Skip to main content
Top
Published in: Advances in Therapy 9/2019

Open Access 01-09-2019 | Macular Degeneration | Brief Report

Effects of Macuprev® Supplementation in Age-Related Macular Degeneration: A Double-Blind Randomized Morpho-Functional Study Along 6 Months of Follow-Up

Authors: Mariacristina Parravano, Massimiliano Tedeschi, Daniela Manca, Eliana Costanzo, Antonio Di Renzo, Paola Giorno, Lucilla Barbano, Lucia Ziccardi, Monica Varano, Vincenzo Parisi

Published in: Advances in Therapy | Issue 9/2019

Login to get access

Abstract

Background

To evaluate the effects of Macuprev® supplementation on macular function and structure in intermediate age-related macular degeneration (AMD) along 6 months of follow-up.

Methods

In this double-blind, monocentric, randomized, and prospective study, 30 patients with intermediate AMD were enrolled and randomly divided into two age-similar groups: 15 patients (AMD-M group; mean age 68.50 ± 8.79 years) received 6-month oral daily supplementation with Macuprev® (Farmaplus Italia s.r.l., Italy, two tablets/day on an empty stomach, before meals; contained in total lutein 20 mg, zeaxanthin 4 mg, N-acetylcysteine 140 mg, bromelain 2500GDU 80 mg, vitamin D3 800 IU, vitamin B12 18 mg, alpha-lipoic acid 140 mg, rutin 157 mg, vitamin C 160 mg, zinc oxide 16 mg, Vaccinium myrtillus 36% anthocyanosides 90 mg, Ganoderma lucidum 600 mg) and 15 patients (AMD-P group; mean age 70.14 ± 9.87) received two tablets of placebo daily on an empty stomach, before meals. A total of 28 eyes, 14 from each AMD group, completed the study. Multifocal electroretinogram (mfERG) and spectral domain-optical coherence tomography (SD-OCT) were assessed at baseline and after 6 months.

Results

At 6-month follow-up, AMD-M eyes showed a significant increase of mfERG response amplitude density (RAD) recorded from the central macular areas (ring 1, 0–2.5°; ring 2, 2.5–5°), whereas non-significant changes of retinal and choroidal SD-OCT parameters were found when values were compared to baseline. Non-significant correlations between functional and structural changes were found. In AMD-P eyes, non-significant differences for each mfERG and SD-OCT parameters were observed at 6 months.

Conclusions

In intermediate AMD, Macuprev® supplementation increases the function of the macular pre-ganglionic elements, with no associated retinal and choroidal ultra-structural changes.

Trial Registration

ClinicalTrials.gov identifier, NCT03919019.

