was evaluated. A total of 90 laying hens were randomly divided into 9 groups: the basal diet (0mg/kg lutein; control) was supplemented with 10, 20, 30, and 40mg/kg lutein from MFM or MFE. During the three-week feeding experiment period, birds had free access to feed and water, and feed consumption and egg production were recorded weekly. Five eggs per group were evaluated weekly for egg quality such as shell-breaking strength, shell thickness, shell ratio, albumen ratio, yolk ratio, yolk color, and Haugh units. The egg yolk color was visually examined using the Roche Yolk Color Fan. The egg yolk color was further examined for yolk color, yellow index, lightness (L*), redness (a*), yellowness (b*), ratio of redness to yellowness (a/b), chroma, and spectrum wavelength reflectance using a spectrophotometer, an objective method. Feed consumption, body weight, egg production, egg mass, and egg quality with the exception of egg yolk color were not affected significantly by the dietary treatments. Compared with the yolk color parameters of the control, those of the dietary treatment groups tended to be higher; and the 40mg/kg lutein from MFM group and the 20, 30, and 40mg/kg lutein from MFE groups were significantly increased (P<0.001). In two-way ANOVA, the visual and objective egg yolk colors, a* and a/b were improved by both the dietary lutein treatment (P<0.05) and the lutein supplementation levels (P<0.001).It was concluded that dietary lutein enhances egg yolk color at levels of approximately 30 to 40mg/kg, and that saponified lutein from MFE appears to be more effective in egg yolk color than non-saponified lutein from MFM.

Effects of carotenoids, immune activation and immune suppression on the intensity of chronic coccidiosis in greenfinches

Allocation trade-offs of carotenoids between their use in the immune system and production of integumentary colouration have been suggested as a proximate mechanism maintaining honesty of signal traits. We tested how dietary carotenoid supplementation, immune activation and immune suppression affect intensity of coccidian infection in captive greenfinches Carduelis chloris, a passerine with carotenoid-based plumage. Immune activation with phytohaemagglutinin (PHA) decreased body mass among birds not supplemented with lutein, while among the carotenoid-fed birds, PHA had no effect on mass dynamics. Immune suppression with dexamethasone (DEX) induced loss of body mass and reduced the swelling response to PHA. DEX and PHA increased the concentration of circulating heterophils. Lutein supplementation increased plasma carotenoid levels but had no effect on the swelling response induced by PHA. PHA and DEX treatments did not affect plasma carotenoids. Immune stimulation by PHA suppressed the infection, but only among carotenoid-supplemented birds. Priming of the immune system can thus aid in suppressing chronic infection but only when sufficient amount of carotenoids is available. Our experiment shows the importance of carotenoids in immune response, but also the complicated nature of this impact, which could be the reason for inconsistent results in studies investigating the immunomodulatory effects of carotenoids. The findings about involvement of carotenoids in modulation of an immune response against coccidiosis suggest that carotenoid-based ornaments may honestly signal individuals’ ability to manage chronic infections.

Dietary lutein and fish oil interact to alter atherosclerotic lesions in a Japanese quail model of atherosclerosis

Interactions between concentration of dietary lutein and fish oil in diets on atherosclerosis incidences were studied in a cholesterol-induced-atherosclerosis (CIA) model. CIA Japanese quail were fed a basal diet with three amounts of lutein (0, 25 and 50 mg/kg diet) and two amounts of fish oil (3% and 6%) in a 3 × 2 factorial in five replications. Samples were collected at 24 and 27 weeks of age. Atherosclerosis lesions in the dorsal aorta were measured by histochemistry sectioning. At 27 weeks of age, increasing dietary fish oil content to 6% decreased (p < 0.01) the atherosclerotic lesions only in the 0 mg lutein supplemented groups. At 27 weeks of age, increasing dietary fish oil content to 6% increased the atherosclerotic lesion score when lutein was supplemented at either 25 or 50 mg/kg feed. Aorta and liver lutein content increased (p < 0.01) with increasing dietary lutein content at 27 weeks of age. Increasing dietary fish oil content to 6% increased (p < 0.01) the aorta fat content by twofold and decreased (p < 0.01) the liver fat by 26% at 27 weeks of age. Increasing the dietary fish oil content to 6% increased (p = 0.01) the total PUFA and decreased (p = 0.03) the total mono unsaturated fatty acids content of the aorta at 27 weeks of age. At 27 weeks of age, increasing dietary fish oil content to 6% decreased the amount of TBARS (p = 0.01) and IL-1 mRNA (p < 0.01) only in the 0 mg lutein supplemented groups. Increasing dietary fish oil content to 6% increased the amount of TBARS and IL-1 mRNA of the aorta when lutein was supplemented at either 25 or 50 mg/kg diet. Dietary lutein supplementation decreased atherosclerosis lesions only at low levels of dietary polyunsaturated fatty acids.

