Central Retinal Enrichment Supplementation Trials (CREST)
CREST aims to assess the impact of enriched macular pigment with all three macular carotenoids on visual performance and blindness.
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The CREST project is funded by the European Research Council (ERC). The main goal of the ERC is to encourage the highest quality research in Europe on the basis of scientific excellence through competitive funding. This funding will be used to test a novel research question on ways to uniquely enrich macular pigment in people with and without eye disease.
This ground-breaking study will advance understanding of the protective role of macular pigment for age-related macular degeneration (AMD), and potentially enhance visual performance in young normal people and in people with AMD. This study will also enable the research team to identify new ideas in this growing area of science.
CREST Project Outline
AMD is the leading cause of blindness in the developed world. The macula, the central part of the retina, is responsible for optimal spatial vision. There is a growing body of evidence that a lack of a dietary pigment at the macula, known as macular pigment (MP), is associated with increased risk of AMD.
MP contains the carotenoids lutein (L), zeaxanthin (Z) and meso-zeaxanthin (meso-Z). The typical western diet contains around 60 carotenoids, and 18 have been identified in human serum. However, only three carotenoids are found at the macula, indicating the unique biological selectivity for their uptake at this location. The function of MP remains undetermined. It is likely that the accumulation of MP has evolved because of its optical and antioxidant properties. For example, MP limits retinal oxidative damage passively (through filtration of blue light) and actively (by quenching free radicals). Furthermore, its optical properties suggest a key role for MP in enhancing visual performance and supporting optimal vision by reducing the effects of chromatic aberration and light scatter.
Recent research has shown that MP can be augmented by dietary supplementation in most (but not all) subjects, suggesting that the macular concentrations of these carotenoids are suboptimal in many people. My research group has discovered that a dip in the central portion of this pigment, seen in around 12% of individuals, is an undesirable feature of its spatial profile and may be linked to an inability to generate meso-Z at the macula. Significantly, central dips in MP are more common in patients with AMD. We have also identified that enrichment of MP, including reconstruction of undesirable central dips, can be achieved by inclusion of meso-Z in a dietary supplement. We propose to uniquely enrich MP, with all three macular carotenoids, and assess its impact on visual performance and experience in normal subjects, and in subjects with AMD. This groundbreaking study will advance our understanding of the protective and optical hypothesis of MP, and potentially improve normal vision and prevent or delay blindness due to AMD.
Meso-Zeaxanthin Ocular Supplementation Trials (MOST)
MOST is an initial investigation into the efficacy of supplementation with meso-zeaxanthin, the central macular carotenoid, for patients with, or at risk of developing, AMD. These studies are comparing different formulations of macular carotenoid supplements and their impact on macular pigment enrichment, visual performance, and disease progression.
Egg Xanthophyll Interventional Trial (EXIT)
Eggs for eyes
The objective of EXIT is the development of a macular carotenoid-enriched egg as an nnovative supplement for vision and cognitive health.