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Zeaxanthin

Zeaxanthin is a yellow plant pigment that gathers in the macula, the center of the retina, where it helps filter blue light. People often look at it for nearsightedness progression, though the evidence there is limited, drawn from about 350 participants. Better-supported findings concern the macula itself: trials found macular pigment rose, and a large trial found lutein and zeaxanthin together reduced age-related macular degeneration progression.

Sources: PMID 22840421; PMID 22858124

Best evidence
Grade B
Conditions studied
2
Outcomes
7
Graded outcomes
0232

Evidence by condition

  • Strong
  • Moderate
  • Limited
  • Very limited

2 conditions, plus general outcomes

General

General: outcomes studied for Zeaxanthin
GradeOutcomeEffectSizeStudiesPeopleStudies list
AMD Progression Risk

The large AREDS2 RCT (n≈4,203) demonstrated that lutein/zeaxanthin (10mg/2mg) reduced AMD progression, with greatest benefit when replacing beta-carotene. Multiple observational studies including the CAREDS ancillary study of the Women's Health Initiative found higher macular pigment density and dietary intake associated with reduced AMD risk, though zeaxanthin is typically co-administered with lutein.

Improves (the measure goes down)Moderate effect8 studies6,500 people

Studies that measured amd progression risk

Macular Pigment Optical Density

Multiple human supplementation trials consistently show that zeaxanthin (typically combined with lutein and/or meso-zeaxanthin) significantly increases macular pigment optical density (MPOD). A 2017 JAMA Ophthalmology RCT and several earlier trials in both AMD patients and healthy adults confirmed dose-dependent MPOD increases over 6-24 months of supplementation.

Improves (the measure goes up)Moderate effect7 studies1,200 people

Studies that measured macular pigment optical density

Contrast Sensitivity

Several human trials report modest improvements in contrast sensitivity following macular carotenoid supplementation. An RCT in early AMD patients (PMID:22858124) and the ZVF study in atrophic AMD (PMID:22027699) showed improvements, though effects in healthy eyes were more modest and not all studies reached significance.

Improves (the measure goes up)Small effect4 studies600 people

Studies that measured contrast sensitivity

Disability Glare Recovery

A controlled trial (PMID:27857944) found macular carotenoid supplementation including zeaxanthin improved disability glare performance and photostress recovery dynamics. The ZVF study also reported glare recovery improvements in atrophic AMD patients supplemented with zeaxanthin, though the evidence base remains limited.

Improves (the measure goes up)Small effect3 studies250 people

Studies that measured disability glare recovery

Diabetic Retinopathy Risk

A narrative review (PMID:28232380) discussed a putative protective role of lutein and zeaxanthin in diabetic retinopathy based on antioxidant mechanisms and limited preclinical data. An exploratory study (PMID:27274188) evaluated macular carotenoid supplementation in various retinal diseases including diabetic retinopathy, but robust clinical trial evidence is lacking.

Improves (the measure goes down)Small effect2 studies

Studies that measured diabetic retinopathy risk

Cataracts

Cataracts: outcomes studied for Zeaxanthin
GradeOutcomeEffectSizeStudiesPeopleStudies list
Nuclear Cataract Risk

The CAREDS ancillary study of the Women's Health Initiative (PMID:18332316, n≈1,787) found inverse associations between dietary and serum lutein/zeaxanthin and age-related nuclear cataract prevalence. Evidence is primarily observational and the independent contribution of zeaxanthin versus lutein is unclear.

Improves (the measure goes down)Small effect3 studies1,800 people

Studies that measured nuclear cataract risk

Age-Associated Memory Impairment and Cognitive Decline (AAMCD)

Age-Associated Memory Impairment and Cognitive Decline (AAMCD): outcomes studied for Zeaxanthin
GradeOutcomeEffectSizeStudiesPeopleStudies list
Cognitive Function

Preliminary evidence suggests a possible role for lutein and zeaxanthin in cognitive function in the elderly (PMID:23053547). A primate study (PMID:22780947) demonstrated that macular lutein and zeaxanthin concentrations are correlated with brain carotenoid levels, providing a plausible biological mechanism, but human intervention data remain very limited.

