EFFICACY OF ORAL GLUTATHIONE ADDITION IN LUTEIN SUPPLEMENTATION ON CONTRAST SENSITIVITY IMPROVEMENT IN DRY AGE-RELATED MACULAR DEGENERATION: A RANDOMIZED CONTROLLED TRIAL

  • RAMZI AMIN Department of Ophthalmology, Sriwijaya University, Palembang, Indonesia.
  • EDWIN BAYU SAPUTRA Department of Ophthalmology, Sriwijaya University, Palembang, Indonesia.

Abstract

Objective: Age-related macular degeneration (ARMD) is the macular abnormality causing central vision loss in the elderly. One prevention for ARMD is the provision of antioxidants, such as lutein. Reduced form of glutathione (GSH) is a source of cysteine and sulfhydryl, playing a role in detoxification, transport, and metabolic processes. Both are prospected to have a synergistic effect in the prevention of ARMD. This study aimed to determine the efficacy of GSH addition in lutein supplementation to improve the contrast sensitivity of dry type ARMD patients.


Methods: This randomized controlled trial was conducted at an eye hospital and a tertiary general hospital from April 2016 to June 2016. This study involved 22 dry ARMD patients. Subjects were randomized and divided into treatment groups with 20 mg lutein with the addition of 500 mg GSH and 20 mg lutein only, for 30 days. Contrast sensitivity measurement was performed with Lea Numbers® Low Contrast Flip Chart before and after the treatment. Contrast sensitivity was analyzed comparatively with paired t-test.


Results: Contrast sensitivity improvement was observed in both the groups. Contrast sensitivity improvement of the group with additional GSH (3.62±1.44, p<0.05) was a 3-fold of the lutein group only (1.25±0.44, p>0.05). The result was statistically significant for the group treated with GSH addition.


Conclusion: GSH addition in lutein supplementation provoked better contrast sensitivity improvement in dry ARMD patients.

Keywords: Age-related macular degeneration, Glutathione, Lutein, Antioxidants, Contrast sensitivity.

Author Biographies

RAMZI AMIN, Department of Ophthalmology, Sriwijaya University, Palembang, Indonesia.

Department of Ophthalmology, Faculty of Medicine, Sriwijaya University, Dr. Moh. Hoesin General Hospital, Palembang, South Sumatra, Indonesia

EDWIN BAYU SAPUTRA, Department of Ophthalmology, Sriwijaya University, Palembang, Indonesia.

Department of Ophthalmology, Faculty of Medicine, Sriwijaya University, Dr. Moh. Hoesin General Hospital, Palembang, South Sumatra, Indonesia