Funding

Research for this study was financially supported by the Italian Ministry of Health and Fondazione Roma. Article processing charges were funded by Farmaplus Italia s.r.l., Italy.
Literature
1.
go back to reference Evans JR, Fletcher AE, Wormald RP, et al. Prevalence of visual impairment in people aged 75 years and older in Britain: results from the MRC trial of assessment and management of older people in the community. Br J Ophthalmol. 2002;86:795–800.CrossRefPubMedPubMedCentral Evans JR, Fletcher AE, Wormald RP, et al. Prevalence of visual impairment in people aged 75 years and older in Britain: results from the MRC trial of assessment and management of older people in the community. Br J Ophthalmol. 2002;86:795–800.CrossRefPubMedPubMedCentral
2.
go back to reference Ferris FL 3rd, Wilkinson CP, Bird A, et al. Beckman initiative for macular research classification committee. Clinical classification of age-related macular degeneration. Ophthalmology. 2013;120:844–51.CrossRefPubMed Ferris FL 3rd, Wilkinson CP, Bird A, et al. Beckman initiative for macular research classification committee. Clinical classification of age-related macular degeneration. Ophthalmology. 2013;120:844–51.CrossRefPubMed
3.
go back to reference Jaffe GJ, Martin DF, Toth CA, et al. Macular morphology and visual acuity in the comparison of age-related macular degeneration treatments trials. Ophthalmology. 2013;120:1860–70.CrossRefPubMedPubMedCentral Jaffe GJ, Martin DF, Toth CA, et al. Macular morphology and visual acuity in the comparison of age-related macular degeneration treatments trials. Ophthalmology. 2013;120:1860–70.CrossRefPubMedPubMedCentral
4.
go back to reference Hood DC. Assessing retinal function with the multifocal technique. Prog Retin Eye Res. 2000;19:607–46.CrossRefPubMed Hood DC. Assessing retinal function with the multifocal technique. Prog Retin Eye Res. 2000;19:607–46.CrossRefPubMed
5.
go back to reference Parisi V, Tedeschi M, Gallinaro G, et al. Carotenoids and antioxidants in age-related maculopathy Italian study: multifocal electroretinogram modifications after 1 year. Ophthalmology. 2008;115:324–33.CrossRefPubMed Parisi V, Tedeschi M, Gallinaro G, et al. Carotenoids and antioxidants in age-related maculopathy Italian study: multifocal electroretinogram modifications after 1 year. Ophthalmology. 2008;115:324–33.CrossRefPubMed
6.
go back to reference Parisi V, Perillo L, Tedeschi M, et al. Macular function in eyes with early age-related macular degeneration with or without contralateral late age-related macular degeneration. Retina. 2007;27:879–90.CrossRefPubMed Parisi V, Perillo L, Tedeschi M, et al. Macular function in eyes with early age-related macular degeneration with or without contralateral late age-related macular degeneration. Retina. 2007;27:879–90.CrossRefPubMed
7.
go back to reference Moschos MM, Nitoda E. The role of mf-ERG in the diagnosis and treatment of age-related macular degeneration: electrophysiological features of AMD. Semin Ophthalmol. 2018;33:461–9.CrossRefPubMed Moschos MM, Nitoda E. The role of mf-ERG in the diagnosis and treatment of age-related macular degeneration: electrophysiological features of AMD. Semin Ophthalmol. 2018;33:461–9.CrossRefPubMed
8.
go back to reference Heinemann-Vernaleken B, Palmowski AM, Allgayer R, Ruprecht KW. Comparison of different high resolution multifocal electroretinogram recordings in patients with age-related maculopathy. Graefes Arch Clin Exp Ophthalmol. 2001;239:556–61.CrossRefPubMed Heinemann-Vernaleken B, Palmowski AM, Allgayer R, Ruprecht KW. Comparison of different high resolution multifocal electroretinogram recordings in patients with age-related maculopathy. Graefes Arch Clin Exp Ophthalmol. 2001;239:556–61.CrossRefPubMed
