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McGwin G, Kar D, Berlin A, Clark ME, Swain TA, Crosson JN, Sloan KR, Owsley C, Curcio CA. Macular and Plasma Xanthophylls Are Higher in Age-related Macular Degeneration than in Normal Aging: Alabama Study on Early Age-related Macular Degeneration 2 Baseline. OPHTHALMOLOGY SCIENCE 2023; 3:100263. [PMID: 36864830 PMCID: PMC9972499 DOI: 10.1016/j.xops.2022.100263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 11/04/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
Purpose Quantification of retinal xanthophyll carotenoids in eyes with and without age-related macular degeneration (AMD) via macular pigment optical volume (MPOV), a metric for xanthophyll abundance from dual wavelength autofluorescence, plus correlations to plasma levels, could clarify the role of lutein (L) and zeaxanthin (Z) in health, AMD progression, and supplementation strategies. Design Cross-sectional observational study (NCT04112667). Participants Adults ≥ 60 years from a comprehensive ophthalmology clinic, with healthy maculas or maculas meeting fundus criteria for early or intermediate AMD. Methods Macular health and supplement use was assessed by the Age-related Eye Disease Study (AREDS) 9-step scale and self-report, respectively. Macular pigment optical volume was measured from dual wavelength autofluorescence emissions (Spectralis, Heidelberg Engineering). Non-fasting blood draws were assayed for L and Z using high-performance liquid chromatography. Associations among plasma xanthophylls and MPOV were assessed adjusting for age. Main Outcome Measures Age-related macular degeneration presence and severity, MPOV in fovea-centered regions of radius 2.0° and 9.0°; plasma L and Z (μM/ml). Results Of 809 eyes from 434 persons (89% aged 60-79, 61% female), 53.3% eyes were normal, 28.2% early AMD, and 18.5% intermediate AMD. Macular pigment optical volume 2° and 9° were similar in phakic and pseudophakic eyes, which were combined for analysis. Macular pigment optical volume 2° and 9° and plasma L and Z were higher in early AMD than normal and higher still in intermediate AMD (P < 0.0001). For all participants, higher plasma L was correlated with higher MPOV 2° (Spearman correlation coefficient [Rs] = 0.49; P < 0.0001). These correlations were significant (P < 0.0001) but lower in normal (Rs = 0.37) than early and intermediate AMD (Rs = 0.52 and 0.51, respectively). Results were similar for MPOV 9°. Plasma Z, MPOV 2°, and MPOV 9° followed this same pattern of associations. Associations were not affected by supplement use or smoking status. Conclusions A moderate positive correlation of MPOV with plasma L and Z comports with regulated xanthophyll bioavailability and a hypothesized role for xanthophyll transfer in soft drusen biology. An assumption that xanthophylls are low in AMD retina underlies supplementation strategies to reduce progression risk, which our data do not support. Whether higher xanthophyll levels in AMD are due to supplement use cannot be determined in this study.
