MACUSHIELD – Trust the Science
The only triple combination of macular pigments contains:
Lutein, Meso-zeaxanthin, and Zeaxanthin in a specific 10:10:2 ratio
Normalizes the level of protective pigment in the macula of the eye
Proven to protect the retina by strengthening the macular pigment
Used by a vast number of patients worldwide
No. 1 recommended product by eye experts in the UK

MacuShield is suitable for:
Risk of macular pigment damage or existing manifestations of macular pigment damage
High visual strain without the possibility of rest, for those working long hours on computers, screens, and other similar electronic devices
Activities involving prolonged exposure to bright sunlight or bright artificial light
Document processing activities where vision is strained for long periods without the possibility of rest

Mechanism of Action:
Macular degeneration is the most common cause of vision loss in developed countries. It is due to degenerative changes in the macula associated with certain pathophysiological processes leading to a reduction in the amount of macular pigment. Risk factors underlying macular degeneration include: age over 55, smoking, family history, poor diet, and cardiovascular disease. Macular pigments play a key role in protecting the macula and provide conditions for the normal physiological activity of cells in this vital area. Therefore, the destruction of the macular pigment layer could create conditions for the development of macular degeneration. Daily requirements for macular carotenoids are 3–6 mg/day (Public Health England 2018). The average daily dietary intake of lutein and zeaxanthin in developed countries is only 1–3 mg/day (Connelly 2011, Abdel-Aal 2013). This fact, along with other risk factors, is the basis for the increasing incidence of macular degeneration. Therefore, it is necessary to supplement macular pigments, specifically in a lutein/meso-zeaxanthin/zeaxanthin ratio of 10:10:2, which shows the highest efficacy in improving macular pigment status and vision quality.
The carotenoids lutein, zeaxanthin, and meso-zeaxanthin are distributed in a very specific way in the macula. The periphery of the macula contains lutein as the dominant carotenoid. In the center of the macula, meso-zeaxanthin is dominant, and between these two areas—the center and the periphery—zeaxanthin is the dominant carotenoid. Therefore, the presence of all three carotenoids is very important. Meso-zeaxanthin is of particular importance because, on the one hand, it is concentrated in the central part of the macula, where a large number of specific light-sensitive cells called “cones” are located, and on the other hand, it is almost entirely absent from the daily diet.
Macular pigments absorb short-wavelength blue light. Light causes phototoxic damage to the macula. Macular pigments are pre-receptorally located. Their primary role is to filter the short-wavelength light spectrum of approximately 460 nm falling onto the receptors. Irradiating photoreceptors with short-wavelength light increases the production of free radicals that destroy the macula. Cigarette smoking, smoke inhalation, ionizing radiation, and light of certain wavelengths cause oxygen photolysis and increase the amount of free radicals. Macular pigments are very powerful antioxidants against free radicals [Li, 2010]. Maximum antioxidant potential is achieved when all three macular pigments are taken in a specific ratio: Lutein / Meso-zeaxanthin / Zeaxanthin – 10:10:2.