Serum Lutein Response Is Greater from Free Lutein Than from Esterified Lutein during 4 Weeks of Supplementation in Healthy Adults

Background: Current data suggest great variability in serum response following lutein ingestion from various sources.Objective: To compare the relative serum response during supplementation with free lutein (fL) and lutein esters (Le).Methods: 72 volunteers (23–52 years; body mass index [BMI] >20 and <30 kg/m2; baseline serum lutein <20 µg/dL [<352 nmol/L]) were identified. Subjects, matched for gender, age, and BMI, were randomly assigned to the fL or Le group. fL and Le capsules contained 12.2 mg of free lutein or 27 mg of lutein ester (equivalent to 13.5 mg free lutein), respectively. Fasting blood was obtained at baseline and after 7, 14, 21, and 28 days of supplementation. Supplements were consumed with standard portions of dry, ready-to-eat cereal and 2% cow's milk.Results: Absolute changes in serum lutein, per mg daily dose, were significantly greater in fL vs. Le after 21 days (p = 0.0012) and remained so after 28 days (p = 0.0011) of supplementation. Serum lutein Area Under the Curve [AUC(day 0-28)] response was 17% greater for fL vs. Le (p = 0.0187). Regression models were used and determined that (1) baseline serum lutein levels and (2) the form of lutein ingested (fL > Le) influence the serum lutein response during supplementation, while subject age, gender, BMI, and serum lipids do not affect serum response.Conclusions: These results suggest that the relative serum lutein response will be significantly greater from supplements containing free lutein than from supplements containing lutein esters. These findings should be useful for future clinical trials exploring the effectiveness of lutein supplementation in the prevention of or protection against age-related macular degeneration and/or cataracts.

The influence of lutein supplementation on macular pigment optical density in patients with dry AMD compared with healthy control subjects

Background Lutein and zeaxanthin are carotenoids that are selectively taken up into the macula of the eye, where they may protect against development of age-related macular degeneration (AMD). Past studies have reported an agedependent decline of macular pigment optical density (MPOD) in patients with AMD. In the present study we investigated the age-dependence of MPOD and melatonin using spectral fundus reflectance. In addition, we hypothesized that patients with AMD have a reduced MPOD as compared to healthy controls.

The Influence of Lutein on Swine Embryo Development

As defence against oxidative stress, living syste ms employ antioxidants that they either produce or take up from the environment. Among these lutein has been shown to be a powerful antioxidant that also functions as a signal molecul e. The goal of this study was to establish the influence of several lutein concentrations on swine embryo development in vitro, in order to improve culture media. Pig oocytes were cultured for 45 hours at 37°C in 5 % CO 2 atmosphere; in M199 containing several lutein (2.5, 4, 5, 8, and 10 µM) concentrations . Then, they were fertilized in TALP medium using spermatozoa capacitated by centrifugation and incubated for 16-18 hours. Afterwards, the presumed zygotes were cultured in NCSU-23 droplets supplemented with lutein (2.5, 4, 5, 8, and 10 µM) in the same conditions. Their development was assessed at 48 and 120 hours. The number of embryos that had developed to the 2 cells, 4-8 cell s and morula stages was compared to the control, and the differences analyzed using the analysis of variance and interpreted using the LSD and Duncan tests. Lutein (2.5 µM) supplementation has a benefi cial effect on embryo development to the morula stage. This is apparent at 48 hours as well as 120 hours.

Lutein supplementation and spatial vision in early AMD

Abstract Purpose To investigate the effect on spatial vision of enhancing macular pigment (MP) with lutein (L) capsules in patients with early AMD. Methods A randomised, placebo‐controlled two‐centred, 12 months study of the effects of L supplementation was conducted in Manchester, UK and Maastricht, The Netherlands. L capsules (10mg Ester), or a placebo were taken daily. 35 patients (mean age 73.4 ± 8.2, VA&gt;0.5 logMar) were randomly assigned to either L (lutein, n=19) or P (placebo, n=16) groups. Best corrected Log MAR visual acuities, contrast sensitivities (CS) at 0.5, 2, 4, 8,12 and 16 c/deg, and MP were measured at baseline and on three, four month intervals, after the start of the 12 month supplementation period. MP was measured using a flicker‐based technique. Results An increase in the mean MP levels was found for the L group; from 0.35±0.19 to 0.47±0.22 OD units that was statistically significant (p&lt;0.0003) while no change in MP was found for the P group. A mean improvement from 0.23±0.12 (baseline) to 0.16±0.10 (visit 4) was found in the VA of the L group (statistically significant, p= 0.004). In the P group there was a non‐significant deterioration in VA from 0.18±0.12 to 0.20±0.12. The mean difference in VA between baseline and visit 4 for the L group was 0.07±0.10 and for the P group was ‐0.03±0.10 (statistically significant difference, p= 0.004). No statistically significant changes were found in CS at any of the tested spatial frequencies for either of the 2 groups. Conclusion Lutein supplementation over a 12 months period improves MP levels in AMD patients and this corresponds to an overall improvement in VA. No such effect is observed in CS.

