Skin and macular carotenoids and relations to academic achievement among school-aged children.

ABSTRACTObjectives: Carotenoids are plant pigments that accumulate in human tissue (e.g. macula and skin) and can serve as biomarkers for diet quality; however, knowledge on skin and macular carotenoids in relation to cognition in children is limited. This study aimed to address this gap by assessing links between skin and macular carotenoids and academic achievement in school-aged children.Methods: Children 7-12 years old (n = 81) participated in a crosssectional study. Skin and macular carotenoids were measured with reflection spectroscopy and heterochromatic flicker photometry, respectively. Academic achievement was measured using Woodcock-Johnson IV (WJ-IV). Body Mass Index was calculated using height and weight measurements, demographic information was collected using a family demographics and pediatric health history questionnaire, and carotenoid intake was assessed using 7-day diet records.Results: Skin carotenoids were not related to macular pigment (r = 0.08, p = 0.22). Adjusting for age, sex, BMI percentile, household income, and total carotenoid consumption (mg/1000kcal), skin carotenoids were predictive of math (ß = 0.27, p = 0.02), broad math (ß = 0.36, p < 0.01) and math calculation (ß = 0.38, p < 0.01). Skin carotenoids displayed trending relationships with broad reading (ß = 0.23, p = 0.05) and reading fluency (ß = 0.22, p = 0.07). There were no significant associations between macular pigment and academic achievement (all ß's ≤ 0.07, all p's ≥ 0.56).Discussion: Skin carotenoids were positively associated with academic abilities in children, while macular carotenoids did not display this relationship. Future interventions examining prospective effects of changes in carotenoids in different tissues on childhood academic achievement are warranted.

Macular Pigment Optical Density and Skin Carotenoids in a Childhood Sample.

BACKGROUND: Carotenoids are plant pigments with light filtering and antioxidant properties that deposit in human tissues, including retina and skin. Descriptive characteristics and covariates of carotenoid status in macula and skin have been examined in adults; however, similar studies in children are limited. Thus, this study aimed to delineate how factors of age, sex, race, weight status, and dietary carotenoid intake relate to macular and skin carotenoids in children. METHODS: Children (7-13 y, N = 375) completed heterochromatic flicker photometry to assess macular pigment optical density (MPOD). Participants underwent anthropometrics to measure weight status (BMI percentile [BMI%]), and parent/guardian provided demographic information. Subsample data were available for skin carotenoids (N = 181), assessed using reflection spectroscopy, and dietary carotenoids (N = 101) using the Block Food Frequency Questionnaire. Relationships between skin and macular carotenoids were assessed using partial Pearson's correlations controlling for age, sex, race, and BMI%. Relationships between dietary carotenoids and macular and skin carotenoids were assessed using stepwise linear regression including age, sex, race, and BMI% in the model. RESULTS: Mean MPOD was 0.56 ± 0.22 and skin carotenoid score was 282 ± 94.6. There was no significant correlation between MPOD and skin carotenoids (r = 0.02, P = 0.76). BMI% was negatively associated with skin (stdß = -0.42, P < 0.001), but not macular carotenoids (stdß = -0.04, P = 0.70). Neither MPOD nor skin carotenoids were associated with age, sex, or race (all P > 0.10). MPOD was positively associated with energy-adjusted reported lutein + zeaxanthin intake (stdß = 0.27, P = 0.01). Skin carotenoids were positively associated with energy-adjusted reported carotenoid intake (stdß = 0.26, P = 0.01). CONCLUSIONS: The mean MPOD values in children were higher than what has been reported in adult populations. Previous studies in adult samples report an average MPOD of 0.21. Although macular and skin carotenoids were not related, they were associated with dietary carotenoids relevant to the respective tissues; however, skin carotenoids may be more susceptible negative influence from higher weight status.

A Dietary Strategy for Optimizing the Visual Range of Athletes.

