Lutein Shows Potential as Nutritional Strategy in Myopia Management

A recent randomized controlled trial involving 180 children aged eight to 12 years found that those who took lutein ester oral supplements for six months showed essentially stabilized choroidal thickness, with a slight increasing trend of 1.16μm, while the control group exhibited progressive subfoveal choroidal thinning of -8.92μm over the same period. Photo: Green People. Click image to enlarge. An early sign of myopia progression, choroidal thinning has been shown to precede changes in axial length in both animal and human studies. Lutein, a carotenoid sourced from diet or supplements, is known to improve retinal health by acting as both a blue-light filter and an antioxidant in the macula. Given these attributes, researchers recently explored lutein as a promising complementary nutritional strategy for the prevention and management of myopia. Their randomized controlled trial found that children who consumed daily lutein ester supplements for six months showed significantly reduced subfoveal and temporal choroidal thinning compared to controls. Included in the study were 180 children aged eight to 12 years at a school in China. Participants were randomly divided into two groups: one group received an 8mg daily sachet of lutein ester, while the control group received a placebo sachet, both consumed for a duration of six months. Ocular examinations were performed at baseline and after six months, using swept-source OCT-A to measure choroidal thickness (CT) across various grid locations centered on the macula. The primary outcome was the difference in changes in CT between the two groups.The results supported a protective effect of lutein ester supplementation against choroidal thinning. The treatment group experienced a negligible increase in subfoveal CT by 1.16μm, while the control group exhibited a significant decrease of 8.92μm. Additionally, when examining temporal CT at 1mm and 1.5mm from the center, the treatment group demonstrated decreases of 2.83μm and 1.24μm, respectively, compared to the control group, which saw declines of 16.76μm and 15.77μm.“A key finding of our trial is the approximately 10µm to 15μm greater increase in CT observed in the intervention group compared to the control group,” the researchers wrote in their paper. They compared the protective effect of lutein to that of ortho-K, which demonstrates a mean difference of 10.62μm after one month of treatment compared to placebo. While other myopia interventions such as low-level red-light therapy and high-dose atropine may exhibit more pronounced CT changes, the authors pointed out that these treatments “carry potential drawbacks, including photophobia, impaired near vision or risks of corneal infection.” They argued, “In contrast, lutein ester supplementation offers advantages in safety, accessibility and cost-effectiveness.” While the mechanisms driving the effects of lutein on choroidal thickness have not been fully explored, the study authors put forth several possible explanations. “Lutein, a powerful antioxidant concentrated in the macula, may protect the choroid by quenching singlet oxygen and scavenging free radicals, thereby reducing oxidative stress in the retinal pigment epithelium and choroidal tissues to preserve their structural integrity and thickness,” they stated. Moreover, lutein contains anti-inflammatory properties that can mitigate the inflammatory cascade and help preserve ocular tissue. It may also improve choroidal blood flow and vascular health by “enhancing blood supply and improving oxygenation and nutrient delivery to the outer retina and retinal pigment epithelium.”Lutein supplementation was not found to affect axial length or spherical equivalent refraction, which the study authors say contrasts with prior research. They explained in their paper, “This discrepancy may be due to the enrolled populations having different levels of myopia severity at baseline, with our study including participants with milder myopia compared to the previous trial.” Furthermore, the relatively short study duration (six months) may have been inadequate to detect significant differences between groups in axial length and spherical equivalent refraction, since these parameters are slow-progressing.Another limitation of this study is its single-center cohort, which restricts variations from environmental factors. The researchers also didn’t analyze how factors such as age, sex and lifestyle influence the effect of lutein on choroidal thickness.The authors conclude that their study “provides novel evidence supporting lutein ester as a viable adjunctive nutritional strategy in clinical myopia management,” though they note that long-term studies are needed to assess whether the observed structural changes lead to a clinically meaningful reduction in axial elongation and myopia progression.Click here for the journal source. Li T, Li J, Deng C, et al. Effect of lutein ester supplement on choroidal thickness in children: a randomized controlled trial. Transl Vis Sci Technol. December 4, 2025. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.