9.
go back to reference Rimayanti U, Kiuchi Y, Yamane K, et al. Inner retinal layer comparisons of eyes with exudative age-related macular degeneration and eyes with age-related macular degeneration and glaucoma. Graefes Arch Clin Exp Ophthalmol. 2014;252:563–70.CrossRefPubMed Rimayanti U, Kiuchi Y, Yamane K, et al. Inner retinal layer comparisons of eyes with exudative age-related macular degeneration and eyes with age-related macular degeneration and glaucoma. Graefes Arch Clin Exp Ophthalmol. 2014;252:563–70.CrossRefPubMed
10.
go back to reference Lee EK, Yu HG. Ganglion cell-inner plexiform layer and peripapillary retinal nerve fiber layer thicknesses in age-related macular degeneration. Invest Ophthalmol Vis Sci. 2015;56:3976–83.CrossRefPubMed Lee EK, Yu HG. Ganglion cell-inner plexiform layer and peripapillary retinal nerve fiber layer thicknesses in age-related macular degeneration. Invest Ophthalmol Vis Sci. 2015;56:3976–83.CrossRefPubMed
11.
go back to reference Wood A, Binns A, Margrain T, et al. Retinal and choroidal thickness in early age-related macular degeneration. Am J Ophthalmol. 2011;152:1030–8.CrossRefPubMed Wood A, Binns A, Margrain T, et al. Retinal and choroidal thickness in early age-related macular degeneration. Am J Ophthalmol. 2011;152:1030–8.CrossRefPubMed
12.
go back to reference Schuman SG, Koreishi AF, Farsiu S, Jung SH, Izatt JA, Toth CA. Photoreceptor layer thinning over drusen in eyes with age-related macular degeneration imaged in vivo with spectral-domain optical coherence tomography. Ophthalmology. 2009;116:488–96.CrossRefPubMedPubMedCentral Schuman SG, Koreishi AF, Farsiu S, Jung SH, Izatt JA, Toth CA. Photoreceptor layer thinning over drusen in eyes with age-related macular degeneration imaged in vivo with spectral-domain optical coherence tomography. Ophthalmology. 2009;116:488–96.CrossRefPubMedPubMedCentral
13.
go back to reference Yang S, Zuo C, Xiao H, et al. Photoreceptor dysfunction in early and intermediate age-related macular degeneration assessed with mfERG and spectral domain OCT. Doc Ophthalmol. 2016;132:17–26.CrossRefPubMed Yang S, Zuo C, Xiao H, et al. Photoreceptor dysfunction in early and intermediate age-related macular degeneration assessed with mfERG and spectral domain OCT. Doc Ophthalmol. 2016;132:17–26.CrossRefPubMed
14.
go back to reference Cohen SY, Dubois L, Tadayoni R, Delahaye-Mazza C, Debibie C, Quentel G. Prevalence of reticular pseudodrusen in age-related macular degeneration with newly diagnosed choroidal neovascularisation. Br J Ophthalmol. 2007;91:354–9.CrossRefPubMed Cohen SY, Dubois L, Tadayoni R, Delahaye-Mazza C, Debibie C, Quentel G. Prevalence of reticular pseudodrusen in age-related macular degeneration with newly diagnosed choroidal neovascularisation. Br J Ophthalmol. 2007;91:354–9.CrossRefPubMed
15.
go back to reference Wilde C, Patel M, Lakshmanan A, Morales MA, Dhar-Munshi S, Amoaku WM. Prevalence of reticular pseudodrusen in eyes with newly presenting neovascular age-related macular degeneration. Eur J Ophthalmol. 2016;26:128–34.CrossRefPubMed Wilde C, Patel M, Lakshmanan A, Morales MA, Dhar-Munshi S, Amoaku WM. Prevalence of reticular pseudodrusen in eyes with newly presenting neovascular age-related macular degeneration. Eur J Ophthalmol. 2016;26:128–34.CrossRefPubMed
16.
