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(Investigative Ophthalmology and Visual Science. 2006;47:2329-2335.)
© 2006 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.05-1235
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Plasma Lutein and Zeaxanthin and Other Carotenoids as Modifiable Risk Factors for Age-Related Maculopathy and Cataract: The POLA Study

Cécile Delcourt,1 Isabelle Carrière,2 Martine Delage,3 Pascale Barberger-Gateau,1 Wolfgang Schalch,4 and the POLA Study Group5

1From the Institut National de la Santé et de la Recherche Médicale (INSERM), Research Unit U593 for Epidemiology, Public Health and Development, Université Victor Segalen Bordeaux 2, Bordeaux, France; 2INSERM, E361, Université Montpellier Montpellier, France; the 3Biochemistry Laboratory, Lapeyronie University Hospital, Montpellier, France; and 4Research and Development, DSM Nutritional Products Ltd., Kaiseraugst, Switzerland.

PURPOSE. To assess the associations of plasma lutein and zeaxanthin and other carotenoids with the risk of age-related maculopathy (ARM) and cataract in the population-based Pathologies Oculaires Liées à l’Age (POLA) Study.

METHODS. Retinal photographs were graded according to the international classification. ARM was defined by the presence of late ARM (neovascular ARM, geographic atrophy) and/or soft indistinct drusen (>125 µm) and/or soft distinct drusen (>125 µm) associated with pigmentary abnormalities. Cataract classification was based on a direct standardized lens examination at the slit lamp, according to Lens Opacities Classification System III. Plasma carotenoids were measured by high-performance liquid chromatography (HPLC), in 899 subjects of the cohort.

RESULTS. After multivariate adjustment, the highest quintile of plasma zeaxanthin was significantly associated with reduced risk of ARM (OR = 0.07; 95% CI: 0.01–0.58; P for trend = 0.005), nuclear cataract (OR = 0.23; 95% CI: 0.08–0.68; P for trend = 0.003) and any cataract (OR = 0.53; 95% CI: 0.31–0.89; P for trend = 0.01). ARM was significantly associated with combined plasma lutein and zeaxanthin (OR = 0.21; 95% CI: 0.05–0.79; P for trend = 0.01), and tended to be associated with plasma lutein (OR = 0.31; 95% CI: 0.09–1.07; P for trend = 0.04), whereas cataract showed no such associations. Among other carotenoids, only ß-carotene showed a significant negative association with nuclear cataract, but not ARM.

CONCLUSIONS. These results are strongly suggestive of a protective role of the xanthophylls, in particular zeaxanthin, for the protection against ARM and cataract.




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