Efficacy Data:
There are numerous publications and studies proving that the triple combination of carotenoid pigments—Lutein / Meso-zeaxanthin / Zeaxanthin in a 10:10:2 ratio—has the highest effect on improving vision.
A study proving increased serum concentrations of Meso-zeaxanthin and Lutein after supplementation with the three macular carotenoids (in a Meso-zeaxanthin/Lutein/Zeaxanthin ratio in [mg] of 10:10:2) leads to a significant increase in the concentration of macular pigments in the serum after two weeks of intake [1].
Patients taking the triple combination of macular carotenoids (in an MZ:L:Z ratio [mg] of 10:10:2) show a significant increase in serum concentrations of these carotenoids and a subsequent increase in macular pigments [2].
The formulation containing the triple combination of macular carotenoids (in an MZ:L:Z ratio [mg] of 10:10:2) was most effective in achieving the highest combined concentration of the three macular pigments in the serum, thereby potentially optimizing the bioavailability of these compounds [3].
The triple combination of macular carotenoids, which also contains meso-zeaxanthin, leads to a greater increase in macular pigment compared to the absence of meso-zeaxanthin in the intake [4].
The triple combination of macular carotenoids potentially offers advantages over preparations lacking meso-zeaxanthin, both in terms of increasing macular pigment and improving vision in individuals suffering from retinal diseases [5].
One study proves that including Meso-zeaxanthin in a supplement formulation provides benefits in terms of increasing macular pigment and enhanced contrast sensitivity in individuals with early-diagnosed macular pigment damage [6].
In individuals without retinal disease, supplementation with a formula containing the triple combination of macular carotenoids leads to measurable improvements in visual performance [7].
In a recent study conducted by researchers at Moorfields Eye Hospital in London, UK, it was proven that the composition containing the triple combination of macular carotenoids in a Meso-zeaxanthin:Lutein:Zeaxanthin ratio of 10:10:2 improves many aspects of visual performance in various retinal diseases [8].
Meta-analysis: a publication from China shows that the triple combination of Meso-zeaxanthin, Lutein, and Zeaxanthin qualitatively improves visual acuity both in patients with age-related macular pigment damage and in individuals without manifestations of macular pigment damage [9].
REFERENCES:
1. 2010 – Connolly et al.
2. 2011 – Connolly et al.
3. 2012 – Meagher et al.
4. 2014 – Thurnham et al.
5. 2012 – Loughman et al.
6. Supplementation with three different macular carotenoid formulations with patients with early age-related macular degeneration. Sarah Sabour-Pickett, PhD, Stephen Beatty, MD, FRCOphth, Eithne Connolly, BSc, James Loughman, PhD, Jim Stack, PhD, †Alan Howard, PhD, Ronald Klein, MD, MPH, Barbara E. Klein, MD, MPH, Stacy M. Meuer, BSc, Chelsea E. Myers, MStat, Kwadwo O. Akuffo, OD, John M. Nolan, PhD
7. Enrichment of Macular Pigment Enhances Contrast Sensitivity in Subjects Free of Retinal Disease: Central Retinal Enrichment Supplementation Trials – Report 1. Nolan JM1, Power R1, Stringham J2, Dennison J1, Stack J1, Kelly D1, Moran R1, Akuffo KO1, Corcoran L1, Beatty S1. 2016 Jun 1;57(7):3429-39. doi: 10.1167/iovs.16-19520.
Macular Pigment Research Group Nutrition Research Centre Ireland, School of Health Sciences, Carriganore House, Waterford Institute of Technology, West Campus, Carriganore, Waterford, Ireland
Nutritional Neuroscience Laboratory, Department of Physiology and Pharmacology, University of Georgia, Athens, Georgia, United States
8. An exploratory study evaluating the effects of macular carotenoid supplementation in various retinal diseases. Roxanne Crosby-Nwaobi, Philip Hykin, Tunde Peto, and Sobha Sivaprasa. Clinical Ophthalmology, 2016 May 11
9. Lutein, Zeaxanthin and Meso-zeaxanthin Supplementation Associated with Macular Pigment Optical Density. Nutrients. 2016 Jul 12;8(7). Ma L1,2, Liu R3,4, Du JH5, Liu T6, Wu SS7, Liu XH8. 1

Packaging:
MacuShield is available in a cardboard box containing 30 soft gelatin capsules, two blisters of 15 capsules each.
Batch number: see packaging.
Net weight: 18.9 g e.

Manufacturer:
ALLIANCE Pharmaceuticals Ltd https://www.alliancepharmaceuticals.com/
Avonbridge House, Bath Road, Chippenham, Wiltshire, UK

Official Representative for Bulgaria:
AVENDRA PHARMA EOOD
website: www.avendrapharma.com
e-mail: info@avendrapharma.com
head office: 3 Pleven St., Ruse
tel.: +359 888 575 008.
central warehouse: 101 Nikolaevska St., Ruse

QUANTITATIVE COMPOSITION:
Quantitative composition per daily intake of one capsule:
Lutein 10 mg
Meso-zeaxanthin 10 mg
Zeaxanthin 2 mg
EXCIPIENTS:
filler: sunflower seed oil (Helianthus annuus)
antioxidant: alpha-tocopheryl acetate /E422/
capsule ingredients: gelling agent – gelatin
stabilizer: glycerol
thickener: beeswax
colorant: iron oxide /E172/

Dosage and Administration:
Take once daily with water during a meal.
Contraindications:
Do not take if you are allergic to any of the ingredients.
Special Warnings:
Consult your doctor during pregnancy and breastfeeding.
Do not exceed the recommended daily dose.
Do not use as a substitute for a varied and balanced diet.
Do not use if the packaging is damaged or missing.
Instructions for Use:
No special instructions.
Side Effects:
No known side effects.

Shelf Life and Storage Conditions:
Store in a cool, dry place at a temperature below 25°C.

Use by: see the date marked on the packaging.
Keep out of reach of children under three years of age.