Current evidence suggests lutein and its isomers play important roles in ocular development in utero and throughout the life span, in vision performance in young and later adulthood, and in lowering risk for the development of common age-related eye diseases in older age. These xanthophyll (oxygen-containing) carotenoids are found in a wide variety of vegetables and fruits, and they are present in especially high concentrations in leafy green vegetables. Additionally, egg yolks and human milk appear to be bioavailable sources. The prevalence of lutein, zeaxanthin, and meso-zeaxanthin in supplements is increasing. Setting optimal and safe ranges of intake requires additional research, particularly in pregnant and lactating women. Accumulating evidence about variable interindividual response to dietary intake of these carotenoids, based on genetic or metabolic influences, suggests that there may be subgroups that benefit from higher levels of intake and/or alternate strategies to improve lutein and zeaxanthin status.

Age-related macular degeneration (AMD) is a degenerative disease of the macula, the region of the retina that is responsible for central vision. It is the leading cause of irreversible vision loss as people age in the United States.¹ In its later stages, AMD affects about 7% of people between the ages of 75 and 84 years.² Early and intermediate stages of AMD, which increase the risk of developing advanced AMD,³ are even more common, affecting about one quarter of people older than 65 years.² Because there is no cure for this condition and limited treatment is available to slow its progression, and there are no established means of prevention, it is important to identify modifiable risk factors that may reduce disease occurrence or prevent progression to the late stages of AMD. The pathogenesis of AMD is likely to involve a complex interaction of cellular and vascular factors, which may be promoted by light damage,⁴ oxidative stress,⁵ and inflammation.⁶

Research from JAMA Ophthalmology — Association Between Vitamin D and Age-Related Macular Degeneration in the Third National Health and Nutrition Examination Survey, 1988 Through 1994

The macula of the human eye progressively degenerates with age, more quickly in some people than in others. This can lead to advanced age-related macular degeneration (AMD), which involves the loss of photoreceptors in the macula of the eye. Treatment for advanced AMD is of limited effectiveness, is costly,¹ and will become even more costly as the number of older Americans increases in the coming decades.² Moreover, it profoundly limits the ability of older adults to function independently. The loss of central vision associated with advanced AMD diminishes the ability to see and recognize other people's faces and to read fine print such as that in newspapers and on pill bottles and food packages.

Purpose.: We tested variants in genes related to lutein and zeaxanthin status for association with age-related macular degeneration (AMD) in the Carotenoids in Age-Related Eye Disease Study (CAREDS). Methods.: Of 2005 CAREDS participants, 1663 were graded for AMD from fundus photography and genotyped for 424 single nucleotide polymorphisms (SNPs) from 24 candidate genes for carotenoid status. Of 337 AMD cases 91% had early or intermediate AMD. The SNPs were tested individually for association with AMD using logistic regression. A carotenoid-related genetic risk model was built using backward selection and compared to existing AMD risk factors using the area under the receiver operating characteristic curve (AUC). Results.: A total of 24 variants from five genes (BCMO1, BCO2, NPCL1L1, ABCG8, and FADS2) not previously related to AMD and four genes related to AMD in previous studies (SCARB1, ABCA1, APOE, and ALDH3A2) were associated independently with AMD, after adjusting for age and ancestry. Variants in all genes (not always the identical SNPs) were associated with lutein and zeaxanthin in serum and/or macula, in this or other samples, except for BCO2 and FADS2. A genetic risk score including nine variants significantly (P = 0.002) discriminated between AMD cases and controls beyond age, smoking, CFH Y402H, and ARMS2 A69S. The odds ratio (95% confidence interval) for AMD among women in the highest versus lowest quintile for the risk score was 3.1 (2.0–4.9). Conclusions.: Variants in genes related to lutein and zeaxanthin status were associated with AMD in CAREDS, adding to the body of evidence supporting a protective role of lutein and zeaxanthin in risk of AMD.

Age-related macular degeneration (AMD), a chronic, late-onset disease that results in degeneration of the macula, is the leading cause of adult irreversible vision loss in developed countries.¹ Age-related macular degeneration affects approximately 9% (8.5 million) of Americans aged 40 years and older.² Earlier stages of AMD, which increase the odds of developing advanced disease,³ are the most common, affecting 8% of persons aged 43 to 54 years and 30% of those older than 75 years.⁴ There is no cure for this condition.⁵ Limited treatment is available to slow its progression, and no established means of prevention exits.⁵ Therefore, it is important to identify modifiable risk factors that may reduce disease occurrence or prevent progression to advanced stages.