Improves (the measure goes up)Small effect2 studies

Studies that measured cognitive function

Key findings

  • AMD Progression RiskImproves (the measure goes down)
  • Macular Pigment Optical DensityImproves (the measure goes up)
  • Contrast SensitivityImproves (the measure goes up)

Safety notes in the studies

  • Multiple observational studies including the CAREDS ancillary study of the Women's Health Initiative found higher macular pigment density and dietary intake associated with reduced AMD risk, though zeaxanthin is typically co-administered with lutein.

Shop the evidence-backed picks

Third-party tested Zeaxanthin products, in the forms the graded studies used where we can match them.

  • Grade B

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Studies cited

18 studies from PubMed

  1. Effect of Dietary Supplementation With Lutein, Zeaxanthin, and ω-3 on Macular Pigment: A Randomized Clinical TrialJAMA Ophthalmology, 2017 · PMID 28973076
  2. Putative protective role of lutein and zeaxanthin in diabetic retinopathyThe British Journal of Ophthalmology, 2017 · PMID 28232380
  3. The Age-Related Eye Disease 2 Study: Micronutrients in the Treatment of Macular DegenerationAdvances in Nutrition, 2017 · PMID 28096126
  4. Lutein, Zeaxanthin and Meso-zeaxanthin Supplementation Associated with Macular Pigment Optical DensityNutrients, 2016 · PMID 27420092
  5. Macular carotenoid supplementation improves disability glare performance and dynamics of photostress recoveryEye and Vision, 2016 · PMID 27857944
  6. An exploratory study evaluating the effects of macular carotenoid supplementation in various retinal diseasesClinical Ophthalmology, 2016 · PMID 27274188
  7. Lutein, zeaxanthin, and meso-zeaxanthin: The basic and clinical science underlying carotenoid-based nutritional interventions against ocular diseaseProgress in Retinal and Eye Research, 2016 · PMID 26541886
  8. Zeaxanthin and ocular health, from bench to bedsideFitoterapia, 2016 · PMID 26705841
  9. Supplementation with three different macular carotenoid formulations in patients with early age-related macular degenerationRetina, 2014 · PMID 24887490
  10. Macular lutein and zeaxanthin are related to brain lutein and zeaxanthin in primatesNutritional Neuroscience, 2013 · PMID 22780947
  11. The Age-Related Eye Disease Study 2 (AREDS2): study design and baseline characteristics (AREDS2 report number 1)Ophthalmology, 2012 · PMID 22840421
  12. Effect of lutein and zeaxanthin on macular pigment and visual function in patients with early age-related macular degenerationOphthalmology, 2012 · PMID 22858124
  13. A possible role for lutein and zeaxanthin in cognitive function in the elderlyThe American Journal of Clinical Nutrition, 2012 · PMID 23053547
  14. Randomized, double-blind, placebo-controlled study of zeaxanthin and visual function in patients with atrophic age-related macular degeneration: the Zeaxanthin and Visual Function Study (ZVF)Optometry, 2011 · PMID 22027699
  15. Macular pigment density and age-related maculopathy in the Carotenoids in Age-Related Eye Disease StudyOphthalmology, 2008 · PMID 17868874
  16. Associations between age-related nuclear cataract and lutein and zeaxanthin in the diet and serum in the Carotenoids in the Age-Related Eye Disease StudyArchives of Ophthalmology, 2008 · PMID 18332316
  17. Associations between intermediate age-related macular degeneration and lutein and zeaxanthin in the Carotenoids in Age-related Eye Disease Study (CAREDS)Archives of Ophthalmology, 2006 · PMID 16908818
  18. Predictors of optical density of lutein and zeaxanthin in retinas of older women in the Carotenoids in Age-Related Eye Disease StudyThe American Journal of Clinical Nutrition, 2006 · PMID 17093164

Protocols that include Zeaxanthin