Carotenoids and antioxidants in age-related maculopathy italian study: multifocal electroretinogram modifications after 1 year.
OBJECTIVE
To evaluate the influence of short-term carotenoid and antioxidant supplementation on retinal function in nonadvanced age-related macular degeneration (AMD).


METHODS
Randomized controlled trial.


METHODS
Twenty-seven patients with nonadvanced AMD and visual acuity > or =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, 69.4+/-4.31 years; 15 eyes); 12 patients had no dietary supplementation during the same period (nontreated AMD [NT-AMD] group; mean age, 69.7+/-6.23 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 degrees of the visual field were assessed in pretreatment (baseline) conditions and, in nonadvanced AMD patients, after 6 and 12 months.


METHODS
Multifocal electroretinogram response amplitude densities (RAD, nanovolt/deg(2)) of the N1-P1 component of first-order binary kernels measured from 5 retinal eccentricity areas between the fovea and midperiphery: 0 degrees to 2.5 degrees (R1), 2.5 degrees to 5 degrees (R2), 5 degrees to 10 degrees (R3), 10 degrees to 15 degrees (R4), and 15 degrees to 20 degrees (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 P<0.01). N1-P1 RADs of R3-R5 observed in T-AMD and NT-AMD were not significantly different (P>0.05) from controls. No significant differences (P>0.05) 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 (P<0.01), whereas no significant (P>0.05) change was observed in N1-P1 RADs of R3-R5. No significant (P>0.05) 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 degrees -5 degrees ) can be improved by the supplementation with carotenoids and antioxidants. No functional changes are present in the more peripheral (5 degrees -20 degrees ) retinal areas.
Parisi
Vincenzo
V
Fondazione G. B. Bietti-Istituto di Ricovero e Cura a Carattere Scientifico, Roma, Italy. vparisi@tin.it
Tedeschi
Massimiliano
M
Gallinaro
Geltrude
G
Varano
Monica
M
Saviano
Sandro
S
Piermarocchi
Stefano
S
D000284:Administration, Oral; D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage*; D001205:Ascorbic Acid / Q000008:administration & dosage; D002338:Carotenoids / Q000008:administration & dosage*; D003300:Copper / Q000008:administration & dosage; D004596:Electroretinography / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D014975:Lutein / Q000008:administration & dosage; D008268:Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000187:drug effects* / Q000503:physiopathology; D014792:Visual Acuity; D014794:Visual Fields; D014810:Vitamin E / Q000008:administration & dosage; D024341:Xanthophylls / Q000008:administration & dosage; D065146:Zeaxanthins; D015032:Zinc / Q000008:administration & dosage
D000975:Antioxidants; D024341:Xanthophylls; D065146:Zeaxanthins; D014810:Vitamin E; D002338:Carotenoids; D003300:Copper; C005948:astaxanthine; D015032:Zinc; D001205:Ascorbic Acid; D014975:Lutein