Visual range is quantified by assessing how far one can see clearly (an ability crucial to many athletes). This ability tends to vary significantly across individuals despite similar personal characteristics. We hypothesize that the primary driver of these differences is the individual response to scattered short-wave light in the environment moderated by the dietarily derived retinal pigments lutein and zeaxanthin.

The influence of the macular carotenoids on women's eye and brain health.

Introduction: The mortality-morbidity paradox refers to the inconsistency in survival and disease between males and females: females live longer but tend to suffer greater age-related disease and disability. Many aspects of the latter can be targeted by lifestyle interventions, such as changes in dietary behavior.Methods: The relevant literature is reviewed.Conclusion: Dietary intake of the pigmented carotenoids appears to be particularly important for issues such as visual and cognitive loss. This may be due to the highly selective presence of a fraction of carotenoids, namely lutein (L) and zeaxanthin (Z), in specific tissues of the eye and brain. At those sites, L and Z have been shown to directly improve function and prevent central nervous system degeneration. On the palliative side, retinal LZ reduce glare disability, discomfort and photostress, improve chromatic contrast and visual range (e.g., the ability to see through blue atmospheric haze). These effects on input reflect changes in neural output such as improved visual processing speed, problem solving, memory and executive function (presumably due, also, to local effects in areas such as the hippocampus and frontal cortex). These effects on function throughout the central nervous system are mirrored by effects on disease progression. As potent antioxidants/anti-inflammatory agents, and "blue-blockers" within the retina, the pigments prevent loss that precedes neurodegenerative diseases such as age-related macular degeneration and some forms of dementia.

Contrast sensitivity functions measured using simple optics and computer testing.

PURPOSE: Contrast sensitivity function (CSF) testing is a common approach to assessing clinical changes to specific aspects of spatial vision. Different stimulus presentations and testing procedures, however, yield significant differences in CSF curves that are more a feature of the method than the observer. In this study, we designed a simple optical device for measuring CSF that could be directly calibrated and compared with a commonly used computer-based system. METHODS: Twenty-one participants (M = 28.95 ± 10.34 years; 66.7% female; 81.0% non-Hispanic White; best corrected visual acuity 6/9 or better) provided photopic CSFs (from measurements at 1.6, 3.2, 8, 16 and 24 cycles per degree, with spatial frequency presentation randomised) using both the Metropsis test platform and a simple optical device over two test sessions (one session/method, randomised, counterbalanced) separated by 1-7 days. The optical system used 520 nm lasers that were made Lambertian using two integrating spheres with a 3.5° circular exit port. These beams were combined with a beam splitter that allowed constant measurement of light output and contrast modulation using sine-wave gratings on glass. In Metropsis, 2° Gabor stimuli were presented for 0.5 s with either a vertical or a horizontal orientation via a two-alternative forced choice paradigm with contrast modulated until four (first) and eight (last) reversals were complete. RESULTS: Both methods took approximately the same amount of time to generate a CSF and yielded curves that were consistent with past studies using similar methods but different from each other. The optical system showed a 3.5 times higher maximum sensitivity and yielded higher test-retest reliability. CONCLUSIONS: Using simple optics to measure CSF yields low noise, high sensitivity and reliability. The ability to calibrate the stimuli directly is an advantage over computer-based methods.

The effect of a short-wave filtering contact lens on color appearance.

