Objective: To evaluate the influence of short-term carotenoid and antioxidant supplementation on retinal function in nonadvanced age-related macular degeneration (AMD). Design: Randomized controlled trial. Participants: Twenty-seven patients with nonadvanced AMD and visual acuity 0.2 logarithm of the minimum angle of resolution were enrolled and randomly divided into 2 age-similar groups: 15 patients had oral supplementation of vitamin C (180 mg), vitamin E (30 mg), zinc (22.5 mg), copper (1 mg), lutein (10 mg), zeaxanthin (1 mg), and astaxanthin (4 mg) (AZYR SIFI, Catania, Italy) daily for 12 months (treated AMD [T-AMD] group; mean age, 69.44.31 years; 15 eyes); 12 patients had no dietary supplementation during the same period (nontreated AMD [NT-AMD] group; mean age, 69.76.23 years; 12 eyes). At baseline, they were compared with 15 age-similar healthy controls. Methods: Multifocal electroretinograms in response to 61 M-stimuli presented to the central 20° of the visual field were assessed in pretreatment (baseline) conditions and, in nonadvanced AMD patients, after 6 and 12 months. Main Outcome Measures: Multifocal electroretinogram response amplitude densities (RAD, nanovolt/deg2) of the N1–P1 component of first-order binary kernels measured from 5 retinal eccentricity areas between the fovea and midperiphery: 0° to 2.5° (R1), 2.5° to 5° (R2), 5° to 10° (R3), 10° to 15° (R4), and 15° to 20° (R5). Results: At baseline, we observed highly significant reductions of N1–P1 RADs of R1 and R2 in T-AMD and NT-AMD patients when compared with healthy controls (1-way analysis of variance P0.01). N1–P1 RADs of R3–R5 observed in T-AMD and NT-AMD were not significantly different (P0.05) from controls. No significant differences (P0.05) were observed in N1–P1 RADs of R1–R5 between T-AMD and NT-AMD at baseline. After 6 and 12 months of treatment, T-AMD eyes showed highly significant increases in N1-P1 RADs of R1 and R2 (P0.01), whereas no significant (P0.05) change was observed in N1–P1 RADs of R3–R5. No significant (P0.05) changes were found in N1–P1 RADs of R1–R5 in NT-AMD eyes. Conclusions: In nonadvanced AMD eyes, a selective dysfunction in the central retina (0°–5°) can be improved by the supplementation with carotenoids and antioxidants. No functional changes are present in the more peripheral (5°–20°) retinal areas. Ophthalmology 2008;115:324–333 © 2008 by the American Academy of Ophthalmology.
Carotenoids and Antioxidants inAge-Related Maculopathy Italian StudyMultifocal Electroretinogram Modifications after 1 Year
PIERMAROCCHI, STEFANO;
2008
Abstract
Objective: To evaluate the influence of short-term carotenoid and antioxidant supplementation on retinal function in nonadvanced age-related macular degeneration (AMD). Design: Randomized controlled trial. Participants: Twenty-seven patients with nonadvanced AMD and visual acuity 0.2 logarithm of the minimum angle of resolution were enrolled and randomly divided into 2 age-similar groups: 15 patients had oral supplementation of vitamin C (180 mg), vitamin E (30 mg), zinc (22.5 mg), copper (1 mg), lutein (10 mg), zeaxanthin (1 mg), and astaxanthin (4 mg) (AZYR SIFI, Catania, Italy) daily for 12 months (treated AMD [T-AMD] group; mean age, 69.44.31 years; 15 eyes); 12 patients had no dietary supplementation during the same period (nontreated AMD [NT-AMD] group; mean age, 69.76.23 years; 12 eyes). At baseline, they were compared with 15 age-similar healthy controls. Methods: Multifocal electroretinograms in response to 61 M-stimuli presented to the central 20° of the visual field were assessed in pretreatment (baseline) conditions and, in nonadvanced AMD patients, after 6 and 12 months. Main Outcome Measures: Multifocal electroretinogram response amplitude densities (RAD, nanovolt/deg2) of the N1–P1 component of first-order binary kernels measured from 5 retinal eccentricity areas between the fovea and midperiphery: 0° to 2.5° (R1), 2.5° to 5° (R2), 5° to 10° (R3), 10° to 15° (R4), and 15° to 20° (R5). Results: At baseline, we observed highly significant reductions of N1–P1 RADs of R1 and R2 in T-AMD and NT-AMD patients when compared with healthy controls (1-way analysis of variance P0.01). N1–P1 RADs of R3–R5 observed in T-AMD and NT-AMD were not significantly different (P0.05) from controls. No significant differences (P0.05) were observed in N1–P1 RADs of R1–R5 between T-AMD and NT-AMD at baseline. After 6 and 12 months of treatment, T-AMD eyes showed highly significant increases in N1-P1 RADs of R1 and R2 (P0.01), whereas no significant (P0.05) change was observed in N1–P1 RADs of R3–R5. No significant (P0.05) changes were found in N1–P1 RADs of R1–R5 in NT-AMD eyes. Conclusions: In nonadvanced AMD eyes, a selective dysfunction in the central retina (0°–5°) can be improved by the supplementation with carotenoids and antioxidants. No functional changes are present in the more peripheral (5°–20°) retinal areas. Ophthalmology 2008;115:324–333 © 2008 by the American Academy of Ophthalmology.
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