Associations between Lutein, Zeaxanthin, and Age-Related Macular Degeneration: An Overview

Age-related macular degeneration, the leading cause of blindness in the elderly, is a degenerative condition of the macula characterized by death or dysfunction of the photoreceptors. With the aging population growing, the incidence of age-related macular degeneration is expected to increase. This raises concern about the future of visual dysfunction related falls and the resulting injuries in the elderly population. Lutein and zeaxanthin are macular pigments that may play a role in reducing the development and progression of age-related macular degeneration. Evidence is accumulating on the consumption of lutein and zeaxanthin (in whole food or supplemental form), the resulting concentrations in the serum, and tissue distribution throughout the body, particularly in the retina. Lutein and zeaxanthin intake increases serum concentrations which in turn increases macular pigment density. Existing literature focuses on factors affecting macular pigment density, functions of lutein and zeaxanthin as blue-light filters and antioxidants, and risk factors associated with age-related macular degeneration. Few studies have focused on the impact of dietary lutein and zeaxanthin on retinal function and the potential to preserve vision and prevent further degeneration. This presents an opportunity for further research to determine an effective dose that delays the progression of age-related macular degeneration.

[1]  H. Hense,et al.  Serum levels of macular carotenoids in relation to age-related maculopathy , 2005, Graefe's Archive for Clinical and Experimental Ophthalmology.

[2]  M. Boulton,et al.  The role of oxidative stress in the pathogenesis of age-related macular degeneration. , 2000, Survey of ophthalmology.

[3]  J. Cruysberg,et al.  Neovascular age-related macular degeneration and its relationship to antioxidant intake. , 2002, Acta ophthalmologica Scandinavica.

[4]  S. Beatty,et al.  Plasma and macular responses to lutein supplement in subjects with and without age-related maculopathy: a pilot study. , 2004, Experimental eye research.

[5]  G Dagnelie,et al.  Lutein improves visual function in some patients with retinal degeneration: a pilot study via the Internet. , 2000, Optometry.

[6]  W. Stahl,et al.  Xanthophyll esters in human skin. , 1998, Archives of biochemistry and biophysics.

[7]  R. Klein,et al.  Ten-year incidence and progression of age-related maculopathy: The Beaver Dam eye study. , 2002, Ophthalmology.

[8]  Werner Gellermann,et al.  Research Abstracts , 2022 .

[9]  J. Nolan,et al.  Macular carotenoids and age-related maculopathy. , 2006, Annals of the Academy of Medicine, Singapore.

[10]  Johannes R. Vingerling,et al.  The prevalence of age-related maculopathy in the Rotterdam Study. , 1995, Ophthalmology.

[11]  R. Bone,et al.  Lutein and zeaxanthin dietary supplements raise macular pigment density and serum concentrations of these carotenoids in humans. , 2003, The Journal of nutrition.

[12]  R. Browne,et al.  Correlates of markers of oxidative status in the general population. , 1998, American journal of epidemiology.

[13]  D. Snodderly,et al.  Nutritional manipulation of primate retinas, I: effects of lutein or zeaxanthin supplements on serum and macular pigment in xanthophyll-free rhesus monkeys. , 2004, Investigative ophthalmology & visual science.

[14]  P. D. de Jong,et al.  Macular pigment and melanin in age-related maculopathy in a general population. , 2002, Investigative ophthalmology & visual science.

[15]  A. Langner,et al.  Effect of dietary zeaxanthin on tissue distribution of zeaxanthin and lutein in quail. , 2002, Investigative ophthalmology & visual science.

[16]  David I W Phillips,et al.  Lutein and zeaxanthin status and risk of age-related macular degeneration. , 2003, Investigative ophthalmology & visual science.

[17]  R. Klein,et al.  Serum antioxidants and age-related macular degeneration in a population-based case-control study. , 1995, Archives of ophthalmology.

[18]  S. Beatty,et al.  Monthly Consistency of Macular Pigment Optical Density and Serum Concentrations of Lutein and Zeaxanthin , 2006, Current eye research.

[19]  D. Snodderly,et al.  Cigarette Smoking and Retinal Carotenoids: Implications for Age-related Macular Degeneration , 1996, Vision Research.

[20]  X. Geng,et al.  Tubulins in the primate retina: evidence that xanthophylls may be endogenous ligands for the paclitaxel-binding site. , 2001, Bioorganic & medicinal chemistry.

[21]  G. Paolisso,et al.  Oxidative stress and insulin action: is there a relationship? , 1996, Diabetologia.

[22]  J. Olson Serum levels of vitamin A and carotenoids as reflectors of nutritional status. , 1984, Journal of the National Cancer Institute.

