Effects of supplementation of macular pigment carotenoids on ocular health: a Raman spectroscopic study of human blood serum of glaucoma patients.

Carotenoids are known for their antioxidant and vision protection roles, with dietary supplements often promoted for eye health. An initial trial, the European Nutrition in Glaucoma Management (ENIGMA), assessed macular pigment optical density (MPOD) and other ocular parameters before and after supplementing glaucoma patients with macular pigment (MP) carotenoids. The trial confirmed significant improvements in clinical ocular health. Blood, containing all major dietary carotenoids, serves as an efficient medium for analysis of carotenoids. Raman spectroscopy, an effective analytical tool, was used to measure the impact of supplementation on serum carotenoid levels and their correlation with MPOD and other ocular responses. Serum samples from baseline and 18-month supplemented participants were analysed. An inverse relationship was found between the percentage change in Raman intensity over the supplementation period and baseline Raman serum measurements, indicating greater relative benefits for people with low MPOD/serum carotenoids pre-supplementation. Partial least squares regression (PLSR) was employed to analyse the spectra after pre-processing, and the loadings reflected the carotenoid content and structural profile. MPOD results correlated at all eccentricities, with a coefficient of determination () of 0.62-0.92 and %Root mean squared error of <44%. Structural, functional, and perceptual parameters also showed good correlation with serum Raman measurements. The results support the ENIGMA trial conclusions, and suggest strategies for optimizing patient responses to supplementation based on baseline carotenoid levels. Additionally, Raman spectroscopy of serum carotenoids shows significant potential as a simple and reliable method for investigating macular pigment carotenoids and assessing patient health.