go back to reference Laíns I, Wang J, Providência J, et al. Choroidal changes associated with subretinal drusenoid deposits in age-related macular degeneration using swept-source optical coherence tomography. Am J Ophthalmol. 2017;180:55–63.CrossRefPubMed Laíns I, Wang J, Providência J, et al. Choroidal changes associated with subretinal drusenoid deposits in age-related macular degeneration using swept-source optical coherence tomography. Am J Ophthalmol. 2017;180:55–63.CrossRefPubMed
18.
go back to reference Yiu G, Chiu SJ, Petrou PA, et al. Relationship of central choroidal thickness with age-related macular degeneration status. Am J Ophthalmol. 2015;159:617–26.CrossRefPubMed Yiu G, Chiu SJ, Petrou PA, et al. Relationship of central choroidal thickness with age-related macular degeneration status. Am J Ophthalmol. 2015;159:617–26.CrossRefPubMed
19.
go back to reference Age-Related Eye Disease Study 2 Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. JAMA. 2013;309:2005–15.CrossRef Age-Related Eye Disease Study 2 Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. JAMA. 2013;309:2005–15.CrossRef
20.
go back to reference Piermarocchi S, Saviano S, Parisi V, et al. Carotenoids in Age-related Maculopathy Italian Study (CARMIS): two-year results of a randomized study. Eur J Ophthalmol. 2011;22:216–25. Piermarocchi S, Saviano S, Parisi V, et al. Carotenoids in Age-related Maculopathy Italian Study (CARMIS): two-year results of a randomized study. Eur J Ophthalmol. 2011;22:216–25.
21.
go back to reference Parisi V, Ziccardi L, Centofanti M, et al. Macular function in eyes with open-angle glaucoma evaluated by multifocal electroretinogram. Invest Ophthalmol Vis Sci. 2012;53:6973–80.CrossRefPubMed Parisi V, Ziccardi L, Centofanti M, et al. Macular function in eyes with open-angle glaucoma evaluated by multifocal electroretinogram. Invest Ophthalmol Vis Sci. 2012;53:6973–80.CrossRefPubMed
22.
go back to reference Hood DC, Bach M, Brigell M, et al. ISCEV standard for clinical multifocal electroretinography (2011 edition). Doc Ophthalmol. 2012;124:1–13.CrossRefPubMed Hood DC, Bach M, Brigell M, et al. ISCEV standard for clinical multifocal electroretinography (2011 edition). Doc Ophthalmol. 2012;124:1–13.CrossRefPubMed
23.
go back to reference Berrow EJ, Bartlett HE, Eperjesi F. The effect of nutritional supplementation on the multifocal electroretinogram in healthy eyes. Doc Ophthalmol. 2016;132:123–35.CrossRefPubMed Berrow EJ, Bartlett HE, Eperjesi F. The effect of nutritional supplementation on the multifocal electroretinogram in healthy eyes. Doc Ophthalmol. 2016;132:123–35.CrossRefPubMed
24.
go back to reference Moschos MM, Dettoraki M, Tsatsos M, Kitsos G, Kalogeropoulos C. Effect of carotenoids dietary supplementation on macular function in diabetic patients. Eye Vis (Lond). 2017;4:23.CrossRef Moschos MM, Dettoraki M, Tsatsos M, Kitsos G, Kalogeropoulos C. Effect of carotenoids dietary supplementation on macular function in diabetic patients. Eye Vis (Lond). 2017;4:23.CrossRef
25.
go back to reference Berrow EJ, Bartlett HE, Eperjesi F, Gibson JM. The effects of a lutein-based supplement on objective and subjective measures of retinal and visual function in eyes with age-related maculopathy—a randomised controlled trial. Br J Nutr. 2013;109:2008–14.CrossRefPubMed Berrow EJ, Bartlett HE, Eperjesi F, Gibson JM. The effects of a lutein-based supplement on objective and subjective measures of retinal and visual function in eyes with age-related maculopathy—a randomised controlled trial. Br J Nutr. 2013;109:2008–14.CrossRefPubMed
26.
go back to reference Ma L, Dou HL, Huang YM, et al. Improvement of retinal function in early age-related macular degeneration after lutein and zeaxanthin supplementation: a randomized, double-masked, placebo-controlled trial. Am J Ophthalmol. 2012;154:625–34.CrossRefPubMed Ma L, Dou HL, Huang YM, et al. Improvement of retinal function in early age-related macular degeneration after lutein and zeaxanthin supplementation: a randomized, double-masked, placebo-controlled trial. Am J Ophthalmol. 2012;154:625–34.CrossRefPubMed
