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New Carotenoid Formulation Offers Advantages for Patients With AMD

The inclusion of meso-zeaxanthin in a carotenoid formulation is crucial if benefits of supplementation are to be realized.

BY PROFESSOR STEPHEN BEATTY

The Age Related Eye Disease Study 2 (AREDS2) demonstrated that supplementation with the macula’s naturally occurring carotenoids is of visual benefit to patients with nonadvanced age-related macular degeneration.^1,2

AREDS2 demonstrated a statistically significant reduction of 9% in risk of progression to advanced AMD for patients receiving the carotenoids (lutein [L] and zeaxanthin [Z]) when compared with patients not receiving these macular pigments.

However, and since that important publication, further research has shown that a formulation containing all three of the macula’s carotenoids (L, Z, and meso-zeaxanthin [MZ]) offers many advantages over AREDS2-like formulations that contain only two of these carotenoids (L and Z), for the following reasons.

First, the inclusion of all three macular carotenoids in an MZ:L:Z (mg) ratio of 10:10:2 is essential if the atypical central dip in the spacial profile of macular pigment (a known risk factor for AMD) is to be normalized.³

In addition, augmentation of macular pigment in AMD, across the macula in AMD-afflicted eyes, is best achieved when the three macular carotenoids are given in an MZ:L:Z (mg) ratio of 10:10:2 (as in MacuHealth Plus).⁴

Visual improvement, in terms of contrast sensitivity and glare disability, are greater in a formulation that contains the three macular carotenoids at this ratio than in alternative formulations.

Following supplementation with L, Z, and MZ, serum concentrations of MZ are the sole serologic determinant of macular pigment augmentation.⁵

Furthermore, concerns have been expressed about the inclusion of high doses of zinc (80 mg) in the AREDS2 formulation, which may represent risk for AMD progression in patients with a particular genetic background. Accordingly, a safe formulation should contain amounts of zinc that are below the tolerable upper limit (40 mg) and above the recommended daily allowance (11 mg for men and 8 mg for women),⁶ as such modifications to the AREDS2 formulation negate the possibility of provoking progression in AMD patients with a particular genetic background.⁷

AIMS	MACUHEALTH-PLUS
Risk reduction for AMD progression in persons with nonadvanced AMD
Risk reduction for visual loss in patients with nonadvanced AMD
Risk reduction for developing AMD in healthy eyes
Optimization of visual performance in patients with nonadvanced AMD

In other words, the evidence base for supplementation in patients with AMD favors an AREDS2 formulation, but without dangerous levels of zinc, and using a supplement that contains all three macular carotenoids in an MZ:L:Z ratio of 10:10:2 (MacuHealth Plus). When using MacuHealth Plus, ophthalmologists can be sure that their patients are benefiting from the AREDS2 formulation without recourse to complex genetic testing, and they also know that they are taking full advantage of the benefits of using all three macular carotenoids.

In summary, AREDS2 has shown that supplementation with the macula’s naturally occurring carotenoids is important for patients with AMD, but subsequent and emerging research has demonstrated that eye care professionals who want to maximally augment their patients’ macular pigment and maximally enhance the visual performance and experience of their patients with AMD should use a formulation containing all three of the macular carotenoids in an MZ:L:Z ratio of 10:10:2 (MacuHealth Plus). RP

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