[23]  D. Snodderly,et al.  Macular pigment density is reduced in obese subjects. , 2002, Investigative ophthalmology & visual science.

[24]  R J Glynn,et al.  A prospective study of cigarette smoking and risk of age-related macular degeneration in men. , 1996, JAMA.

[25]  R. Klein,et al.  Association of zinc and antioxidant nutrients with age-related maculopathy. , 1996, Archives of ophthalmology.

[26]  R. E. Anderson,et al.  Polyunsaturated fatty acids and vitamin E in rat rod outer segments during light damage. , 1986, Investigative ophthalmology & visual science.

[27]  P. Barberger‐Gateau,et al.  Plasma lutein and zeaxanthin and other carotenoids as modifiable risk factors for age-related maculopathy and cataract: the POLA Study. , 2006, Investigative ophthalmology & visual science.

[28]  G. Britton,et al.  Structure and properties of carotenoids in relation to function , 1995, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[29]  D. Albanes,et al.  Effects of supplemental beta-carotene, cigarette smoking, and alcohol consumption on serum carotenoids in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. , 1997, The American journal of clinical nutrition.

[30]  Da-You Zhao,et al.  Transformations of selected carotenoids in plasma, liver, and ocular tissues of humans and in nonprimate animal models. , 2002, Investigative ophthalmology & visual science.

[31]  G. Dagnelie,et al.  Are lutein and zeaxanthin conditionally essential nutrients for eye health? , 2003, Medical hypotheses.

[32]  D M Snodderly,et al.  Evidence for protection against age-related macular degeneration by carotenoids and antioxidant vitamins. , 1995, The American journal of clinical nutrition.

[33]  K. Yeum,et al.  Carotenoid bioavailability and bioconversion. , 2003, Annual review of nutrition.

[34]  B. Hammond,et al.  Macular pigment density in monozygotic twins. , 1995, Investigative ophthalmology & visual science.

[35]  R. Klein,et al.  The five-year incidence and progression of age-related maculopathy: the Beaver Dam Eye Study. , 1997, Ophthalmology.

[36]  S. Richer ARMD--pilot (case series) environmental intervention data. , 1999, Journal of the American Optometric Association.

[37]  A. Dobson,et al.  Diabetes mellitus and serum carotenoids: findings of a population-based study in Queensland, Australia. , 2005, The American journal of clinical nutrition.

[38]  E. Dratz,et al.  A reinvestigation of the fatty acid content of bovine, rat and frog retinal rod outer segments. , 1979, Experimental eye research.

[39]  F. Delori,et al.  Elevated retinal zeaxanthin and prevention of light-induced photoreceptor cell death in quail. , 2002, Investigative ophthalmology & visual science.

[40]  S. Fliesler,et al.  Chemistry and metabolism of lipids in the vertebrate retina. , 1983, Progress in lipid research.

[41]  Stuart Richer,et al.  Double-masked, placebo-controlled, randomized trial of lutein and antioxidant supplementation in the intervention of atrophic age-related macular degeneration: the Veterans LAST study (Lutein Antioxidant Supplementation Trial). , 2004, Optometry.

[42]  W. Stahl,et al.  Physical Quenching of Singlet Oxygen and cis‐trans Isomerization of Carotenoids a , 1993 .

[43]  R. Guymer,et al.  Body Mass Index Modifiable Risk Factors for Age-related Macular Degeneration , 2006 .

[44]  P. Mazurek,et al.  Lutein and zeaxanthin as protectors of lipid membranes against oxidative damage: the structural aspects. , 1999, Archives of biochemistry and biophysics.

[45]  M. Rambeau,et al.  Lycopene but not lutein nor zeaxanthin decreases in serum and lipoproteins in age-related macular degeneration patients. , 2005, Clinica chimica acta; international journal of clinical chemistry.

[46]  W. Stahl,et al.  Macular pigments lutein and zeaxanthin as blue light filters studied in liposomes. , 2001, Archives of biochemistry and biophysics.

[47]  R. Bone,et al.  The macular pigment: a possible role in protection from age-related macular degeneration. , 1997, Advances in pharmacology.

[48]  P. Bernstein,et al.  Retinal tubulin binds macular carotenoids. , 1997, Investigative ophthalmology & visual science.

[49]  T. Spector,et al.  Heritability of macular pigment: a twin study. , 2005, Investigative ophthalmology & visual science.

[50]  N. Krinsky,et al.  PROTECTIVE ACTION OF CAROTENOID PIGMENTS AGAINST PHOTODYNAMIC DAMAGE TO LIPOSOMES* , 1973, Photochemistry and photobiology.

[51]  A. Hofman,et al.  Age-related macular degeneration and smoking. The Rotterdam Study. , 1996 .

