Evidence Level
Moderate
The CREST studies (Central Retinal Enrichment Supplementation Trials) demonstrated that a three-carotenoid formula including meso-zeaxanthin produced greater increases in macular pigment optical density than two-carotenoid formulas. Nolan et al. (2016) showed the triple formula improved contrast sensitivity and visual performance in AMD patients. Meso-zeaxanthin is increasingly recognized as an essential component of comprehensive macular supplementation.