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Key Words
- ALSTAR2, Alabama Study on Early Age-related Macular Degeneration 2
- AMD, age-related macular degeneration
- AREDS, age-related eye disease studies
- Age-related macular degeneration
- Autofluorescence
- BrM, Bruch’s membrane
- HDL, high density lipoprotein
- L, Lutein
- Lutein
- MP, macular pigment
- MPOD, macular pigment optical density
- MPOV, macular pigment optical volume
- Macular xanthophyll pigment
- RPE, retinal pigment epithelium
- Z, Zeaxanthin
- Zeaxanthin
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Affiliation(s)
- Gerald McGwin
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Deepayan Kar
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Andreas Berlin
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Ophthalmology, University Hospital Wurzburg, Wurzburg, Germany
| | - Mark E. Clark
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Thomas A. Swain
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jason N. Crosson
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Retina Consultants of Alabama, Birmingham, Alabama
| | - Kenneth R. Sloan
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Computer Science, School of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Cynthia Owsley
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Christine A. Curcio
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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The Differential Contribution of Macular Pigments and Foveal Anatomy to the Perception of Maxwell's Spot and Haidinger's Brushes. Vision (Basel) 2023; 7:vision7010011. [PMID: 36810315 PMCID: PMC9944110 DOI: 10.3390/vision7010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/28/2023] [Accepted: 01/31/2023] [Indexed: 02/10/2023] Open
Abstract
The relationship of macular pigments and foveal anatomy to the perception of Maxwell's spot (MS) and Haidinger's brushes (HB) entoptic phenomena were investigated. Dual-wavelength-autofluorescence and OCT were used to define macular pigment density and foveal anatomy in 52 eyes. MS was generated by alternating unpolarized red/blue and red/green uniform field illumination. HB was generated by alternating the linear polarization axis of a uniform blue field. In Experiment 1, horizontal widths of MS and HB were measured using a micrometer system and compared with macular pigment densities and OCT-defined morphometry. MS radius (mean 1.4°) was significantly less than HB radius (mean 1.6°), with the spatial extent of both phenomena falling between the boundaries of the foveola and foveal pit. Multiple regression showed MS and HB radii to be significantly associated with the macular pigment spatial profile radius. HB radius, but not MS radius, was also significantly associated with foveolar morphometry. Experiment 2 compared perceptual profiles of MS with macular pigment distribution patterns and demonstrated close agreement. The size and appearance of MS is a direct indicator of macular pigment density and distribution. Measures of HB radii are less specific, with dependence on both macular pigment density and foveal structure.
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Jaggi D, Solberg Y, Dysli C, Lincke J, Habra O, Wolf S, Zinkernagel M. FLUORESCENCE LIFETIME IMAGING OPHTHALMOSCOPY AS PREDICTOR OF LONG-TERM FUNCTIONAL OUTCOME IN MACULA-OFF RHEGMATOGENOUS RETINAL DETACHMENT. Retina 2022; 42:2388-2394. [PMID: 36394892 PMCID: PMC9665949 DOI: 10.1097/iae.0000000000003612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE To assess whether macular fluorescence lifetimes may serve as a predictor for long-term outcomes in macula-off rhegmatogenous retinal detachment. METHODS A single-center observational study was conducted. Patients with pseudophakic macula-off rhegmatogenous retinal detachment were included and evaluated 1 and 6 months after successful reattachment surgery. Fluorescence lifetime imaging ophthalmoscopy lifetimes in the central Early Treatment Diabetic Retinopathy Study grid subfield, in two distinct channels (short spectral channel and long spectral channel) were analyzed. Best-corrected visual acuity optical coherence tomography of the macula and fluorescence lifetimes were measured at month 1 and month 6. RESULTS Nineteen patients were analyzed. Lifetimes of the previously detached retinas were prolonged compared with the healthy fellow eyes. Short lifetimes at month 1 were associated with better best-corrected visual acuity improvement (short spectral channel: r2 = 0.27, P < 0.05, long spectral channel: r2 = 0.23, P < 0.05) and with good final best-corrected visual acuity (short spectral channel: r2 = 0.43, P < 0.01, long spectral channel: r2 = 0.25, P < 0.05). Lifetimes were prolonged in some cases of outer retinal damage in optical coherence tomography scans. CONCLUSION Fluorescence lifetime imaging ophthalmoscopy might serve as a prediction tool for functional recovery in pseudophakic macula-off rhegmatogenous retinal detachment. Retinal fluorescence lifetimes could give insight in molecular processes after rhegmatogenous retinal detachment.
