Ретроспективний аналіз прогресування ранньої сухої форми вікової дегенерації макули в залежності від застосування комплексного нутрицевтика (4 роки спостереження)

N.S. Lutsenko; O.A. Rudycheva; O.A. Isakova; N.S. Kyrylova

doi:10.31288/oftalmolzh202361115

Authors

N.S. Lutsenko Educational and Scientific Institute of Postgraduate Education, Zaporizhzhia State Medical and Pharmaceutical University, CNE “Zaporizhzhia Regional Clinical Hospital” of the Zaporizhzhia Regional Council
O.A. Rudycheva Educational and Scientific Institute of Postgraduate Education, Zaporizhzhia State Medical and Pharmaceutical University, CNE “Zaporizhzhia Regional Clinical Hospital” of the Zaporizhzhia Regional Council
O.A. Isakova Educational and Scientific Institute of Postgraduate Education, Zaporizhzhia State Medical and Pharmaceutical University, CNE “Zaporizhzhia Regional Clinical Hospital” of the Zaporizhzhia Regional Council
N.S. Kyrylova Educational and Scientific Institute of Postgraduate Education, Zaporizhzhia State Medical and Pharmaceutical University, CNE “Zaporizhzhia Regional Clinical Hospital” of the Zaporizhzhia Regional Council

DOI:

https://doi.org/10.31288/oftalmolzh202361115

Keywords:

age-related macular degeneration, nutraceutical, progression, optical coherence tomography, changes in retinal morphology

Abstract

Purpose: To retrospectively analyze the optical coherence tomography (OCT) changes in retinal morphology and progression in these changes in patients with early dry age-related macular degeneration (AMD) receiving versus not receiving a multi-component nutraceutical daily for four years.
Material and Methods: We retrospectively analyzed disease progression in 52 patients (98 eyes) with early dry AMD who had been regularly followed up for four years. Group 1 was comprised of 24 patients (98 eyes) who had been receiving vitamin and mineral tablets containing the AREDS2 formulation plus resveratrol and vitamin D daily for four years. Group 2 was comprised of 28 patients (53 eyes) who had not been receiving any nutritional supplement. Retinal morphology was assessed by OCT and OCT angiography.
Results: In group 1, best-corrected visual acuity (BCVA) did not change after completion of the 4-year observation period compared to baseline (0.6 ± 02, p = 0.72). In group 2, BCVA was 0.6 ± 0.2 at baseline and decreased to 0.2 ± 0.2 in four years (p ≤ 0.001). In patients with a low to moderate risk of progression in groups 1 and 2, the four-year progression rate was 15.4% and 45.4%, respectively, which corresponds to an annual progression rate of 3.8% and 11.3%, respectively. In patients with a high risk of progression in groups 1 and 2, the four-year progression rate was 26.3% and 80%, respectively, which corresponds to an annual progression rate of 6.5% and 20%, respectively. Patients who had early dry AMD eyes with a low to moderate risk of progression (and a high risk of progression) at baseline and were not taking the nutritional supplement, had 4.58 greater odds (95% CI, 1.291 – 16.267; р = 0.018) [and 11.2 greater odds (95% CI, 2.505 – 50.081; р = 0.0016)] of having AMD progression than those receiving the nutritional supplement daily for four years.
Conclusion: A regular intake of tablets containing the AREDS2 formulation plus resveratrol and vitamin D slows the progression of early dry AMD, especially in eyes with a high risk of disease progression, and contributes to the preservation of visual function.

References

Cheung LK, Eaton A. Age-related macular degeneration. Pharmacotherapy. 2013 Aug 11;33(8):838-55. https://doi.org/10.1002/phar.1264

Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol. 2012 May;96(5):614-8. https://doi.org/10.1136/bjophthalmol-2011-300539

Tuychibaeva D. Epidemiological and clinical-functional aspects of the combined course of age-related macular degeneration and primary glaucoma. J.ophthalmol.(Ukraine).2023 Jun 30;(3):3-8. https://doi.org/10.31288/oftalmolzh2023338

