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Lutein/zeaxanthin may not significantly reduce rate of cataract
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Daily oral supplementation with lutein/zeaxanthin had an insignificant effect on rates of cataract development and cataract surgery, according to a sub-analysis of the Age-Related Eye Disease Study 2.
Results of the study were released at the Association for Research in Vision and Ophthalmology meeting and published in JAMA and JAMA Ophthalmology.
The primary outcome measure of AREDS2 was the effect of lutein/zeaxanthin and two omega-3 long-chain polyunsaturated fatty acids on progression to advanced age-related macular degeneration. The impact of the supplements on cataract was a secondary outcome.
Substituting lutein/zeaxanthin for beta carotene was safer for patients who took those supplements to reduce their risk of AMD, according to G. Baker Hubbard, MD, of Emory University, one of the trial centers.
“We know these supplements work to lower macular degeneration, but adding the omega-3 fatty acids and adding lutein and zeaxanthin doesn’t make it work any better. But it does show that if you substitute lutein/zeaxanthin for beta carotene, you get the same beneficial effect but it’s safer,” Hubbard told Ocular Surgery News.
Hubbard also noted that lutein/zeaxanthin was safer for smokers and that there was no clear difference for non-smokers.
“Where the safety difference was seen was in patients who are smokers and at risk for lung cancer. If you’re a non-smoker, then it’s not so clear cut that lutein/zeaxanthin is any safer than beta carotene. If you’re a smoker, then it’s definitely safer to use the lutein/zeaxanthin in substitution for the beta carotene,” Hubbard said.
The multicenter, double-masked clinical trial included 4,203 patients with a high risk of progression to advanced AMD; 6,027 eyes of 3,159 patients were enrolled in the cataract trial and 1,389 eyes of 876 patients underwent cataract surgery. Median follow-up was 4.7 years. Mean patient age was 72 years.
Seven hundred seventy-five patients received a placebo, 787 received lutein/zeaxanthin, 803 received docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), and 794 received combined lutein/zeaxanthin, DHA and EPA.
The 5-year probability of progression to cataract surgery was 24% in the lutein/zeaxanthin group and the no lutein/zeaxanthin group.
Among the 6,027 eyes, 1,833 eyes (30%) developed any kind of cataract; 1,504 eyes (25%) developed severe cataract. There was no statistically significant difference between the lutein/zeaxanthin group and the no lutein/zeaxanthin group regarding cataract development.
None of the nutrients analyzed had an impact on rates of vision loss of 15 or more letters.
Disclosure: Hubbard has no relevant financial disclosures.
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