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Affiliation(s)
- Damian Jaggi
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Yasmin Solberg
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Chantal Dysli
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Joel Lincke
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Oussama Habra
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Sebastian Wolf
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Martin Zinkernagel
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and
- Department of BioMedical Research, University of Bern, Bern, Switzerland
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Olvera-Barrios A, Kihara Y, Wu Y, N. Warwick A, Müller PL, Williams KM, Rudnicka AR, Owen CG, Lee AY, Egan C, Tufail A. Foveal Curvature and Its Associations in UK Biobank Participants. Invest Ophthalmol Vis Sci 2022; 63:26. [PMID: 35900728 PMCID: PMC9344217 DOI: 10.1167/iovs.63.8.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 07/08/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose To examine whether sociodemographic, and ocular factors relate to optical coherence tomography (OCT)-derived foveal curvature (FC) in healthy individuals. Methods We developed a deep learning model to quantify OCT-derived FC from 63,939 participants (age range, 39-70 years). Associations of FC with sociodemographic, and ocular factors were obtained using multilevel regression analysis (to allow for right and left eyes) adjusting for age, sex, ethnicity, height (model 1), visual acuity, spherical equivalent, corneal astigmatism, center point retinal thickness (CPRT), intraocular pressure (model 2), deprivation (Townsend index), higher education, annual income, and birth order (model 3). Fovea curvature was modeled as a z-score. Results Males had on average steeper FC (0.077; 95% confidence interval [CI] 0.077-0.078) than females (0.068; 95% CI 0.068-0.069). Compared with whites, non-white individuals showed flatter FC, particularly those of black ethnicity. In black males, -0.80 standard deviation (SD) change when compared with whites (95% CI -0.89, -0.71; P 5.2e10-68). In black females, -0.70 SD change when compared with whites (95% CI -0.77, -0.63; p 2.3e10-93). Ocular factors (visual acuity, refractive status, and CPRT) showed a graded inverse association with FC that persisted after adjustment. Macular curvature showed a positive association with FC. Income showed a linear trend increase in males (P for linear trend = 0.005). Conclusions We demonstrate marked differences in FC with ethnicity on the largest cohort studied for this purpose to date. Ocular factors showed a graded association with FC. Implementation of FC quantification in research and on the clinical setting can enhance the understanding of clinical macular phenotypes in health and disease.
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Affiliation(s)
- Abraham Olvera-Barrios
- Medical retina, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, London, United Kingdom
| | - Yuka Kihara
- Roger and Angie Karalis Johnson Retina Center, University of Washington, Seattle, WA, United States
- Department of Ophthalmology, School of Medicine, University of Washington, Seattle, WA, United States
| | - Yue Wu
- Roger and Angie Karalis Johnson Retina Center, University of Washington, Seattle, WA, United States
- Department of Ophthalmology, School of Medicine, University of Washington, Seattle, WA, United States
| | - Alasdair N. Warwick
- Medical retina, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Philipp L. Müller
- Medical retina, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Macula Center, Südblick Eye Centers, Augsburg, Germany
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Katie M. Williams
- Medical retina, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Section of Ophthalmology, School of Life Course Sciences, FoLSM, King's College London, United Kingdom
| | - Alicja R. Rudnicka
- Population Health Research Institute, St. Georges, University of London, London, United Kingdom
| | - Christopher G. Owen
- Population Health Research Institute, St. Georges, University of London, London, United Kingdom
| | - Aaron Y. Lee
- Roger and Angie Karalis Johnson Retina Center, University of Washington, Seattle, WA, United States
- Department of Ophthalmology, School of Medicine, University of Washington, Seattle, WA, United States
| | - Catherine Egan
- Medical retina, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, London, United Kingdom
| | - Adnan Tufail
- Medical retina, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, London, United Kingdom
| | - on behalf of the UK Biobank Eyes and Vision Consortium
- Medical retina, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, London, United Kingdom
- Roger and Angie Karalis Johnson Retina Center, University of Washington, Seattle, WA, United States
- Department of Ophthalmology, School of Medicine, University of Washington, Seattle, WA, United States
- Institute of Cardiovascular Science, University College London, London, United Kingdom
- Macula Center, Südblick Eye Centers, Augsburg, Germany
- Department of Ophthalmology, University of Bonn, Bonn, Germany
- Section of Ophthalmology, School of Life Course Sciences, FoLSM, King's College London, United Kingdom
- Population Health Research Institute, St. Georges, University of London, London, United Kingdom
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Romero-Bascones D, Barrenechea M, Murueta-Goyena A, Galdós M, Gómez-Esteban JC, Gabilondo I, Ayala U. Foveal Pit Morphology Characterization: A Quantitative Analysis of the Key Methodological Steps. ENTROPY 2021; 23:e23060699. [PMID: 34205877 PMCID: PMC8227188 DOI: 10.3390/e23060699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/25/2022]
Abstract
Disentangling the cellular anatomy that gives rise to human visual perception is one of the main challenges of ophthalmology. Of particular interest is the foveal pit, a concave depression located at the center of the retina that captures light from the gaze center. In recent years, there has been a growing interest in studying the morphology of the foveal pit by extracting geometrical features from optical coherence tomography (OCT) images. Despite this, research has devoted little attention to comparing existing approaches for two key methodological steps: the location of the foveal center and the mathematical modelling of the foveal pit. Building upon a dataset of 185 healthy subjects imaged twice, in the present paper the image alignment accuracy of four different foveal center location methods is studied in the first place. Secondly, state-of-the-art foveal pit mathematical models are compared in terms of fitting error, repeatability, and bias. The results indicate the importance of using a robust foveal center location method to align images. Moreover, we show that foveal pit models can improve the agreement between different acquisition protocols. Nevertheless, they can also introduce important biases in the parameter estimates that should be considered.