Effect of lutein supplementation on macular pigment optical density in patients with AMD

Abstract Purpose Reduced macular pigment optical density (MPOD) and reduced lutein/zeaxanthin intake have been shown to be associated with age‐related macular degeneration (AMD). As such supplementation with lutein has been suggested as a therapeutic option in AMD. In the present study we hypothesized that lutein supplementation may improve MPOD in AMD patients. Methods This hypothesis was tested in a randomized, double‐masked, placebo‐controlled parallel group study in patients with AMD with a 6 months study period. The randomization of lutein (20mg daily months 1‐3, 10 mg daily months 4‐6) versus placebo was 2:1. 126 patients with nonexudative AMD were included in this trial. Study visits were scheduled at baseline and 1 month, 3 months and 6 months after start of lutein or placebo intake. MPOD was measured with a custom built optical reflectometer based on a model of light propagation in the human retina. Statistical analysis was assessed using a repeated measures ANOVA model. Results 104 patients finished the study as scheduled. Eight patients only showed up for the baseline visit and were not included in the analysis. In the remaining 14 patients who did not finish the trial the last observation was carried forward. Supplementation with lutein induced a highly significant increase in MOPD (p &lt; 0.001 versus placebo). In the lutein group MPOD was 0.35 ± 0.02 at baseline and 0.43 ± 0.02 after 6 months of supplementation. Conclusion These data indicate that supplementation with lutein improves MPOD in AMD patients. Given that reduced MPOD is a risk factor for AMD these data suggest that supplementation with lutein is beneficial in AMD.

Lutein supplementation improves scotopic sensitivity recovery in AMD

Abstract Purpose To monitor photopic and scotopic sensitivity recovery during a one year period of supplementation with lutein (L). Methods A two centred, placebo controlled study of L supplementation was conducted in Maastricht, The Netherlands and Manchester, UK. L capsules (10mg ester), or placebo (P) were taken by AMD patients daily. There were 29 patients in the L group and 31 patients in the P group. Sensitivity recovery functions and MPOD (Macular Pigment Optical Density) were measured at baseline and at 4, 8 and 12 months. MPOD was measured with a flicker‐based method. Sensitivity recovery following a bleach was obtained by recording visual thresholds (white 1 deg target, nasal eccentricity 11 deg). Results In the L group, there was a mean increase of MPOD from 0.40 (0.17) at baseline to 0.54 (0.21), at visit 4, SDs in brackets (p&lt; 0.0001). In the P group, MPOD was 0.47 (0.19) at baseline and 0.49 (0.19) at visit 4. The mean rod recovery rate for the L group was 3.1 dB/min (1.08) at baseline that increased to 3.65 (0.31) at visit 4. This was statistically significant (p =0.17). The mean rod recovery rate for the P group was reduced from 3.3 (1.3) to 3.1 (1.35), (NS). The rod recovery time for the L group reduced from 15.9 minutes (7.9) to 14.5 minutes (8.4), NS. In the P group, rod recovery time increased from 14.3 (7.7) to 16.8 minutes (p= 0.021). For cone recovery or rod‐cone break time no significant differences between baseline and visit 4 in either the L group or the P group were found. Conclusion Rod‐based sensitivity recovery kinetics are improved after the augmentation of MPOD with lutein. In patients in whom there is no increase in MP a significant increase in rod‐based sensitivity recovery time can be expected.

Möglichkeiten der objektiven Messung der optischen Dichte der Makula

Determination of the optical density of the macular pigment may be used for an assessment of the efficacy of oral lutein supplementation in patients with dry AMD. Beside subjective methods like heterochrome flicker photometry, objective methods like the 2-wavelength auto-fluorescence method and the 1-wavelength reflection method are in clinical use today. Both methods show comparable results. For a long-term assessment of the efficacy of oral lutein supplementation, different parameters like mean and maximal optical density as well as the integral over optical density on all pixels ("volume") should be used. The parameter volume often increases also in cases in which other parameters do not change anymore. The 1-wavelength reflection method is used for the newly initiated LUTEGA study. This study will investigate the long-term effects of a fixed lutein/omega-3-fatty acid combination on the optical density in patients with dry AMD.