We assessed the effect of a contact lens that filters short-wavelength (SW) visible light on color appearance. These effects were modeled and measured by direct comparison to a clear contact lens. Sixty-one subjects were enrolled, and 58 completed as cohort; 31 were 18 to 39 years old (mean ± SD, 29.6 ± 5.6), 27 were 40 to 65 years old (50.1 ± 8.1). A double-masked contralateral design was used; participants randomly wore a SW-filtering contact lens on one eye and a clear control lens on the other eye. Subjects then mixed three primaries (including a short-wave primary, strongly within the absorbance of the test lens) until a perceived perfect neutral white was achieved with each eye. Color appearance was quantified using chromaticity coordinates measured with a spectral radiometer within a custom-built tricolorimeter. Color vision in natural scenes was simulated using hyperspectral images and cone fundamentals based on a standard observer. Overall, the chromaticity coordinates of matches that were set using the SW-filtering contact lens (n = 58; x = 0.345, y = 0.325, u' = 0.222, v' = 0.470) and clear contact lens (n = 58; x = 0.344, y = 0.325, u' = 0.223, v' = 0.471) were not significantly different, regardless of age group. Simulations indicated that, for natural scenes, the SW-filtering contact lens that was evaluated changes L/(L+M) and S/(L+M) chromatic contrast by no more than -1.4% to +1.1% and -36.9% to +5.0%, respectively. Tricolorimetry was used to measure color appearance in subjects wearing a SW-filtering lens in one eye and a clear lens in the other, and the results indicate that imparting a subtle tint to a contact lens, as in the SW-filtering lens that was evaluated, does not alter color appearance for younger or older subjects. A model of color vision predicted little effect of the lens on chromatic contrast for natural scenes.

The Influence of HEV-Filtering Contact Lenses on Behavioral Indices of Glare.

OBJECTIVES: We assessed the effects of a HEV-filtering contact lens on positive dysphotopsia (halos and starbursts) and a behavioral index of scatter measured using two-point light thresholds. These effects were assessed by direct comparison to a clear (i.e., non-HEV filtering) contact lens tested in the fellow eye. METHODS: Sixty-one subjects were randomized and fit with study lenses and 58 subjects completed the study. A double-masked contralateral design was used. Subjects were randomized to test lens-OD, control lens-OS, or vice versa. Participants were exposed to a point source of broadband simulated sunlight (a 403-nm condition was also tested) that created the appearance of halos/starbursts. The degree of dysphotopsia was measured as the diameter of broadband and violet-induced halos, and broadband light-induced starbursts. Two-point thresholds were assessed as the minimum resolvable distance between two pinpoints of light. RESULTS: The HEV-filtering lens was statistically superior ( P <0.0001) to the clear lens in all the conditions tested. The HEV-filtering lens significantly reduced halo diameter by 30%, starburst diameter by 23%, and resolvable distance in the two-point condition by 18% (white) and 30% (violet). CONCLUSIONS: HEV-filtering contact lenses can reduce some deleterious effects of bright broadband light by decreasing light scatter, halos, and starbursts.

Reduction of Glare Discomfort and Photostress Recovery Time Through the Use of a High-Energy Visible-Filtering Contact Lens.

OBJECTIVES: Glare discomfort (GDC) is the slight pain (discomfort) that arises when exposed to light that exceeds one's adaptive state. Such light can also cause a temporary loss in visual function (photostress, PS). We tested the hypothesis that filtering with a high-energy visible (HEV) light-filtering contact lens can reduce GDC and speed PS recovery time. METHODS: Sixty-one subjects were randomized and fit with study lenses and 58 subjects completed as cohort (20-65 years of age). A double-masked, randomized, contralateral design was used (HEV filter on one eye; control lens on the other). Participants were given a 5-s exposure to a broadband white photostressor. Video images were analyzed, and palpebral fissure size during exposure was measured, as was PS recovery time to a 2-degree mid-wave target. RESULTS: The HEV-filtering test lens was statistically superior ( P <0.0001) to the clear comparison contact lens with respect to the magnitude of squint (44.9% squint reduction) and photostress recovery time (24.3% faster recovery). CONCLUSIONS: High-energy visible light-filtering contacts can reduce GDC and speed PS recovery. Filtering HEV light before it is incident upon the retina is a natural strategy (e.g., by the lens and macular pigment) for attenuating some of the deleterious effects of bright broadband light.

Single Nucleotide Polymorphisms in CD36 Are Associated with Macular Pigment among Children.

