Improvement of Visual Functions and Fundus Alterations in Early Age-Related Macular Degeneration Treated with a Combination of Acetyl-<i>L</i>-Carnitine, n-3 Fatty Acids, and Coenzyme Q10

Vol. 219, No. 3, 2005

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Original Paper

Improvement of Visual Functions and Fundus Alterations in Early Age-Related Macular Degeneration Treated with a Combination of Acetyl-L-Carnitine, n-3 Fatty Acids, and Coenzyme Q10
J. Feher^a, B. Kovacs^b, I. Kovacs^{b, c}, M. Schveoller^b, A. Papale^a, C. Balacco Gabrieli^a

Ophthalmic Neuroscience Program,
^aDepartment of Ophthalmology, University of Rome 'La Sapienza', Rome, Italy;
^bDepartment of Ophthalmology, University of Pecs, Pecs, and
^cSecond Department of Ophthalmology, Semmelweis University, Budapest, Hungary

Address of Corresponding Author

Ophthalmologica 2005;219:154-166 (DOI: 10.1159/000085248)

Key Words

Age-related macular degeneration
Acetyl-L-carnitine
n-3 fatty acids
Coenzyme Q10
Mitochondria
Clinical trial
Visual field
Visual acuity
Drusen

Abstract

The aim of this randomized, double-blind, placebo-controlled clinical trial was to determine the efficacy of a combination of acetyl-L-carnitine, n-3 fatty acids, and coenzyme Q10 (Phototrop^®) on the visual functions and fundus alterations in early age-related macular degeneration (AMD). One hundred and six patients with a clinical diagnosis of early AMD were randomized to the treated or control groups. The primary efficacy variable was the change in the visual field mean defect (VFMD) from baseline to 12 months of treatment, with secondary efficacy parameters: visual acuity (Snellen chart and ETDRS chart), foveal sensitivity as measured by perimetry, and fundus alterations as evaluated according to the criteria of the International Classification and Grading System for AMD. The mean change in all four parameters of visual functions showed significant improvement in the treated group by the end of the study period. In addition, in the treated group only 1 out of 48 cases (2%) while in the placebo group 9 out of 53 (17%) showed clinically significant (>2.0 dB) worsening in VFMD (p = 0.006, odds ratio: 10.93). Decrease in drusen-covered area of treated eyes was also statistically significant as compared to placebo when either the most affected eyes (p = 0.045) or the less affected eyes (p = 0.017) were considered. These findings strongly suggested that an appropriate combination of compounds which affect mitochondrial lipid metabolism, may improve and subsequently stabilize visual functions, and it may also improve fundus alterations in patients affected by early AMD.

Author Contacts

Janos Feher, MD, PhD
Via Lombardia, 23/c
IT-00187 Rome (Italy)
Tel./Fax +39 06 420 10 510
E-Mail j.feher@libero.it

Article Information

This paper was presented in part as a poster at the Annual Meeting of the American Academy of Ophthalmology, November 15-18, 2003, Anaheim (Calif.), and at the Annual Meeting of ARVO 2004, Fort Lauderdale (Fla.).

Received: June 17, 2004
Accepted after revision: October 22, 2004
Number of Print Pages : 13
Number of Figures : 3, Number of Tables : 4, Number of References : 68

Medline Abstract (ID 15947501)

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