Carotenoids in Age-related Maculopathy Italian Study (CARMIS): two-year results of a randomized study

Eur J Ophthalmol. Mar-Apr 2012;22(2):216-25. doi: 10.5301/ejo.5000069.

Abstract

Purpose: The high concentration of carotenoids in the macula, plus evidence linking oxidative stress to age-related macular degeneration (AMD) and carotenoids to antioxidation, generated the hypothesis that higher antioxidant intakes can prevent AMD. The aim of this study was to determine whether nutritional supplementation with a targeted nutritional supplement improves visual acuity and visual function in AMD.

Methods: In this multicenter, prospective open-label randomized study, 145 patients were randomly assigned to 2 different treatment groups. Interventions were lutein (10 mg), zeaxanthin (1 mg), astaxanthin (4 mg; AZYR SIFI, Catania, Italy), and antioxidants/vitamins supplementation formula or no dietary supplementation for 2 years. Primary outcome was mean changes in visual acuity (VA) at 12 and 24 months. Other measures included contrast sensitivity (CS) and National Eye Institute visual function questionnaire (NEI VFQ-25) scores at 12 and 24 months.

Results: Patients in the treated group showed stabilization of VA with significantly (p=0.003) better VA scores (81.4 ± 7.2) compared to the nontreated group (76.8 ± 8.9) at 24-month follow-up. An improvement in CS (p=0.001) and final mean NEI VFQ-25 composite scores at 12 and 24 months higher in treated group compared to nontreated group were also shown (p<0.001).

Conclusions: Patients treated with lutein/zeaxanthin and astaxanthin together with other nutrients were more likely to report clinically meaningful stabilization/improvements in VA, CS, and visual function through 24 months compared with nontreated subjects. Further studies are needed with more patients and for longer periods of time.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Aged
  • Aged, 80 and over
  • Antioxidants / administration & dosage*
  • Ascorbic Acid / administration & dosage
  • Carotenoids / administration & dosage*
  • Contrast Sensitivity / physiology
  • Copper / administration & dosage
  • Dietary Supplements*
  • Female
  • Follow-Up Studies
  • Humans
  • Italy
  • Lutein / administration & dosage
  • Macular Degeneration / drug therapy*
  • Macular Degeneration / physiopathology
  • Male
  • Middle Aged
  • Prospective Studies
  • Sickness Impact Profile
  • Surveys and Questionnaires
  • Visual Acuity / physiology
  • Vitamin E / administration & dosage
  • Vitamins / administration & dosage*
  • Xanthophylls / administration & dosage
  • Zeaxanthins
  • Zinc Compounds / administration & dosage

Substances

  • Antioxidants
  • Vitamins
  • Xanthophylls
  • Zeaxanthins
  • Zinc Compounds
  • Vitamin E
  • Carotenoids
  • Copper
  • astaxanthine
  • Ascorbic Acid
  • Lutein