BACKGROUND: High macular pigment optical density (MPOD) has been associated with improved eye health and better cognitive functions. Genetic variations have been associated with MPOD in adults. However, these associations between genetic variations and MPOD have not been studied in children. OBJECTIVES: This was a secondary analysis of the FK2 (Fitness Improves Thinking in Kids 2) trial (n = 134, 41% male). The aim was to determine differences in MPOD among children (aged 7-9 y) based on genetic variants that either are biologically relevant to lutein (L) and zeaxanthin (Z) accumulation or have been associated with MPOD in adults. METHODS: MPOD was measured using customized heterochromatic flicker photometry via a macular densitometer. DXA was used to assess whole-body and visceral adiposity. DNA was extracted from saliva samples and was genotyped for 26 hypothesis-driven single nucleotide polymorphisms and 75 ancestry-informative markers (AIMs). Habitual diet history was obtained via 3-d food logs completed by parents (n = 88). General linear models were used to compare MPOD between different genotypes. Principal component analysis was performed for the AIMs to account for ethnic heterogeneity. RESULTS: Children carrying ≥1 minor allele on ß-carotene-15,15'-monooxygenase (BCO1)-rs7501331 (T allele) (P = 0.045), cluster of differentiation 36(CD36)-rs1527483 (T allele) (P = 0.038), or CD36-rs3173798 (C allele) (P = 0.001) had significantly lower MPOD (range: 14.1%-26.4%) than those who were homozygotes for the major alleles. MPOD differences based on CD36-rs3173798 genotypes persisted after adjustment for dietary L and Z intake. CONCLUSIONS: The findings indicate that genetic variations of CD36 and BCO1 contribute to MPOD in children. The influence of genetic variation in CD36-rs3173798 persisted after adjusting for variation in dietary intake.This trial was registered at clinicaltrials.gov as NCT01619826.

The Effects of a Senofilcon A Contact Lens With and Without a Photochromic Additive on Positive Dysphotopsia Across Age.

OBJECTIVE: The visual effects of wearing a photochromic contact lens (test) were directly compared with a nonphotochromic contact lens (control). Positive dysphotopsia (halos, starbursts) and intraocular scatter (behaviorally determined) were assessed. Both younger and middle-aged subjects were evaluated to examine the influence of age. METHODS: Fifty-four subjects (18-62 years) were tested using a contralateral design. Subjects were fit with a photochromic contact lens on one eye and a nonphotochromic contact lens on the other eye, randomly assigned. Testing occurred with and without photochromic activation (darkened) by use of a violet activator (365 nm, half-bandwidth 20 nm). The extent of dysphotopsia (halos and spokes) was measured using an aperture (∼4 mm) that created a bright point source of light 45 inches from the plane of the eye. Between the point source and subject, a centering precision caliper was used to measure lateral spread. Two-point thresholds were determined by measuring the minimum distance between two points of broadband xenon light. RESULTS: The photochromic contact lens produced smaller halo diameters than the control contact lens, both activated (41% on average) and inactivated (21% on average), and age strata was a significant factor (P<0.001) with the older group showing a greater reduction. The photochromic contact lens produced smaller starburst diameters than the control contact lens, both activated (37% on average) and inactivated (23% on average), and age strata was a significant factor (P=0.001) with the older group showing a greater reduction. The two-point thresholds were reduced (25% activated, 9% inactivated) on average but the age effect was not significant (P<0.10). CONCLUSIONS: The senofilcon A lens with photochromic additive reduced the extent of positive dysphotopsia compared with the same lens without the additive, regardless whether the lens was activated or not. The visual benefit was greatest with the older subjects.

The Effect of a Photochromic Contact Lens on Visual Function Indoors: A Randomized, Controlled Trial.

