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. Author manuscript; available in PMC: 2017 Sep 25.
Published in final edited form as: Annu Rev Nutr. 2016 Jul 17;36:571–602. doi: 10.1146/annurev-nutr-071715-051110

Table 1. Summary of studies (2004–2015; including more than 50 subjects) investigating the relationships among macular pigment optical density, supplementation with lutein, zeaxanthin, and/or meso-zeaxanthin, and visual performance.

Cross-sectional observational studies
Study author(s) and year (reference) Sample Measure of lutein/zeaxanthin status Vision outcome Result
Beirne 2013 (14) 73 subjects (ages 20–71) MPOD Foveal acuity MPOD was not significantly related to foveal acuity
Hammond et al. 2013 (66) 150 healthy young subjects (mean age 22) MPOD GD, photostress recovery, chromatic contrast Higher MPOD was significantly correlated with improved GD, photostress recovery, and chromatic contrast
Renzi & Hammond 2010 (152) 50 healthy elderly subjects (mean age 72)
28 healthy young subjects (mean age 23)		 MPOD Luminance contrast Higher MPOD levels were significantly correlated with a greater luminance contrast
Renzi & Hammond 2010 (153) 70 subjects, full-temporal function outcome (ages 15–84)
354 subjects for CFF outcome (ages 16–92)		 MPOD CFF, TCSF MPOD was positively correlated with TCSF in the center but not the parafovea. It also positively correlated with CFF
Randomized trials
Study author(s) and year (reference) Sample Intervention Intervention influence on L/Z status Duration Vision outcome Outcomes associated withsupplementation
Chous et al. 2016 (43) 67 type 1 and type 2 diabetes patients (mean age 56)

  1. L and Z plus antioxidants

  2. Placebo

 Increased mean MPOD 6 months CS, color discrimination Better visual performance was observed for all measures in the supplemented group
Huang et al. 2015 (78) 112 early-AMD patients (ages 61–78)

  1. l0 mg L

  2. 20 mg L

  3. l0 mg L, l0 mg Z

  4. Placebo

 Increased mean MPOD and serum L/Z 2 years VA, CS, photostress CS significantly improved with supplementation; intervention 2 had the most improvement. No significant changes in photostress recovery or VA were observed
Akuffo et al. 2015 (2) 47 early-AMD patients (mean age 66)

  1. 20 m gL, 0.86 mg Z

  2. 10 mg L, 2 mg Z, l0 mg MZ

  3. 3 mg L, 2 mg Z, 17 mg MZ

 Increased mean MPOD except in intervention 1 at the location of 1.75° from the foveal center 3 years VA, CSAMD progression CS significantly improved at certain spatial frequencies in all interventions. No improvements in VA or AMD progression were observed
Hammond et al. 2014 (67) 115 healthy college students (ages 18–40)

  1. 10 mg L, 2 mg Z

  2. Placebo

 Increased mean MPOD and serum L/Z 1 year Photostress recovery, chromatic contrast, GD Photostress recovery and chromatic contrast were improved but GD was not
Bovier et al. 2014 (37) 92 healdiy young subjects (ages 18–32)

  1. 20 mg Z

  2. 26 mg Z, 8 mg L, 190 mg omega-3 fatty acid

  3. Placebo

 Increased MPOD 4 months CFF thresholds, visual motor reaction time, visual processing speed Increased CFF thresholds, visual motor reaction times, and visual processing speeds were observed for groups that received any supplement
Sabour-Pickett et al. 2014 (159) 52 early-AMD patients (mean age 66)

  1. 20 mg L, 2 mg Z

  2. 10 mg MZ, 10 mg L, 2 mg Z

  3. 17 mg MZ, 3 mg L, 2 mg Z

 Increased mean MPOD at all locations in interventions 2 and 3 but only at 1.75° in group 1 1 year CS CS improved at all spatial frequencies in intervention 3 and in low spatial frequencies in interventions 1 and 2
Age-Related Eye Disease Study Investig. 2013 (1) 4,203 participants (ages 50-85)

  1. 10 mg L, 2 mg Z

  2. Omega-3s

  3. L/Z with omega-3s

  4. Placebo

 ND 5 years VA more than 15 letters No improvements were observed for VA of 15 letters or more
Yao et al. 2013 (192) 120 drivers (ages 25–47)

  1. 20 mgL

  2. Placebo

 Increased mean MPOD and increased serum L 1 year VA, CS, GD No significant improvements in VA were observed, but CS and GD in supplemented group increased significantly. Improved scores on the NEI-VFQ were also observed for the supplemented group
Ma et al. 2012 (116) 108 AMD patients (ages 50-79)

  1. l0 mg L

  2. 20mg L

  3. 10 mg L plus l0 mg Z

  4. Placebo

 Increased mean MPOD 48 weeks BCVA, CS Improvements in MPOD were positively correlated with improvements in VA and CS at 3, 6, and 12 cycles
Weigert et al. 2011 (187) 126 patients (ages 50–90)

  1. 20 mg L for 3 months, 10 mg L for additional 3 months

  2. Placebo

 Increased mean MPOD 6 months VA Despite no significant improvement in VA, MPOD increases were related to improvements in VA
Piermarocchi et al. 2012 (147) 145 patients (ages 55–80)

  1. 10 mg L, 1 mg Z with other antioxidants

  2. Placebo

 ND 2 years VA, CS, NEI-VFQ VA was stabilized, and improvements in CS and NEI-VFQ score were observed
Nolan etal. 2011 (135) 121 healthy subjects (ages 18–41)

  1. 12 mg L, 1 mg Z

  2. Placebo

 Increased mean MPOD and increased serum L/Z 1 year VA, CS, GD, photostress No significant improvement of visual performance despite increased MPOD levels
Dawczynski et al. 2013 (49) 172 patients with early, intermediate, and advanced AMD (ages 50–95)

  1. 10 mg L, 1 mg Z, and other antioxidants, either once (dose 1) or twice (dose 2) daily

  2. Placebo

 Increased mean MPOD 1 year VA VA was improved (mean 2 letters for dose 1 and 1.4 letters for dose 2)
Beatty et al. 2013 (12) 433 patients with early AMD in both eyes or in one eye accompanied by advanced AMD in the fellow eye (ages 50–85)

  1. 12mgL, 0.6 mg Z, with other antioxidants

  2. Placebo

 Increased serum L/Z 3 years VA, CS, AMD progression VA improved in the supplemented group and progression along AMD severity scale was lower. No significant improvements in CS were observed
Richer et al. 2011 (156) 60 patients with atrophic AMD (mean age 75)

  1. 8 mg Z

  2. 8 mg Z, 8 mg L

  3. 9 mg L

 Increased mean MPOD at 1° 1 year VA, GD, CS High-contrast VA improved in intervention 1. Low-contrast VA, CS, and GD improved in intervention 3
Hu et al. 2011 (77) 67 patients with nonproliferative diabetic retinopathy (ages 42–76)

  1. 6 mg L, 0.5 mg Z

  2. Placebo

 Increased serum L/Z 3 months VA, CS, macular edema (foveal thickness) VA and CS improved, and macular edema was reduced in supplemented group

Abbreviations: AMD, age-related macular degeneration; BCVA, best-corrected visual acuity; CFF, critical flicker frequency; CS, contrast sensitivity; GD, glare disability; L, lutein; MPOD, macular pigment optical density; MZ, meso-zeaxanthin; ND, MPOD or serum L/Z were not determined; NEI-VFQ, National Eye Institute Vision Function Questionnaire; TCSF, temporal contrast sensitivity function; VA, visual acuity; Z, zeaxanthin.