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New research · Ophthalmology
Investigative ophthalmology & visual science · 1d
Cross-sectionalInvestigative ophthalmology & visual science · 2026

Xanthophyll Carotenoid Intake, Plasma Levels, and Retinal Visualization in Aging and Age-Related Macular Degeneration: ALSTAR2.

Christine A Curcio, Liyan Gao, Jiaxin Pu … Cynthia Owsley
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OphthalmologyCross-sectional

Intermediate age-related macular degeneration is associated with higher retinal xanthophylls.

Xanthophyll Carotenoid Intake, Plasma Levels, and Retinal Visualization in Aging and Age-Related Macular Degeneration: ALSTAR2.

Christine A Curcio et al. · Investigative ophthalmology & visual science · 2026
Purpose

The purpose of this study was to determine cross-sectional associations among intake of xanthophyll carotenoids lutein and zeaxanthin (L&Z), plasma L&Z, and two wavelength autofluorescence (2WAF) retinal imaging in aging and age-related macular degeneration (AMD).

Methods

Adults ≥63 years old from a comprehensive ophthalmology clinic underwent assessments: macular health (Age-Related Eye Disease Study [AREDS] 9-step); self-reported L&Z intake from diet (LZQ Food Frequency Questionnaire) and supplements; total intake; macular pigment optical volume (MPOV; in 2WAF); non-fasting plasma L&Z; and HDL and LDL cholesterol.

n = 369 eyes
Results
± 0.61
higher average macular pigment levels in people with intermediate AMD
n = 369 eyes
More results

We studied 369 persons (74 ± 5.8 years, 60% women, 89% White, 62% never-smoker, and 23% supplement use) and 369 eyes (48.4% healthy, 26.0% early AMD [eAMD], and 25.2% intermediate AMD [iAMD]).

Groups did not differ in dietary intake (3.8 ± 4.5, 3.4 ± 3.2, and 3.7 ± 3.8 mg/d), plasma HDL, or HDL/LDL.

More results

Associations were strong between plasma L&Z and MPOV (r = 0.41-0.67, P < 0.01); moderate between total intake and plasma L&Z (Spearman r = 0.29-0.50, P < 0.01); weaker but significant for L&Z intake, and MPOV (r = 0.22-0.30, P < 0.01) of 3-mm-diameter macula lutea only, for eAMD and iAMD.

“
Conclusion · 1 of 2

In a large US sample, we assess for the first time L&Z intake from diet and supplements and determined the relative strength of correlations among intake, plasma, and retinal xanthophylls.

Conclusion · 2 of 2

We replicate our earlier finding of elevated retinal and plasma L&Z in iAMD. LZQ and 2WAF are suitable outcome measures for future interventions that directly test the impact of L&Z on AMD onset and progression.

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