Role of Carotenoids in Prevention and Treatment of Age-related Macular Degeneration: Review of Studies and Future Perspectives
Age-related macular degeneration (AMD) is a chronic degenerative disease of the retina characterized by degradation of photoreceptors and retinal pigment epithelial cells in the macula, leading to loss of visual acuity and sharpness (Golestaneh et al., 2017; Rickman et al., 2018).
The most common eye disease among the elderly, especially those over 65 years old, and is a leading cause of irreversible blindness globally (WHO, 2019).
Currently, available treatment options only reduce the rate of disease progression and are not effective in managing AMD in all patients.
AMD is a multifactorial disease where oxidative and inflammatory stress play central roles.
The macula is an area of the retina highly exposed to oxidative stress caused by light and high metabolic levels (Abokyi et al., 2020; Jabbehdari and Handa, 2021). Lutein, zeaxanthin, and meso-zeaxanthin are carotenoids known as macular pigments because of their specific accumulation in the macula.
These carotenoids have strong antioxidant and light-absorbing activities, which can protect the macula from oxidative damage and light-induced stress.
This review aims to highlight the role of oxidative and inflammatory stress in the pathogenesis of age-related macular degeneration and evaluate the benefits of plant carotenoids in mitigating AMD development based on relevant cellular, animal, and clinical studies.
Factors associated with their efficacy have been evaluated to formulate a non-invasive and proactive preventive and treatment strategy against age-related macular degeneration.
Clinical studies have demonstrated the benefits of all three carotenoids on the eyes of healthy individuals (Bone et al., 2020; Bone et al., 2018; Green-Gomez et al., 2020; Loughman et al., 2012), and this review specifically focuses on their potential to halt AMD progression to support future guidelines on functional foods or complementary medicine.
A detailed study explored the benefits of these important compounds through a combination of clinical, cellular, and animal research.
RESULTS – It was highlighted that the amount and timing of carotenoid administration can influence their protective effects. This information is crucial for developing synergistic approaches aimed at improving vision in AMD patients.
Essential to note that the protective effects of macular pigments are maximized when all three carotenoids are integrated.
However, it appears that lutein alone is sufficient to prevent macular degeneration and is a more cost-effective and environmentally sustainable choice compared to supplementation with meso-zeaxanthin or zeaxanthin.
Additionally, the modes of carotenoid administration could be optimized to enhance their effectiveness. Direct administration into the eye could represent a promising strategy, considering the lipophilic nature of these pigments and their ability to filter harmful light. These developments could have a significant impact on the prevention and treatment of age-related macular degeneration.
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Source: Dao Nguyen, Thilini Thrimawithana, Terrence J. Piva, Danilla Grando, Tien Huynh Benefits of plant carotenoids against age-related macular degeneration, Journal of Functional Foods, Volume 106, 2023, 105597, ISSN 1756-4646, https://doi.org/10.1016/j.jff.2023.105597.