Originally adapted to augment macular pigment for anti-inflammatory, antioxidative, blue
light, and visual performance purposes, supplementation with carotenoids has been tested
in animal models for protective effects against traumatic brain injury (TBI). Results
have been promising, as mice provided with the three main carotenoids (Lutein,
Meso-Zeaxanthin, and Zeaxanthin) following TBI displayed reduced levels of
pro-inflammatory markers (IL-1β, IL-6, and GFAP) and increased levels of GAP43, NCAM, and
BDNF, signaling activation of anti-oxidant systems.
Due to inflammation of the visual system following trauma, immune responses in the eye
are for both reparative and protective purposes. However, cytokines released by immune
cells compromise visual acuity by means of inflammation and fibrosis (scarring). As such,
inflammation to the visual system (including visual processing structures in the brain)
carries the danger of visual impairment. Research examining chronic inflammatory
responses in the optic tract and subsequent visual dysfunction found mTBI in rodent
models to increase GFAP, tumor necrosis factor (TNF), and degeneration of axons up to 3.5
months post-injury. As such, inflammation of the visual system is a measurable phenomenon
in rodent models, conveying the need for human subjects research. The nutrients found in
the proposed test supplement, lutein, zeaxanthin, meso-zeaxanthin, along with the omega-3
fatty acids DHA and EPA, are deposited in the brain regions that are often found to be
affected by a collision-related head injury. Thus, an exploratory study of this topic is
proposed, utilizing the three main carotenoids in the form of a MacuHealth supplement.
Optical Coherence Tomography has become a critical clinical tool when discovering and
diagnosing disease and neurological disorders of the eyes. It works to map the retina in
order to give ophthalmologists precise measurements of the tissues which make up this
important part of human anatomy and helps medical experts to diagnosis diseases of the
eye such as Glaucoma and Macular Degeneration. In terms of retinal nerve fiber layer
thickness (RNFL), a study found Olympic boxers to have thinner RNFL compared to controls.
Another study found RNFL thickness as a significant predictor of athlete vs control
status, with 4.8-um of thinning seen on average in athletes (boxing, football) when
compared to controls.
Although vision disorders are so common, VQOL - to our knowledge - is not specifically
addressed following exposure to repetitive head impacts (RHI), concussion, or during
return-to-play protocol. In sports such as football, hockey, and boxing where
participants are exposed to RHI, participation while experiencing decreased VQOL or
visual functionality could prove costly to the health of those athletes. Poor visual
acuity and photophobia following concussion have been cited as indicators of poor VQOL.
As such, use of the VFQ-25 and the 10-Item Supplement may be important additions to
current clinical practice when evaluating the baseline health status of athletes, and
following the completion of a collision-sport season.