SIGNIFICANCE: Photochromic soft contact lenses contain light-sensitive additives that allow them to darken when exposed to ultraviolet or violet light. One question, however, is whether the lenses influence vision indoors (minimally activated). In this study, we found that the minimally activated lenses improved many aspects of visual function under bright light. PURPOSE: Photochromic contact lenses were designed to darken when exposed to outdoor sunlight. The filtering that results improves visual function under bright light conditions. Not all bright light exposures occur outdoors. In this study, we tested whether a photochromic contact lens improved visual function under conditions where the lens was minimally activated (i.e., no more than it normally would be in an indoor environment). METHODS: A subject-masked contralateral design was used comparing a photochromic contact lens randomized to one eye against a nonphotochromic contact in the other eye of the same subject. Sixty subjects (mean = 34.90 ± 11.24 years) were tested. The primary endpoints consisted of four visual function outcomes: photostress recovery, glare disability, glare discomfort, and chromatic contrast. Photostress recovery was quantified by measuring the time needed to recover visual acquisition of a grating target after 5 seconds of an intense xenon white flash exposure; glare disability was evaluated as the energy in a surrounding xenon white annulus necessary to veil a central grating target; and glare discomfort was assessed using bioimaging of the squint response. Chromatic contrast was measured as thresholds for a green-yellow (580 nm) grating target superposed on a blue (460 nm) background. RESULTS: The minimally activated photochromic contact demonstrated improved visual performance compared with the nonphotochromic control across all visual functions tested (P < .01). CONCLUSIONS: Even under conditions of exiguous activation (e.g., as would be expected indoors or while driving at night), a photochromic contact will improve many of the more deleterious aspects of bright light.

Lutein and Zeaxanthin Influence Brain Function in Older Adults: A Randomized Controlled Trial.

OBJECTIVES: The present study constitutes the first randomized controlled trial to investigate the relation of lutein (L) and zeaxanthin (Z) to brain function using functional magnetic resonance imaging (fMRI). It was hypothesized that L and Z supplementation in older adults would enhance neural efficiency (i.e., reduce activation) and cognitive performance on a verbal learning task relative to placebo. METHODS: A total of 44 community-dwelling older adults (mean age=72 years) were randomly assigned to receive either placebo or L+Z supplementation (12 mg/daily) for 1 year. Neurocognitive performance was assessed at baseline and post-intervention on an fMRI-adapted task involving learning and recalling word pairs. Imaging contrasts of blood-oxygen-level-dependent (BOLD) signal were created by subtracting active control trials from learning and recall trials. A flexible factorial model was employed to investigate the expected group (placebo vs. supplement) by time (baseline vs. post-intervention) interaction in pre-specified regions-of-interest. RESULTS: L and Z appeared to buffer cognitive decline on the verbal learning task (Cohen's d=.84). Significant interactions during learning were observed in left dorsolateral prefrontal cortex and anterior cingulate cortex (p < .05, family-wise-error corrected). However, these effects were in the direction of increased rather than decreased BOLD signal. Although the omnibus interaction was not significant during recall, within-group contrasts revealed significant increases in left prefrontal activation in the supplement group only. CONCLUSIONS: L and Z supplementation appears to benefit neurocognitive function by enhancing cerebral perfusion, even if consumed for a discrete period of time in late life. (JINS, 2018, 24, 77-90).

Macular pigment optical density is positively associated with academic performance among preadolescent children.

OBJECTIVE: Macular pigment optical density (MPOD) - a non-invasive indicator of retinal xanthophylls and correlate of brain lutein - has been associated with superior cognitive function among adult populations. Given that lutein accumulation in the brain occurs in early life, it is possible that the cognitive implications of greater MPOD may be evident in childhood. METHODS: Participants aged 8-9 years (n = 56) completed MPOD measurements via heterochromatic flicker photometry. Academic performance was assessed using the Kaufman Test of Academic and Educational Achievement II (KTEA). Habitual dietary intake of L and Z was measured among a subsample of participants (n = 35) using averaged 3-day food records. Stepwise hierarchical regression models were developed to determine the relationship between MPOD and academic achievement tests, following the adjustment of key covariates including sex, aerobic fitness, body composition, and intelligence quotient (IQ). RESULTS: The regression analyses revealed that MPOD improved the model, beyond the covariates, for overall academic achievement (ΔR2 = 0.10, P < 0.01), mathematics (ΔR2 = 0.07, P = 0.02), and written language composite standard scores (ΔR2 = 0.15, P < 0.01). DISCUSSION: This is the first study to demonstrate that retinal L and Z, measured as MPOD, is positively related to academic achievement in children, even after accounting for the robust effects of IQ and other demographic factors. These findings extend the positive associations observed between MPOD and cognitive abilities to a pediatric population. Trail registration: The Fitness Improves Thinking in Kids 2 (FITKids2) trial was registered at www.clinicaltrials.gov as NCT01619826.

