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From Supplements to Sight: Quantifying the Impact of Lutein and Carotenoid on Age-Related Macular Degeneration-A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

  • 2026-01
  • Journal of ophthalmology 2026(1)
    • Wei-Xiang Wang
    • Chen-Chi Wang
    • Wei-Cherng Hsu
    • Yi-Jie Peng

Study Design

Type
Review
Sample size
n = 860
Population
860 participants with age-related macular degeneration (AMD)
Methods
Meta-analysis of 9 RCTs evaluating oral lutein alone or in combination with zeaxanthin or epilutein, with pre- and post-treatment measurements of MPOD and BCVA

Purpose

To quantify the effects of lutein-containing supplementation on structural and functional visual outcomes in patients with age-related macular degeneration (AMD), with particular focus on disease stage and treatment exposure.

Methods

A meta-analysis of randomized, placebo-controlled trials was conducted. Nine RCTs involving 860 participants were included. Eligible studies evaluated oral lutein alone or in combination with zeaxanthin or epilutein and reported pre- and post-treatment measurements of macular pigment optical density (MPOD) and best-corrected visual acuity (BCVA). Random-effects models were applied to calculate pooled effect sizes using Hedges' g. Subgroup and meta-regression analyses were performed to explore stage-specific responses and dose-duration associations.

Results

Across the 9 RCTs, lutein-containing supplementation significantly improved MPOD (Hedges' g = -0.589, p < 0.001) and BCVA (Hedges' g = -0.827, p = 0.001). Improvements were predominantly observed in early-stage AMD, whereas no statistically significant benefit was detected in late-stage disease. Lutein monotherapy demonstrated greater visual benefit than combination regimens. Meta-regression analyses revealed significant positive associations between treatment effect and both supplementation duration and total lutein exposure. Contrast sensitivity and serum lutein concentrations also improved significantly.

Conclusion

Lutein-based supplementation is associated with measurable structural and functional visual benefits in early-stage AMD. Treatment effects appear dose- and duration-dependent, while evidence in late-stage AMD remains limited. These findings support early intervention strategies and warrant further investigation into long-term therapeutic impact.

Research Insights

  • Lutein→Improved Best-Corrected Visual Acuity

    Improvements were predominantly observed in early-stage AMD, whereas no statistically significant benefit was detected in late-stage disease.

    Effect
    Neutral
    Effect size
    Small
    Dose
    not specified in abstract
  • Lutein→Improved Contrast Sensitivity

    Contrast sensitivity and serum lutein concentrations also improved significantly.

    Effect
    Beneficial
    Effect size
    Small
    Dose
    not specified in abstract
  • Lutein→Improved Macular Pigment Optical Density

    Improvements were predominantly observed in early-stage AMD, whereas no statistically significant benefit was detected in late-stage disease.

    Effect
    Neutral
    Effect size
    Small
    Dose
    not specified in abstract
  • Lutein→Increased Lutein Level

    Contrast sensitivity and serum lutein concentrations also improved significantly.

    Effect
    Beneficial
    Effect size
    Small
    Dose
    not specified in abstract
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