27.
go back to reference Snodderly DM, Handelman GJ, Adler AJ. Distribution of individual macular pigment carotenoids in central retina of macaque and squirrel monkeys. Invest Ophthalmol Vis Sci. 1991;32:268–79.PubMed Snodderly DM, Handelman GJ, Adler AJ. Distribution of individual macular pigment carotenoids in central retina of macaque and squirrel monkeys. Invest Ophthalmol Vis Sci. 1991;32:268–79.PubMed
28.
go back to reference Bone RA, Landrum JT, Fernandez L, Tarsis SL. Analysis of the macular pigment by HPLC: retinal distribution and age study. Invest Ophthalmol Vis Sci. 1988;29:843–9.PubMed Bone RA, Landrum JT, Fernandez L, Tarsis SL. Analysis of the macular pigment by HPLC: retinal distribution and age study. Invest Ophthalmol Vis Sci. 1988;29:843–9.PubMed
29.
go back to reference Curcio CA. Photoreceptor topography in ageing and age-related maculopathy. Eye (Lond). 2001;15:376–83.CrossRef Curcio CA. Photoreceptor topography in ageing and age-related maculopathy. Eye (Lond). 2001;15:376–83.CrossRef
30.
go back to reference Curcio CA, Sloan KR, Kalina RE, Hendrickson AE. Human photoreceptor topography. J Comp Neurol. 1990;292:497–523.CrossRefPubMed Curcio CA, Sloan KR, Kalina RE, Hendrickson AE. Human photoreceptor topography. J Comp Neurol. 1990;292:497–523.CrossRefPubMed
31.
go back to reference Obana A, Tanito M, Gohto Y, Okazaki S, Gellermann W, Bernstein PS. Changes in macular pigment optical density and serum lutein concentration in Japanese subjects taking two different lutein supplements. PLoS One. 2015;10:e0139257.CrossRefPubMedPubMedCentral Obana A, Tanito M, Gohto Y, Okazaki S, Gellermann W, Bernstein PS. Changes in macular pigment optical density and serum lutein concentration in Japanese subjects taking two different lutein supplements. PLoS One. 2015;10:e0139257.CrossRefPubMedPubMedCentral
32.
go back to reference Stahl W, Sies H. Bioactivity and protective effects of natural carotenoids. Biochim Biophys Acta. 2005;1740:101–7.CrossRefPubMed Stahl W, Sies H. Bioactivity and protective effects of natural carotenoids. Biochim Biophys Acta. 2005;1740:101–7.CrossRefPubMed
33.
go back to reference Huang Y, Dou H, Huang F, et al. Changes following supplementation with lutein and zeaxanthin in retinal function in eyes with early age-related macular degeneration: a randomised, double-blind, placebo-controlled trial. Br J Ophthalmology. 2015;99:371–5.CrossRef Huang Y, Dou H, Huang F, et al. Changes following supplementation with lutein and zeaxanthin in retinal function in eyes with early age-related macular degeneration: a randomised, double-blind, placebo-controlled trial. Br J Ophthalmology. 2015;99:371–5.CrossRef
34.
go back to reference Seddon JM, Ajani UA, Sperduto RD, et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group. J Am Med Assoc. 1994;272:1413–20.CrossRef Seddon JM, Ajani UA, Sperduto RD, et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group. J Am Med Assoc. 1994;272:1413–20.CrossRef
35.
go back to reference Bone RA, Landrum JT, Mayne ST, Gomez CM, Tibor SE, Twaroska EE. Macular pigment in donor eyes with and without AMD: a case–control study. Invest Ophthalmol Vis Sci. 2001;42:235–40.PubMed Bone RA, Landrum JT, Mayne ST, Gomez CM, Tibor SE, Twaroska EE. Macular pigment in donor eyes with and without AMD: a case–control study. Invest Ophthalmol Vis Sci. 2001;42:235–40.PubMed
36.