Macular Carotenoids, Aerobic Fitness, and Central Adiposity Are Associated Differentially with Hippocampal-Dependent Relational Memory in Preadolescent Children.

OBJECTIVES: To examine the associations of macular pigment carotenoids (lutein, meso-zeaxanthin, and zeaxanthin), aerobic fitness, and central adiposity with hippocampal-dependent relational memory in prepubescent children. STUDY DESIGN: Children between 7 and 10 years of age (n = 40) completed a task designed to assess relational memory performance and participated in aerobic fitness, adiposity, and macular pigment optical density (MPOD) assessment. Aerobic fitness was assessed via a modified Balke treadmill protocol designed to measure maximal oxygen volume. Central adiposity was assessed via dual-energy x-ray absorptiometry. MPOD was measured psychophysically by the use of customized heterochromatic flicker photometry. Statistical analyses included correlations and hierarchical linear regression. RESULTS: Aerobic fitness and MPOD were associated negatively with relational memory errors (P < .01), whereas central adiposity was associated positively with relational memory errors (P < .05). Hierarchical regression analysis revealed that MPOD accounted for a significant amount of the variance in relational memory performance even after we accounted for aerobic fitness (ß = -0.388, P = .007). CONCLUSIONS: Even after we adjusted for aerobic fitness and central adiposity, factors known to relate to hippocampal-dependent memory, MPOD positively and significantly predicted hippocampal-dependent memory performance. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01619826.

Relationship of Lutein and Zeaxanthin Levels to Neurocognitive Functioning: An fMRI Study of Older Adults.

OBJECTIVES: It is well known that the carotenoids lutein (L) and zeaxanthin (Z) improve eye health and an accumulating evidence base suggests cognitive benefits as well. The present study investigated underlying neural mechanisms using functional magnetic resonance imaging (fMRI). It was hypothesized that lower L and Z concentrations would be associated with neurobiological inefficiency (i.e., increased activation) during cognitive performance. METHODS: Forty-three community-dwelling older adults (mean age=72 years; 58% female; 100% Caucasian) were asked to learn and recall pairs of unrelated words in an fMRI-adapted paradigm. L and Z levels were measured in retina (macular pigment optical density) and serum using validated procedures. RESULTS: Following first-level contrasts of encoding and retrieval trials minus control trials (p<.05, family-wise error corrected, minimum voxel cluster=8), L and Z were found to significantly and negatively relate to blood-oxygen-level-dependent signal in central and parietal operculum cortex, inferior frontal gyrus, supramarginal gyrus, planum polare, frontal and middle temporal gyrus, superior parietal lobule, postcentral gyrus, precentral gyrus, occipital cortex bilaterally, and cerebellar regions. CONCLUSIONS: To the authors' knowledge, the present study represents the first attempt to investigate neural mechanisms underlying the relation of L and Z to cognition using fMRI. The observed results suggest that L and Z promote cognitive functioning in old age by enhancing neural efficiency. (JINS, 2017, 23, 11-22).

Mind Your Heart: A Mindful Eating and Diet Education eHealth Program.

OBJECTIVE: Examine user perceptions of the Mind Your Heart (MYH) program, a mindful eating and nutrition education program delivered via an eHealth system. METHODS: Sixteen participants (41.5 ± 13.1 years) completed sample MYH lessons over 3 weeks. We examined changes in mindfulness from the State Mindfulness Scale via text messages sent 3 times per week. We assessed MYH user perceptions in a semistructured interview after 3 weeks. Analyses included Spearman's correlation, repeated measures ANOVA, and thematic analysis. RESULTS: State Mindfulness Scale scores were significantly improved (F[1,15] = 5.35, P = 0.01) from week 1 (M = 2.28 ± 0.80) to week 3 (M = 2.75 ± 1.04). Four themes emerged: (1) MYH is supportive of health goals, (2) text messages act as an intervention, (3) facilitators or inhibitors of use, and (4) enhancing engagement. CONCLUSIONS AND IMPLICATIONS: Based on participant feedback, the final version of MYH should include example-based learning to translate abstract concepts like mindful eating into action.

The Effects of Blue-Light Filtering Intraocular Implants on Glare Geometry.

PURPOSE: One common complaint with natural opacified lenses is the deleterious effects of higher-order ocular aberrations and intraocular scatter, such as halos and starbursts, which are not always remedied with surgery and intraocular lens (IOL) implantation. Blue-light filtering (BLF) IOL filter scatter-prone short-wave light. Here, we determine whether BLF IOL reduce halo and starburst size. METHODS: This study was a case-control design, between- and within-subjects (contralateral implantation). Sixty-nine participants with either the BLF IOL (n = 25; AlconSN60AT), clear IOL (n = 24; AlconSA60AT or WF), or both (n = 20) IOL participated. Participants were exposed to a point source of broadband simulated sunlight, which created the appearance of halos/starbursts. Dysphotopsia was measured as the diameter of broadband light-induced halos and starbursts. RESULTS: A case-control analysis. Halo size was significantly larger (t[35.05] = 2.98, p = 0.005) in participants with the clear control lens (M = 3°55' ± 2°48'), compared to the BLF IOL (M = 1°84' ± 1°34'). Starburst size was not significantly different between groups. Contralateral analysis. Halo size was significantly smaller (t = -3.89, p = .001) in test eyes with the BLF (M = 3°16' ± 2°35') compared to the fellow control eyes (M = 5°42' ± 3°17'). Starburst size was also significantly smaller (t = -2.60, p < 0.018) in BLF test eyes (M = 9°57' ± 4°25') than the fellow eye with the clear IOL (M = 12°33' ± 5°25'). CONCLUSIONS: BLF IOL filter short-wave light and mimic retinal screening by the young, natural crystalline lens. Such filtering can reduce some deleterious effects of bright light by decreasing ocular diffusion/halos and starbursts.

Macular pigment is inversely related to circulating C-reactive protein concentrations in school-aged children.

Xanthophyll carotenoids (i.e., lutein and zeaxanthin) are plant pigments that selectively deposit in the macula of the eye and provide retinal tissue with protection against photooxidative stress. Although having greater xanthophylls in various tissues is related to lower inflammation in adulthood and infancy, this relationship is underinvestigated in childhood. Thus, this study aimed to elucidate the relationships between macular xanthophyll status and inflammation in school-aged children. We hypothesized that greater macular pigment would be associated with lower systemic concentrations of C-reactive protein (CRP). Forty children (aged 7-12 years) from the East-Central Illinois area were recruited. Data were collected in a convenience sample over multiple visits to the laboratory that occurred over 1 month, including all individuals who provided adequate blood samples for analyses. Macular pigment optical density (MPOD) was assessed using customized heterochromatic flicker photometry. Dietary lutein and zeaxanthin were determined using 7-day diet records. Capillary dried blood spot samples were analyzed for CRP concentrations via enzyme-linked immunosorbent assay. Whole-body percentage fat (%Fat) was measured using dual-energy x-ray absorptiometry. Two-step hierarchical linear regression modelling was used to assess relationships between MPOD and CRP, following adjustment of pertinent covariates and the removal of outliers (N = 3). MPOD was negatively associated with CRP concentrations, after controlling for a priori covariates of age, sex, %Fat, and dietary lutein and zeaxanthin (ß = -0.58, ΔR2 = 0.22, P = .004). Age, sex, dietary lutein and zeaxanthin, and %Fat did not significantly contribute to the model. This study provides novel evidence that macular pigment and peripheral inflammation are inversely related in childhood.

Blue-Light Filtering Intraocular Implants and Darker Irises Reduce the Behavioral Effects of Higher-Order Ocular Aberrations.

PURPOSE: Higher order ocular aberrations (e.g. entopic scatter) arising from cornea and lens, decreases retinal image contrast by dispersing part of the image-forming optics over a broad retinal surface. Selective filtering of the light that is most susceptible to aberration (high-energy "blue" light) may reduce some of the behavioral effects. This was tested by comparing the performance of a blue-light filtering (BLF) vs a clear intraocular lens implant (IOL). METHODS: 52 participants with IOL (BLF: AlconSN60AT; clear: AlconSA60AT; N = 98 test eyes; M = 67.33 ± 7.48 years; 58.8% Female; 25.5% non-White) were recruited. Our outcome measure was based on the minimum resolvable distance between two points of light (two-point thresholds), formed using broadband xenon or isolated short-wave energy (425 nm). Iris color was measured by visual inspection and comparison against standard images. RESULTS: In the broadband condition, patients with BLF IOL had smaller two-point thresholds (M = 17.17 ± 5.71 mm; F[1,48] = 2.60; p = 0.045) than clear controls (M = 20.93 ± 10.22 mm). Similar improvements were found in the short-wave condition (MBLF=17.02 ± 5.30; Mclear=21.42 ± 10.99; p = 0.04). In the contralateral broadband comparison, eyes with the BLF had significantly smaller two-point thresholds (M = 18.10 ± 10.47 mm; t = -2.90, p < 0.001) than the clear IOL (M = 20.89 ± 10.61 mm). Similar effects were seen in the short-wave condition (MBLF=18.23 ± 9.88; Mclear = 21.06 ± 10.47; p = 0.001). Darker iris color was related to reduced scatter across IOL types, in both shortwave (F[2,48] = 4.62, p = 0.02) and broadband (F[2,48] = 5.27, p = 0.009) conditions. CONCLUSIONS: Anterior screening, be it by a darker iris or a BLF IOL, is directly related to decreases in two-point light thresholds.

Enhancing children's cognitive function and achievement through carotenoid consumption: The Integrated Childhood Ocular Nutrition Study (iCONS) protocol.

Lutein and zeaxanthin (L + Z) are carotenoids that accumulate in neural tissue and potentially confer benefits to cognition. Whereas cross-sectional studies have revealed positive associations between macular carotenoids (MC) and cognition, no studies have investigated whether L + Z supplementation impacts MC and cognition in childhood. Accordingly, the Integrated Childhood Ocular Nutrition Study aims to investigate the impact of L + Z supplementation over 9-months on academic abilities, attentional control, memory, and MC among preadolescent children. Children 8-10 years (N = 288) will enroll in a 9-month double-blind, placebo-controlled, randomized trial. The study is registered and approved as a clinical trial on the U.S. National Library of Medicine http://ClinicalTrials.gov registry (NCT05177679). Participants will be randomized into an active (10 mg lutein+2 mg zeaxanthin) or waitlist placebo-controlled group. Primary outcomes include hippocampal-dependent memory, attentional inhibition, and academic achievement using a spatial reconstruction task, an Eriksen flanker task, and the Kaufman Test of Academic and Educational Achievement 3rd edition, respectively. Secondary outcomes include event-related brain potentials of attentional resource allocation and information processing speed (i.e., P3/P300 amplitude and latency) recorded during the flanker task. Macular pigment optical density (MPOD) will be assessed using heterochromatic flicker photometry. Cognitive assessments will be completed prior to and after completion of the supplementation period. MPOD will be quantified prior to, at the mid-point of (4-5 months), and after (9 months) the supplementation period. It is hypothesized that L + Z supplementation will improve cognition and academic achievement. Further, benefits for cognition and achievement are anticipated to be mediated by increases in MC among treatment group participants.