[52]  S. Mayne,et al.  Macular pigment in donor eyes with and without AMD: a case-control study. , 2001, Investigative ophthalmology & visual science.

[53]  W. Willett,et al.  Measurement of retinoids and carotenoids in breast adipose tissue and a comparison of concentrations in breast cancer cases and control subjects. , 1997, The American journal of clinical nutrition.

[54]  Yin Chang,et al.  The spatial distribution of macular pigment in humans , 2001, Current eye research.

[55]  W. White,et al.  Intestinal absorption, serum clearance, and interactions between lutein and beta-carotene when administered to human adults in separate or combined oral doses. , 1995, The American journal of clinical nutrition.

[56]  B. Rosner,et al.  Progression of age-related macular degeneration: association with dietary fat, transunsaturated fat, nuts, and fish intake. , 2003, Archives of ophthalmology.

[57]  A. Morland,et al.  Macular pigments: their characteristics and putative role , 2004, Progress in Retinal and Eye Research.

[58]  R Hiller,et al.  Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group. , 1994, JAMA.

[59]  Elizabeth J Johnson Obesity, lutein metabolism, and age-related macular degeneration: a web of connections. , 2005, Nutrition reviews.

[60]  R. Bone,et al.  Distribution of lutein and zeaxanthin stereoisomers in the human retina. , 1997, Experimental eye research.

[61]  B. Falsini,et al.  Influence of short-term antioxidant supplementation on macular function in age-related maculopathy: a pilot study including electrophysiologic assessment. , 2003, Ophthalmology.

[62]  D. Snodderly,et al.  Preservation of visual sensitivity of older subjects: association with macular pigment density. , 1998, Investigative ophthalmology & visual science.

[63]  E. Dratz,et al.  Carotenoids in the human macula and whole retina. , 1988, Investigative ophthalmology & visual science.

[64]  P. Mecocci,et al.  Cigarette smoking cessation increases plasma levels of several antioxidant micronutrients and improves resistance towards oxidative challenge , 2003, British Journal of Nutrition.

[65]  N. Bressler,et al.  Clinicopathologic correlation of drusen and retinal pigment epithelial abnormalities in age-related macular degeneration. 1994. , 2005, Retina.

[66]  Paul Mitchell,et al.  Ten-year incidence and progression of age-related maculopathy: the blue Mountains Eye Study. , 2007, Ophthalmology.

[67]  B. Clevidence,et al.  Association of carotenoids with human plasma lipoproteins. , 1993, Methods in enzymology.

[68]  D. Snodderly,et al.  Dietary modification of human macular pigment density. , 1997, Investigative ophthalmology & visual science.

[69]  F. Khachik,et al.  Identification and quantitation of carotenoids and their metabolites in the tissues of the human eye. , 2001, Experimental eye research.

[70]  K. E. Sprague,et al.  A one year study of the macular pigment: the effect of 140 days of a lutein supplement. , 1997, Experimental eye research.

[71]  M. Boulton,et al.  Lipofuscin is a photoinducible free radical generator. , 1993, Journal of photochemistry and photobiology. B, Biology.

[72]  S. Beatty,et al.  Macular pigment and percentage of body fat. , 2004, Investigative ophthalmology & visual science.

[73]  R. Bone,et al.  Lutein, zeaxanthin, and the macular pigment. , 2001, Archives of biochemistry and biophysics.

[74]  R P Danis,et al.  Macular pigment optical density in a midwestern sample. , 2001, Ophthalmology.

[75]  A. Ramé [Age-related macular degeneration]. , 2006, Revue de l'infirmiere.

[76]  R. E. Anderson,et al.  Lipid peroxidation and retinal degeneration. , 1984, Current eye research.

[77]  R. Bone,et al.  Analysis of the macular pigment by HPLC: retinal distribution and age study. , 1988, Investigative ophthalmology & visual science.

[78]  W. Noell,et al.  Possible mechanisms of photoreceptor damage by light in mammalian eyes , 1980, Vision Research.

[79]  A. Lichtenstein,et al.  Lutein and zeaxanthin concentrations in plasma after dietary supplementation with egg yolk. , 1999, The American journal of clinical nutrition.

[80]  L. Kaplan,et al.  Carotenoid composition, concentrations, and relationships in various human organs. , 1990, Clinical physiology and biochemistry.

[81]  B. Hammond,et al.  Interocular differences in macular pigment density. , 1992, Investigative ophthalmology & visual science.

[82]  G. Block,et al.  Smoking and exposure to environmental tobacco smoke decrease some plasma antioxidants and increase gamma-tocopherol in vivo after adjustment for dietary antioxidant intakes. , 2003, The American journal of clinical nutrition.

