1.A randomized controlled trial on the effect of Lutein Supplementation on Macular Pigment Optical Density and Macular Function in Pseudophakic Patients
Victor Ephraime V. Paulino ; Edward C. Uy ; Sherman O. Valero
Philippine Journal of Ophthalmology 2021;46(2):88-95
Objective:
To evaluate the efficacy of oral lutein supplementation on macular pigment optical density (MPOD)
levels and macular function in pseudophakic eyes that underwent phacoemulsification.
Methods:
This was a prospective, randomized, parallel-arm, single-masked study comparing oral lutein supplement
20 mg/tablet (Lutax 20) with non-supplementation in pseudophakic eyes. We assessed MPOD, low-luminance
deficit (LLD), visual recovery time (VRT) using photostress test, and adverse events. One hundred twenty-eight
(128) eyes were enrolled and randomized 1:1 to active treatment (lutein supplementation) or no treatment (no
supplementation). The supplementation period was 12 weeks and patients were assessed every 4 weeks over a
period of 16 weeks.
Results:
Sixty-four (64) eyes in each group completed the study. A significant increase in MPOD (p<0.001) was
observed in the lutein supplemented group, from 0.36 DU at baseline to 0.55 DU at week 12, with a mean increase
of 6.32 ± 1.72% per 4 weeks of supplementation compared with a mean MPOD decrease rate of 0.63 ± 0.48%
in the non-supplementation group. A significant reduction in LLD was observed in the lutein-treated group, from
LogMAR 0.063 at baseline to LogMAR 0.023 at Week 12 (p=0.003). VRT was also significantly shorter in the
treatment from a baseline of 83.06 to 68.80 seconds at Week 12 (p<0.001).
Conclusion
Lutein supplementation (20 mg/tablet; Lutax 20) demonstrated a significant degree of MPOD
augmentation, and reductions in LLD and VRT among patients who underwent phacoemulsification with lens
implantation.
Lutein
;
Dietary Supplements
2.Peripapillary microvascular parameters in unilateral open-angle glaucoma using the optical coherence tomography-angiography
Victor Ephraime V. Paulino ; John Mark S. de Leon
Philippine Journal of Ophthalmology 2022;47(2):56-63
Objective:
This study compared the peripapillary retinal nerve fiber layer (pRNFL) microangiographic
properties [vessel area density (VAD) and blood flux index (BFI)] of unilateral open-angle glaucomatous eyes
to contralateral eyes-at-risk, and to eyes of healthy age- and sex-matched subjects.
Methods:
This was a single-center, case-control study of Filipinos diagnosed with unilateral primary openangle glaucoma (POAG) or normal-tension glaucoma (NTG). Mean overall and quadrantal VAD and BFI of
the three groups were measured with optical coherence tomography- angiography (OCT-A). Area under the
receiver operating characteristic (AROC) was used to measure diagnostic ability.
Results:
Twenty-two (22) glaucomatous subjects (15 POAG and 7 NTG eyes), 22 contralateral eyes-at-risk,
and 22 normal eyes from age- and sex-matched control subjects completed the study. Eyes with glaucoma
showed lower mean overall VAD (40%) and BFI (0.37) compared to eyes-at-risk (44.4% and 0.42, respectively;
p <0.001) and control eyes (45.6% and 0.44, respectively; p <0.001). Mean VAD and BFI values of eyes-at-risk
and control groups did not significantly differ from each other. Overall pRNFL thickness showed highest
diagnostic accuracy for glaucoma (AROC = 0.97), followed by VAD (0.94), and BFI (0.88) (p=0.46).
Conclusion
VAD and BFI were significantly diminished in unilateral open-angle glaucoma, suggesting that
the utility of OCT-A in the detection of glaucoma is comparable to pRNFL thickness.
Microcirculation
;
Glaucoma
;
Angiography