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Affiliation(s)
- David Romero-Bascones
- Biomedical Engineering Department, Faculty of Engineering (MU-ENG), Mondragon Unibertsitatea, 20500 Mondragón, Spain; (D.R.-B.); (M.B.)
| | - Maitane Barrenechea
- Biomedical Engineering Department, Faculty of Engineering (MU-ENG), Mondragon Unibertsitatea, 20500 Mondragón, Spain; (D.R.-B.); (M.B.)
| | - Ane Murueta-Goyena
- Department of Preventive Medicine and Public Health, Faculty of Medicine and Nursery, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain;
- Neurodegenerative Disease Research Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (J.C.G.-E.); (I.G.)
| | - Marta Galdós
- Ophthalmology Department, Cruces University Hospital, 48903 Barakaldo, Spain;
| | - Juan Carlos Gómez-Esteban
- Neurodegenerative Disease Research Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (J.C.G.-E.); (I.G.)
| | - Iñigo Gabilondo
- Neurodegenerative Disease Research Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain; (J.C.G.-E.); (I.G.)
- IKERBASQUE: The Basque Foundation for Science, 48013 Bilbao, Spain
| | - Unai Ayala
- Biomedical Engineering Department, Faculty of Engineering (MU-ENG), Mondragon Unibertsitatea, 20500 Mondragón, Spain; (D.R.-B.); (M.B.)
- Correspondence: ; Tel.: +34-943794700
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Bartlett H, Howells O, Eperjesi F. The role of macular pigment assessment in clinical practice: a review. Clin Exp Optom 2021; 93:300-8. [DOI: 10.1111/j.1444-0938.2010.00499.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Hannah Bartlett
- Ophthalmic Research Group, School of Life & Health Sciences, Aston University, Birmingham, United Kingdom
E‐mail:
| | - Olivia Howells
- Ophthalmic Research Group, School of Life & Health Sciences, Aston University, Birmingham, United Kingdom
E‐mail:
| | - Frank Eperjesi
- Ophthalmic Research Group, School of Life & Health Sciences, Aston University, Birmingham, United Kingdom
E‐mail:
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Rutledge GA, Pratt SG, Richer SP, Huntjens B, Perry CB, Pratt G, Podella C. Foveal macular pigment dip in offspring of age-related macular degeneration patients is inversely associated with omega-3 index. BMC Ophthalmol 2020; 20:473. [PMID: 33267825 PMCID: PMC7709463 DOI: 10.1186/s12886-020-01742-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/23/2020] [Indexed: 12/23/2022] Open
Abstract
Background Offspring of parent(s) with age-related macular degeneration (AMD) have a 45% lifetime risk of developing the disease. High foveal macular pigment optical density (MPOD) is protective, whereas individuals with a “foveal macular pigment dip” (FMPD) are at increased risk. Shortage of the dietary carotenoids lutein, zeaxanthin as well as fish consumption are reported AMD risk factors. This Early Biomarkers of AMD (EBAMD) study evaluates serum factors that protect foveal MPOD architecture in Caucasian offspring of parent(s) with AMD. Methods N = 130 subjects [mean (SD) age 62.8 (8.6) years; 36/94 male/female] were recruited from Scripps Health/ Scripps Memorial Hospital/ Scripps Mericos Eye Institute between 2012 and 2017. Macula pigment 3D topography was evaluated using specular reflectance. Buccal genetic cheek swab, circulating serum dietary carotenoids and long-term RBC omega-3 fatty acid status, as well as common secondary clinical structural and vision function parameters were obtained. Results 41 % of offspring of AMD parent(s) presented with FMPD. These