The science behind Vision

Vision’s formulation builds on 20 years of data from the AREDS and AREDS 2 clinical trials, which involved thousands of participants and have persistently demonstrated long-term benefits for macular health. By combining insights from these landmark studies with the latest advancements in xanthophyll research, Vision offers comprehensive support for maintaining macular health and promoting eye longevity. 
Ingredients in Vision

Based on the clinically proven AREDS 2 for long-term macular support

The macula contains the highest concentration of photoreceptors (light-sensing cells) and is responsible for sharp, detailed central vision—critical for tasks like reading, doing close-up work, driving, and recognizing faces—and color vision. As we age, the integrity of the macula declines. The AREDS and AREDS 2 supplement formulas were established by the National Eye Institute (NEI)’s clinical trials involving thousands of participants to combat this decline. 

The first trial, known as AREDS, was initiated in 1996 and involved 4,757 participants, aged 55-80 years and 11 clinical centers. Researchers examined the effects of a nutrient formula consisting of vitamins C, E, beta-carotene, and zinc on participants’ macular health, over the course of five years. The study demonstrated significant benefits of the AREDS formulation on maintaining long-term macular health. The formulation demonstrated continued effects in a second, five-year follow-up study [1]. 

Based on new learnings around macular health, the NEI launched a second AREDS 2 study in 2006 to determine if the original formulation could be improved. One of the major changes examined in this second study was the replacement of beta-carotene in the original AREDS formulation with lutein and zeaxanthin. Lutein and zeaxanthin were of interest because they are major constituents of the macular pigment and serve a variety of functions in the eye including filtering blue light and providing antioxidant defense. Levels of these critical macular pigments also decline with age, as much as 10% per decade [2]. Lutein was not commercially available at the start of the original AREDS study. The AREDS 2 trial involved 4,203 participants, aged 50 to 85 and 82 clinical centers across the U.S. and lasted five years. The study demonstrated that replacing beta-carotene with lutein and zeaxanthin resulted in even greater benefits for supporting macular health [3]. In a second 10-year follow-on study, the AREDS 2 formula continued to show persistent benefits and confirmed its superior efficacy compared to the original AREDS formula [4]. 

Vision contains ingredients based on the clinically proven AREDS 2 formula (including lutein and zeaxanthin) to support long-term macular health.

 

Meso-zeaxanthin, the third macular pigment

As mentioned above, lutein and zeaxanthin are major components of the macular pigment, a yellow pigment that accumulates in the macula and functions to block blue light and provide antioxidant protection. There is, however, a third component of the macular pigment, called meso-zeaxanthin. Meso-zeaxanthin is concentrated at the very center of the macula (at the fovea where visual acuity is highest) while zeaxanthin is spread across a slightly wider area, followed by lutein which forms a ring around meso-zeaxanthin and zeaxanthin.

Macular pigment distribution in the retina

Studies now demonstrate that supplementation with all three pigments provides significant advantages for vision and macular health compared to lutein and zeaxanthin alone. For example, while supplementation with lutein and zeaxanthin results in a modest increase in macular pigment density [5,6], adding meso-zeaxanthin to the formulation results in a greater and more rapid increase in macular pigment density [7]. 

Chart showing how supplementation with macular pigments results in increased macular pigment desnsity
Chart: Supplementation with all three macular pigments (M+Z+L) resulted in a significant increase in macular pigment density compared to supplementation with Z+L (provided by AREDS2) or placebo. *P < 0.05. Adapted from Loughman et al., 2012.
 

Furthermore, supplementation with all three pigments results in significant improvements in contrast sensitivity (ability to distinguish details and foreground versus background and a significant predictor of visual performance in the real world) and vision in glare and low-light conditions [7]. Supplementation with lutein and zeaxanthin alone do not show the same level of benefits.

The PIXEL Complex in Vision contains all three pigments, meso-zeaxanthin, zeaxanthin, and lutein, in the specific ratio and amount clinically demonstrated to increase macular pigment density and improve contrast sensitivity and vision in glare and low-light conditions.

 

Astaxanthin, the fourth pigment in the PIXEL Complex and a potent antioxidant

Like meso-zeaxanthin, zeaxanthin, and lutein, astaxanthin is a xanthophyll carotenoid, a subcategory of carotenoids (pigments found in nature that act as potent antioxidants and absorb light of different colors or wavelengths). Astaxanthin possesses a unique molecular structure which imparts an antioxidant capacity that's almost ten times higher than zeaxanthin, lutein, or beta carotene [8]. In a clinical study, astaxanthin supplementation over a period of three weeks resulted in a significant reduction in markers of oxidative stress and increase in markers of antioxidant capacity in the blood in overweight and obese individuals [9].

Unlike meso-zeaxanthin, zeaxanthin, and lutein, astaxanthin is not naturally present in the retina. However, it has been shown to cross the blood-retina barrier and protect retinal cells from oxidative stress in preclinical models [10,11]. In human clinical studies, astaxanthin has been shown to improve blood flow to the retina (critical for supplying oxygen and nutrients) and counter the negative effects of extended screen use on eye accommodation (focus adjustment) and hand-eye coordination [12-14]. These benefits are thought to be mediated by astaxanthin’s potent antioxidant activity.

The retina is one of the most metabolically active tissues in the body, resulting in high levels of reactive oxygen species (ROS) production. Combined with near-constant exposure to high-energy blue light and a large concentration of fatty acids prone to oxidation and ROS production, the retina is particularly vulnerable to oxidative stress [15]. Oxidative stress, when unchecked, can negatively impact essential molecules, cells, and structures in the eye and, ultimately, visual function.

The PIXEL Complex in Vision contains astaxanthin, a powerful antioxidant, along with macular pigments meso-zeaxanthin, zeaxanthin, and lutein, which together provide daily antioxidant protection to support visual performance, eye health, and eye longevity.

You can learn more about the benefits you can expect with Vision here.


Go Deeper → Read the Studies

  1. AREDS report no. 8. Arch Ophthalmol. 2001;119(10):1417–1436. 
  2. Obana A, Gohto Y, Tanito M, et al. Graefes Arch Clin Exp Ophthalmol. 2014;252(8):1221-1228.
  3. AREDS2 report No. 3. JAMA Ophthalmol. 2014;132(2):142-149. 
  4. AREDS2 Report 28. JAMA Ophthalmol. 2022;140(7):692-698. 
  5. Loughman J, Akkali MC, Beatty S, et al. Vision Res. 2010;50(13):1249-1256. 
  6. Nolan JM, Loughman J, Akkali MC, et al. Vision Res. 2011;51(5):459-469. 
  7. Loughman J, Nolan JM, Howard AN, et al., Invest Ophthalmol Vis Sci. 2012;53(12):7871-7880.
  8. Miki W. Pure Appl. Chem. 1991;63:141–146. 
  9. Choi HD, Kim JH, Chang MJ, et al., Phytother Res. 2011;25(12):1813-1818. 
  10. Petri D, Lundebye AK. Comp Biochem Physiol C Toxicol Pharmacol. 2007;145(2):202-209. 
  11. Janani R, Anitha RE, Perumal MK, et al. Exp Eye Res. 2021;206:108555. 
  12. Yasunori N, Mihara M, Takahashi J, et al., J Clin Ther and Med. 2005;21(5).
  13. Nagaki, Y., Hayasaka, S., Yamada, et al., J Trad Med. 2002;19:170-173. 
  14. Yoshida K, Sakai O, Honda T, et al. Nutrients. 2023;15(6):1459. 
  15. Ozawa Y. Redox Biol. 2020;37:101779.