[83]  X. D. Wang,et al.  Review: absorption and metabolism of beta-carotene. , 1994, Journal of the American College of Nutrition.

[84]  R. Klein,et al.  Lutein and zeaxanthin in the diet and serum and their relation to age-related maculopathy in the third national health and nutrition examination survey. , 2001, American journal of epidemiology.

[85]  D. Snodderly,et al.  Relation among serum and tissue concentrations of lutein and zeaxanthin and macular pigment density. , 2000, The American journal of clinical nutrition.

[86]  C. Hasler Functional foods: benefits, concerns and challenges-a position paper from the american council on science and health. , 2002, The Journal of nutrition.

[87]  G. Jensen,et al.  14-year incidence, progression, and visual morbidity of age-related maculopathy: the Copenhagen City Eye Study. , 2005, Ophthalmology.

[88]  Lawrence A. Yannuzzi,et al.  Dietary Carotenoids, Vitamins A, C, and E, and Advanced Age-Related Macular Degeneration , 1994 .

[89]  O. Sommerburg,et al.  Lutein and zeaxanthin are associated with photoreceptors in the human retina. , 1999, Current eye research.

[90]  A. Hofman,et al.  The risk and natural course of age-related maculopathy: follow-up at 6 1/2 years in the Rotterdam study. , 2003, Archives of ophthalmology.

[91]  A. J. Wenzel,et al.  Diet and serum carotenoid concentrations affect macular pigment optical density in adults 45 years and older. , 2005, The Journal of nutrition.

[92]  R. Bone,et al.  Biologic mechanisms of the protective role of lutein and zeaxanthin in the eye. , 2003, Annual review of nutrition.

[93]  J. Erdman,et al.  Concentrations of selected carotenoids and vitamin A in human liver, kidney and lung tissue. , 1991, The Journal of nutrition.

[94]  D. Verma,et al.  Age related macular degeneration: Authors' reply , 2003, BMJ : British Medical Journal.

[95]  E. Dratz,et al.  The role of antioxidants in the retina and retinal pigment epithelium and the nature of prooxidant-induced damage , 1986 .

[96]  B. Hammond,et al.  Macular pigment optical density in a Southwestern sample. , 2000, Investigative ophthalmology & visual science.

[97]  Edmond Rock,et al.  Short-term supplementation with lutein affects biomarkers of lutein status similarly in young and elderly subjects , 2003, Experimental Gerontology.

[98]  Shih-Jen Chen,et al.  Optical measurement of human retinal macular pigment and its spatial distribution with age. , 2002, Medical physics.

[99]  J. Nowak,et al.  Age-related macular degeneration (AMD): pathogenesis and therapy. , 2006, Pharmacological reports : PR.

[100]  J. Castenmiller,et al.  The food matrix of spinach is a limiting factor in determining the bioavailability of beta-carotene and to a lesser extent of lutein in humans. , 1999, The Journal of nutrition.

[101]  C. Zucker,et al.  Nutritional manipulation of primate retinas. IV. Effects of n--3 fatty acids, lutein, and zeaxanthin on S-cones and rods in the foveal region. , 2005, Experimental eye research.

[102]  Martha Neuringer,et al.  Nutritional manipulation of primate retinas, II: effects of age, n-3 fatty acids, lutein, and zeaxanthin on retinal pigment epithelium. , 2004, Investigative ophthalmology & visual science.

[103]  G. Reaven,et al.  Relation between insulin resistance and plasma concentrations of lipid hydroperoxides, carotenoids, and tocopherols. , 2000, The American journal of clinical nutrition.

[104]  Elizabeth J Johnson The role of carotenoids in human health. , 2002, Nutrition in clinical care : an official publication of Tufts University.

[105]  S. Seregard,et al.  Drusen maculopathy: a risk factor for AMD. Can we prevent visual loss? , 2003, Acta ophthalmologica Scandinavica.

[106]  R. Bone,et al.  Distribution of macular pigment components, zeaxanthin and lutein, in human retina. , 1992, Methods in enzymology.

[107]  D. Snodderly,et al.  Nutritional manipulation of primate retinas, III: Effects of lutein or zeaxanthin supplementation on adipose tissue and retina of xanthophyll-free monkeys. , 2005, Investigative ophthalmology & visual science.

[108]  D M Snodderly,et al.  The macular pigment. I. Absorbance spectra, localization, and discrimination from other yellow pigments in primate retinas. , 1984, Investigative ophthalmology & visual science.

[109]  D M Snodderly,et al.  Biological control of primate macular pigment. Biochemical and densitometric studies. , 1991, Investigative ophthalmology & visual science.

[110]  B. Trump,et al.  Microsomal Lipid Peroxidation: Morphological Characterization , 1972, Science.