offspring were about 4 years younger than those without FMPD (controls; P = 0.012) and had thinner foveas (P = 0.010). There were no differences in gender, BMI, % body fat, visual acuity or contrast sensitivity between those with and without FMPD. % RBC membrane docosahexaenoic acid (DHA) was reduced in FMPD offspring vs. control offspring (P = 0.04). The Omega-3 Index was significantly decreased in the FMPD group (P = 0.03). Conclusions The percentage of FMPD in AMD offspring is nearly twice that reported for the general population in the scientific literature. Offspring presenting FMPD had similar AMD genetic risk, but significantly reduced % RBC membrane omega-3 fatty acids and thinner foveas compared with those without FMPD. Our data supports the importance of ‘essential fatty’ acids as an independent AMD risk factor.
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Affiliation(s)
- Grant A Rutledge
- Scripps Health/Scripps Memorial Hospital/Scripps Mericos Eye Institute - Scripps Clinical Research Service, La Jolla, CA, USA. .,Department of Ecology and Evolutionary Biology, University of California, Irvine, CA, USA. .,USDA Human Nutrition Research Center on Aging, Boston, MA, USA.
| | - Steven G Pratt
- Scripps Health/Scripps Memorial Hospital/Scripps Mericos Eye Institute - Scripps Clinical Research Service, La Jolla, CA, USA
| | - Stuart P Richer
- Eye Clinics, Captain James A. Lovell Federal Health Care Center, North Chicago, IL, USA
| | - Byki Huntjens
- Centre for Applied Vision Research, Division of Optometry and Vision Sciences, City, University of London, London, UK
| | - C Blake Perry
- Scripps Health/Scripps Memorial Hospital/Scripps Mericos Eye Institute - Scripps Clinical Research Service, La Jolla, CA, USA
| | - Gunilla Pratt
- Scripps Health/Scripps Memorial Hospital/Scripps Mericos Eye Institute - Scripps Clinical Research Service, La Jolla, CA, USA
| | - Carla Podella
- Eye Clinics, Captain James A. Lovell Federal Health Care Center, North Chicago, IL, USA
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Kar D, Clark ME, Swain TA, McGwin G, Crosson JN, Owsley C, Sloan KR, Curcio CA. Local Abundance of Macular Xanthophyll Pigment Is Associated with Rod- and Cone-Mediated Vision in Aging and Age-Related Macular Degeneration. Invest Ophthalmol Vis Sci 2020; 61:46. [PMID: 32729911 PMCID: PMC7425747 DOI: 10.1167/iovs.61.8.46] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Purpose We assessed the association between the abundance of macular xanthophyll carotenoid pigment using dual-wavelength autofluorescence and multimodal vision testing including rod-mediated dark adaptation (RMDA), a measure of retinoid re-supply, in adults ≥60 years old with and without age-related macular degeneration (AMD). Methods AMD severity was determined using the nine-step Age-Related Eye Disease Study grading. Tests probed cones (best-corrected visual acuity, contrast sensitivity), cones and rods (low-luminance visual acuity, low-luminance deficit, mesopic light sensitivity), or rods only (scotopic light sensitivity, RMDA). Signal attenuation by macular pigment optical density (MPOD) was estimated using a ratio of blue and green autofluorescence signal to yield mean MPOD in a 1°-diameter fovea-centered disk, mean MPOD in a 2°-diameter disk centered on a perifoveal RMDA test location, and macular pigment optical volume (MPOV, or integrated MPOD) in a 4°-diameter fovea-centered disk. Age-adjusted associations between vision and imaging measures were determined. