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CompletedNCT01354093Updated Jun 23, 2017

The Role of Macular Pigment Carotenoids in the Pathogenesis and Treatment of Macular Telangiectasia Type 2 (MacTel)

An observational study in Idiopathic Juxtafoveal Telangiectasia, sponsored by Paul S. Bernstein. Completed at 1 site in United States. Open to participants aged 50 Years to 85 Years. Per ClinicalTrials.gov, last updated 2017-06-23.

Sponsored by Paul S. Bernstein · Observational

Study type
Observational
Model
Other
Time perspective
Prospective
Enrollment
8
Ages
50 Years to 85 Years
Sex
All
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Study summary

Macular telangiectasia type 2 ("MacTel Type 2") is an uncommon eye disorder that results in slow vision loss beginning in middle age. The macula is the central part of the retina, which lines the back of the eye like the film of a camera. The macula is responsible for central or reading vision. Telangiectasis refers to dilated, leaky vessels, for example varicose veins in the legs. One of the earliest manifestations of macular telangiectasia type 2 is an acquired reduction and/or redistribution of the macular pigment carotenoids at the foveal center. Currently, the biochemical mechanisms and clinical significance underlying these changes are not known, but it seems likely that better understanding of this phenomenon could lead to new interventions against MacTel.

The objectives of this study are to image the maculas of MacTel subjects using two-wavelength autofluorescence imaging and resonance Raman imaging to target the 7-degree radius pigment ring characteristic of macular telangiectasia type 2 in order to gain further insight into the significance of this early clinical sign, and to evaluate whether supplementation with oral zeaxanthin can normalize macular pigment distribution in MacTel subjects

Read the detailed description

One of the earliest manifestations of macular telangiectasia type 2 ("MacTel") is an acquired reduction and/or redistribution of the macular pigment carotenoids at the foveal center. Currently, the biochemical mechanisms and clinical significance underlying these changes are not known, but it seems likely that better understanding of this phenomenon could lead to new interventions against MacTel.

Dr. Bernstein's laboratory at the Moran Eye Center of the University of Utah has focused for the past fifteen years on the role of the macular pigment carotenoids, lutein and zeaxanthin, in maintaining macular health. These xanthophyll carotenoids are derived exclusively from the diet, especially from green leafy vegetables and orange-yellow fruits and vegetables. They are thought to protect the macula from light-induced oxidative damage by virtue of their light-screening and antioxidant properties. Dietary supplement products, from infant formula to those aimed at seniors, primarily contain lutein; however the central macula (the fovea) actually has been shown to have higher concentrations of zeaxanthin.

Dr. Bernstein's lab has identified and characterized the binding proteins responsible for the uptake and stabilization of lutein and zeaxanthin in the macula, developed new, noninvasive methods to quantify and image carotenoids in the retina and many other non-ocular tissues, and has participated in intervention trials of lutein and zeaxanthin against age-related macular degeneration. As a leading site for identification of MacTel families in North America as part of the "MacTel Project", Dr. Bernstein and other researchers at the University of Utah have unique expertise in the biochemistry and biophysics of the macular pigment carotenoids that may help to hasten progress toward effective diagnosis and intervention against MacTel in a highly collaborative manner.

Macular Pigment Imaging:

Dr. Bernstein has extensive experience with various methods to image and quantify macular pigment in the living human eye, especially using autofluorescence imaging (AFI) and resonance Raman imaging (RRI). Dr. Bernstein is also currently utilizing these methods to evaluate age-related macular degeneration (AMD) patients participating in the "AREDS2" study.

The objectives of this study are two-fold:

  1. To image the maculas of MacTel subjects using two-wavelength autofluorescence imaging (AFI) and resonance Raman imaging (RRI) to target the 7-degree radius pigment ring characteristic of macular telangiectasia type 2 in order to gain further insight into the significance of this early clinical sign;
  2. To evaluate whether supplementation with oral zeaxanthin can normalize macular pigment distribution in MacTel subjects.

This is an open-label pilot study that will enroll up to ten patients affected with macular telangiectasia type 2 and evaluate them every six months for two years. All participants will take 20 mg of zeaxanthin supplement per day for the duration of the study. Macular pigment distributions will be determined using two-wavelength autofluorescence imaging and resonance Raman imaging.

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Conditions studied

  • Idiopathic Juxtafoveal Telangiectasia

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Keywords

  • MacTel
  • Macular telangiectasia type 2
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In context

Telangiectasis

153 studies on the registry are indexed under Telangiectasis; 16 are open to participants now.

This study's enrollment of 8 is below the median of 100 across 37 observational studies indexed under Telangiectasis.

Browse Telangiectasis studies →

Lead sponsor

Paul S. Bernstein is the lead sponsor of 3 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
50 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Up to ten subjects of either gender who have MacTel (as confirmed by the MacTel central study Reading Center) will be invited to participate. Only those who can conveniently travel to the University of Utah for study evaluations will be approached since the project does not have sufficient funding to reimburse for travel expenses. Participants must agree to discontinue use of any other supplements containing substantial amounts of carotenoids for one month prior to the baseline visit and for the duration of the study.

Eligibility criteria

Inclusion Criteria:

  • Male or female subjects who have MacTel and can conveniently travel to the University of Utah for study evaluations
05

Study design

Observational model
Other
Time perspective
Prospective
Enrollment
8 participants (actual)
Patient registry
No

Groups and cohorts

  • MacTel Type 2 20 mg/day dose group

    Participants will have macular telangiectasis type 2 as confirmed by the reading center. Participants will take 20 mg of zeaxanthin per day.

    Drug: zeaxanthin

  • MacTel Type 2 10 mg/day dose group

    Participants will have macular telangiectasia type 2 as confirmed by the reading center. Participants will take 10 mg of zeaxanthin per day.

    Drug: zeaxanthin

Interventions

  • Drugzeaxanthin

    10 mg of EyePromise 10 (zeaxanthin) supplement, taken twice a day

  • Drugzeaxanthin

    10 mg of EyePromise 10 (zeaxanthin) supplement, taken once a day

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What researchers measure

Primary outcomes

  1. Change from baseline in macular pigment distribution and concentration

    The primary outcome measure will be will be change from baseline in macular pigment distribution and concentration.

    Time frame: 1 year

Secondary outcomes

  1. Change in visual acuity

    Secondary outcome measures will be best-corrected visual acuity, contrast sensitivity, and changes in retinal thickness measured by spectral domain OCT (optical coherence tomography).

    Time frame: 1 year

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Study locations

1 site
  • Moran Eye Center, University of Utah
    Salt Lake City, Utah 84132, United States
08

References and documents

Publications

  • Bernstein PS, Delori FC, Richer S, van Kuijk FJ, Wenzel AJ. The value of measurement of macular carotenoid pigment optical densities and distributions in age-related macular degeneration and other retinal disorders. Vision Res. 2010 Mar 31;50(7):716-28. doi: 10.1016/j.visres.2009.10.014. Epub 2009 Oct 23. PubMed 19854211 ↗
  • Bhosale P, Li B, Sharifzadeh M, Gellermann W, Frederick JM, Tsuchida K, Bernstein PS. Purification and partial characterization of a lutein-binding protein from human retina. Biochemistry. 2009 Jun 9;48(22):4798-807. doi: 10.1021/bi9004478. PubMed 19402606 ↗
  • Sharifzadeh M, Zhao DY, Bernstein PS, Gellermann W. Resonance Raman imaging of macular pigment distributions in the human retina. J Opt Soc Am A Opt Image Sci Vis. 2008 Apr;25(4):947-57. doi: 10.1364/josaa.25.000947. PubMed 18382494 ↗
  • Loane E, Nolan JM, O'Donovan O, Bhosale P, Bernstein PS, Beatty S. Transport and retinal capture of lutein and zeaxanthin with reference to age-related macular degeneration. Surv Ophthalmol. 2008 Jan-Feb;53(1):68-81. doi: 10.1016/j.survophthal.2007.10.008. PubMed 18191658 ↗
  • Bhosale P, Bernstein PS. Vertebrate and invertebrate carotenoid-binding proteins. Arch Biochem Biophys. 2007 Feb 15;458(2):121-7. doi: 10.1016/j.abb.2006.10.005. Epub 2006 Oct 30. PubMed 17188641 ↗
  • Sharifzadeh M, Bernstein PS, Gellermann W. Nonmydriatic fluorescence-based quantitative imaging of human macular pigment distributions. J Opt Soc Am A Opt Image Sci Vis. 2006 Oct;23(10):2373-87. doi: 10.1364/josaa.23.002373. PubMed 16985523 ↗
  • Bhosale P, Larson AJ, Frederick JM, Southwick K, Thulin CD, Bernstein PS. Identification and characterization of a Pi isoform of glutathione S-transferase (GSTP1) as a zeaxanthin-binding protein in the macula of the human eye. J Biol Chem. 2004 Nov 19;279(47):49447-54. doi: 10.1074/jbc.M405334200. Epub 2004 Sep 7. PubMed 15355982 ↗
  • Bhosale P, Serban B, Zhao DY, Bernstein PS. Identification and metabolic transformations of carotenoids in ocular tissues of the Japanese quail Coturnix japonica. Biochemistry. 2007 Aug 7;46(31):9050-7. doi: 10.1021/bi700558f. Epub 2007 Jul 14. PubMed 17630780 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 23, 2017, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT01354093
Lead sponsor
Paul S. Bernstein
Responsible party
Paul S. Bernstein (Professor of Ophthalmology, University of Utah) — Sponsor-investigator
First posted
May 16, 2011
Start date
Nov 2011
Primary completion
Jan 2017
Completion
Jan 2017
Last update
Jun 23, 2017

Study contacts

Paul S. Bernstein, M.D., Ph.D.
principal investigator · University of Utah

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jun 2017. You cannot join it, but the record below documents what was studied.

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