References

1. Schubert HD. Retina and vitreous. In: Cantor LB, Rapuano CJ, Cioffi GA, editors. Basic and Clinical Science Course 2014-2015. Sec. 12. San Francisco: American Academy of Ophthalmology; 2014. p. 55-63.
2. Klein R, Peto T, Bird A, Vannewkirk MR. The epidemiology of age-related macular degeneration. Am J Ophthalmol 2004;137:486-95.
3. Schubert HD. Retina and vitreous. In: Cantor LB, Rapuano CJ, Cioffi GA, editors. Basic and Clinical Science Course 2014-2015. Sec. 12. San Francisco: American Academy of Ophthalmology; 2014. p. 281-7.
4. Amin HI, McDonald HR, Johnson RN, Ai E, Schatz H. Acquired macular disease. In: Tasman W, Jaeger EA, editors. Duane’s Clinical Ophthalmology [CD-ROM]. Baltimore: Lippincott Williams and Wilkins; 2003.
5. Chopdar A, Chakravarthy U, Verma D. Age related macular degeneration. BMJ 2003;326:485-8.
6. Townsend DM, Tew KD, Tapiero H. The importance of glutathione in human disease. Biomed Pharmacother 2003;57:145-55.
7. Pereira RB, Sousa C, Costa A, Andrade PB, Valentão P. Glutathione and the antioxidant potential of binary mixtures with flavonoids: Synergism and antagonisms. Molecules 2013;18:8858-72.
8. Meschino J. Glutathione: The body’s master detoxifier and antioxidant. Dyn Chiropr 2009;27:1-11.
9. Lapenna D, de Gioia S, Ciofani G, Mezzetti A, Ucchino S, Calafiore AM. Glutathione-related antioxidant defenses in human atherosclerotic plaques. Circulation 1998;97:1930-4.
10. Berendschot TT, Goldbohm RA, Klöpping WA, van de Kraats J, van Norel J, van Norren D. Influence of lutein supplementation on macular pigment, assessed with two objective techniques. Invest Ophthalmol Vis Sci 2000;41:3324-6.
11. Seddon JM, Ajani UA, Sperduto RD, Hiller R, Blair N, Burton TC, et al. Dietary carotenoids, Vitamin A, C, and E, and advanced age-related macular degeneration. Eye Disease Case Control Study Group. JAMA 1994;272:1413-20.
12. Hamid AA, Aiyelaagbe OO, Usman LA, Ameen OM, Lawal A. Antioxidant: Its medicinal and pharmacological applications. Afr J Pure Appl Chem 2010;4:142-51.
13. Tang Y, Zhou Y. Age-related decline of contrast sensitivity for second-order stimuli: Earlier onset, but slower progression, than for first-order stimuli. J Vis 2009;9:18.
14. Solberg JL, Brown JM. No sex differences in contrast sensitivity and reaction time to spatial frequency. Percept Mot Skills 2002;94:1053-5.
15. Richer S, Stiles W, Statkute L, Pulido J, Frankowski J, Rudy D, et al. Double-masked, placebo-controlled, randomized trial of lutein and antioxidant supplementation in the intervention of atrophic age-related macular degeneration: The veterans LAST study (lutein antioxidant supplementation trial). Optometry 2004;75:216-30.
16. Landrum JT, Bone RA, Joa H, Kilburn MD, Moore LL, Sprague KE. A one year study of the macular pigment: The effect of 140 days of a lutein supplement. Exp Eye Res 1997;65:57-62.
17. Olmedilla B, Granado F, Blanco I, Vaquero M, Cajigal C. Lutein in patient with age-cataract and age related macular degeneration: Along term supplementation study. J Sci Food Agric 2001;81:904-99.
18. Dagnelie G, Zorge IS, McDonald TM. Lutein Improves visual function in some patient with retinal degeneration: A pilot study via internet. Optometry 2000;71:147-64.
19. Gale CR, Hall NF, Phillips DI, Martyn CN. Lutein and zeaxanthin status and risk of age-related macular degeneration. Invest Ophthalmol Vis Sci 2003;44:2461-5.
20. Purushothaman BP, Valsan G, Kuttan R. Oxycarotenoid lutein reverses the toxicity induced by carbofuran in wistar rats. Int J Pharm Pharm Sci 2018;10:10-5.
21. Chaiyasan W, Sangly P. Development and characterization of topical ophthalmic formulations containing lutein-loaded mucoadhesive nanoparticles. Int J Pharm Pharm Sci 2016;8:261-6.
22. Aw TY, Wierzbicka G, Jones DP. Oral glutathione increases tissue glutathione in vivo. Chem Biol Interact 1991;80:89-97.
23. Allen ND, Jason and Ryan D. Bradley. Effects of oral glutathione supplementation on systemic oxidative stress biomarkers in human volunteers. J Altern Complement Med 2011;17:827-33.
24. Sabour-Pickett S, Beatty S, Connolly E, Loughman J, Stack J, Howard A, et al. Supplementation with three different macular carotenoid formulations in patients with early age-related macular degeneration. Retina 2014;34:1757-66.
Statistics
73 Views | 130 Downloads
Citatons
How to Cite
AMIN, R., and E. B. SAPUTRA. “EFFICACY OF ORAL GLUTATHIONE ADDITION IN LUTEIN SUPPLEMENTATION ON CONTRAST SENSITIVITY IMPROVEMENT IN DRY AGE-RELATED MACULAR DEGENERATION: A RANDOMIZED CONTROLLED TRIAL”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 12, no. 3, Feb. 2019, pp. 397-9, doi:10.22159/ajpcr.2019.v12i3.30753.
Section
Original Article(s)