Pennington KL, DeAngelis MM. Epidemiology of age-related macular degeneration (AMD): associations with cardiovascular disease phenotypes and lipid factors. Eye Vis (Lond). 2016 Dec 22;3:34. https://doi.org/10.1186/s40662-016-0063-5

Shintani T, Klionsky DJ. Autophagy in health and disease: a double-edged sword. Science. 2004 Nov 5;306(5698):990-5. https://doi.org/10.1126/science.1099993

Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8. Arch Ophthalmol. 2001 Oct;119(10):1417-36. https://doi.org/10.1001/archopht.119.10.1417

Age-Related Eye Disease Study 2 (AREDS2) Research Group; Chew EY, Clemons TE, Sangiovanni JP, Danis RP, Ferris FL 3rd, Elman MJ,et al. Secondary analyses of the effects of lutein/zeaxanthin on age-related macular degeneration progression: AREDS2 report No. 3. JAMA Ophthalmol. 2014 Feb;132(2):142-9. https://doi.org/10.1001/jamaophthalmol.2013.7376

National Institute for Health and Care Excellence (NICE). Age-related macular degeneration: diagnosis and management. Appendix K, Age-related macular degeneration classification. [Internet]. London: National Institute for Health and Care Excellence (NICE); 2018 Jan[cited 2023 Jul 29]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536460/

MedCalc Software Ltd. Odds ratio calculator[Internet].Belgium: MedCalc Software Ltd;2023 [accessed 2023 Jul 29]. Available from: https://www.medcalc.org/calc/odds_ratio.php

Beatty S, Boulton M, Henson D, Koh HH, Murray IJ. Macular pigment and age-related macular degeneration. Br J Ophthalmol. 1999 Jul;83(7):867-77. https://doi.org/10.1136/bjo.83.7.867

Bone RA, Landrum JT, Guerra LH, Ruiz CA. Lutein and zeaxanthin dietary supplements raise macular pigment density and serum concentrations of these carotenoids in humans. J Nutr. 2003 Apr;133(4):992-8. https://doi.org/10.1093/jn/133.4.992

Aslam T, Delcourt C, Holz F, García-Layana A, Leys A, Silva RM, Souied E. European survey on the opinion and use of micronutrition in age-related macular degeneration: 10 years on from the Age-Related Eye Disease Study. Clin Ophthalmol. 2014 Oct 10;8:2045-53. https://doi.org/10.2147/OPTH.S63937

Bryl A, Falkowski M, Zorena K, Mrugacz M. The Role of Resveratrol in Eye Diseases-A Review of the Literature. Nutrients. 2022 Jul 20;14(14):2974. https://doi.org/10.3390/nu14142974

Layana AG, Minnella AM, Garhöfer G, Aslam T, Holz FG, Leys A, Silva R, et al. Vitamin D and Age-Related Macular Degeneration. Nutrients. 2017 Oct 13;9(10):1120. https://doi.org/10.3390/nu9101120

Tikellis G, Robman LD, Dimitrov P, Nicolas C, McCarty CA, Guymer RH. Characteristics of progression of early age-related macular degeneration: the cardiovascular health and age-related maculopathy study. Eye (Lond). 2007 Feb;21(2):169-76. https://doi.org/10.1038/sj.eye.6702151

Brandl C, Günther F, Zimmermann ME, Hartmann KI, Eberlein G, Barth T, et al. Incidence, progression and risk factors of age-related macular degeneration in 35-95-year-old individuals from three jointly designed German cohort studies. BMJ Open Ophthalmol. 2022 Jan 4;7(1):e000912. https://doi.org/10.1136/bmjophth-2021-000912

Robman L, Vu H, Hodge A, Tikellis G, Dimitrov P, McCarty C, Guymer R. Dietary lutein, zeaxanthin, and fats and the progression of age-related macular degeneration. Can J Ophthalmol. 2007 Oct;42(5):720-6. https://doi.org/10.3129/i07-116

Robman L, Mahdi O, McCarty C, et al. Exposure to Chlamydia pneumoniae infection and progression of age-related macular degeneration. Am J Epidemiol. 2005 Jun 1;161(11):1013-9. https://doi.org/10.1093/aje/kwi130