Introduction
This was our first exploratory study investigating what happens in the blood and in the eye at the macular pigment when you supplement with all three macular carotenoids, lutein, zeaxanthin, and meso-zeaxanthin. Known as the Meso-Zeaxanthin Ocular Supplementation Trial, or MOST trial, this research marked an important turning point in understanding how targeted nutrition can benefit eye health.
Why was the research undertaken?
Previously, our focus was mainly on lutein and zeaxanthin because those were the carotenoids we knew made up the macular pigment. We also know that meso-zeaxanthin was a crucial part of the macular pigment but we didn’t have access to this carotenoid until now. Once we gained access to meso-zeaxanthin, we wanted to find out if adding it to the mix would improve absorption and, crucially, have a greater effect on macular pigment levels, especially in the central retina. This area is often the most vulnerable in people at risk of macular degeneration, so it was important to see if supplementation could help here.
How was the study conducted?
Because this was an exploratory trial, our main goal was to see if people would respond positively to taking all three carotenoids together. A major challenge was that we had to develop a new method to detect meso-zeaxanthin in the blood, since the blood delivers these nutrients to the eye. This methodological breakthrough allowed us to track absorption accurately for the first time.
What were the results?
The results were even better than we had hoped. We confirmed that all three carotenoids, including meso-zeaxanthin, entered the bloodstream successfully without interfering with each other’s absorption. More importantly, supplementation led to a significant increase in macular pigment, especially at the very centre of the retina. This was a huge breakthrough because, in patients at risk of macular degeneration, we often see a “central dip” or “volcano” pattern in their macular pigment. For the first time, this study suggested we could correct that dip through targeted supplementation.
What is the societal benefit?
This study was the start of a major shift in how we think about preventing or slowing macular degeneration. Demonstrating that meso-zeaxanthin plays a vital role in rebuilding the central macular pigment laid the foundation for future nutritional strategies that are more complete and personalised. Our findings support the potential for triple carotenoid formulations to help preserve vision, especially in people at higher risk of visual decline.
