Keywords
macular degeneration
oxidative stress
Abstract
CONTEXT: Degenerative ocular diseases, such as age-related
macular degeneration and senile cataract, affect millions of individuals
worldwide. In the absence of effective curative pharmacological interventions at
early stages, preventive approaches acquire strategic relevance in medical
practice. Within this context, ocular-tropic carotenoids – lutein, zeaxanthin, and
meso-zeaxanthin – have been identified as key biomolecules in retinal protection,
acting through synergistic antioxidant, anti-inflammatory, and blue light filtering
mechanisms.
METHODS: A systematic and critical review of the specialised literature was
performed, exploring publications from the past 10 years indexed in major
databases: PubMed, ScienceDirect, MDPI, and NCBI. Included were randomised
clinical trials, meta-analyses, and fundamental biochemical investigations
evaluating the effects of carotenoid supplementation on macular pigment optical
density (MPOD). Concurrently, data from international public health guidelines
were integrated to enable a transdisciplinary approach.
RESULTS: Nutritional supplementation with lutein and zeaxanthin was
associated with significant increases in MPOD and improvements in visual
function parameters. Findings from the AREDS and AREDS2 studies
demonstrated a reduction in the risk of progression from intermediate to advanced
stages by approximately 25%. At the molecular level, carotenoids reduce oxidative
stress, modulate inflammatory pathways (including inhibition of NF-κB and IL-
6), and contribute to retinal function stability. From a public health perspective,
these interventions exhibit a favourable cost-effectiveness profile and can be
incorporated into primary and secondary prevention strategies, particularly in the
geriatric population with increased nutritional vulnerability.
CONCLUSION: In an epidemiological context marked by a rising incidence
of degenerative ocular diseases, carotenoids emerge as agents with scientifically
documented potential and demonstrated efficacy both clinically and
biochemically. Their integration into public health strategies may contribute to
reducing the visual and economic burden associated with chronic ocular diseases
against the backdrop of demographic ageing.