go back to reference Malinow MR, Feeney-Burns L, Peterson LH, Klein ML, Neuringer M. Diet-related macular anomalies in monkeys. Invest Ophthalmol Vis Sci. 1980;19:857–63.PubMed Malinow MR, Feeney-Burns L, Peterson LH, Klein ML, Neuringer M. Diet-related macular anomalies in monkeys. Invest Ophthalmol Vis Sci. 1980;19:857–63.PubMed
37.
go back to reference Thomson LR, Toyoda Y, Langner A, et al. Elevated retinal zeaxanthin and prevention of light-induced photoreceptor cell death in quail. Invest Ophthalmol Vis Sci. 2002;43:3538–49.PubMed Thomson LR, Toyoda Y, Langner A, et al. Elevated retinal zeaxanthin and prevention of light-induced photoreceptor cell death in quail. Invest Ophthalmol Vis Sci. 2002;43:3538–49.PubMed
38.
go back to reference Carver KA, Yang D. N-Acetylcysteine amide protects against oxidative stress-induced microparticle release from human retinal pigment epithelial cells. Invest Ophthalmol Vis Sci. 2016;57:360–71.CrossRefPubMedPubMedCentral Carver KA, Yang D. N-Acetylcysteine amide protects against oxidative stress-induced microparticle release from human retinal pigment epithelial cells. Invest Ophthalmol Vis Sci. 2016;57:360–71.CrossRefPubMedPubMedCentral
39.
go back to reference Nakayama M, Aihara M, Chen YN, Araie M, Tomita-Yokotani K, Iwashina T. Neuroprotective effects of flavonoids on hypoxia-, glutamate-, and oxidative stress-induced retinal ganglion cell death. Mol Vis. 2011;17:1784–93.PubMedPubMedCentral Nakayama M, Aihara M, Chen YN, Araie M, Tomita-Yokotani K, Iwashina T. Neuroprotective effects of flavonoids on hypoxia-, glutamate-, and oxidative stress-induced retinal ganglion cell death. Mol Vis. 2011;17:1784–93.PubMedPubMedCentral
40.
go back to reference Kim YS, Kim M, Choi MY, et al. Alpha-lipoic acid reduces retinal cell death in diabetic mice. Biochem Biophys Res Commun. 2018;503:1307–14.CrossRefPubMed Kim YS, Kim M, Choi MY, et al. Alpha-lipoic acid reduces retinal cell death in diabetic mice. Biochem Biophys Res Commun. 2018;503:1307–14.CrossRefPubMed
41.
go back to reference Evans JR, Lawrenson JG. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. Cochrane Database Syst Rev. 2012;14(11):CD00025440. Evans JR, Lawrenson JG. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. Cochrane Database Syst Rev. 2012;14(11):CD00025440.
42.
go back to reference de Lencastre Novaes LC, Jozala AF, Lopes AM, et al. Stability, purification, and applications of bromelain: a review. Biotechnol Prog. 2016;32:5–13.CrossRefPubMed de Lencastre Novaes LC, Jozala AF, Lopes AM, et al. Stability, purification, and applications of bromelain: a review. Biotechnol Prog. 2016;32:5–13.CrossRefPubMed
43.
go back to reference Kauppinen A, Paterno JJ, Blasiak J, Salminen A, Kaarniranta K. Inflammation and its role in age-related macular degeneration. Cell Mol Life Sci. 2016;73:1765–86.CrossRefPubMedPubMedCentral Kauppinen A, Paterno JJ, Blasiak J, Salminen A, Kaarniranta K. Inflammation and its role in age-related macular degeneration. Cell Mol Life Sci. 2016;73:1765–86.CrossRefPubMedPubMedCentral
Metadata
Title
Effects of Macuprev® Supplementation in Age-Related Macular Degeneration: A Double-Blind Randomized Morpho-Functional Study Along 6 Months of Follow-Up
Authors
Mariacristina Parravano
Massimiliano Tedeschi
Daniela Manca
Eliana Costanzo
Antonio Di Renzo
Paola Giorno
Lucilla Barbano
Lucia Ziccardi
Monica Varano
Vincenzo Parisi
Publication date
01-09-2019
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 9/2019
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-019-01016-2

Other articles of this Issue 9/2019

Advances in Therapy 9/2019 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.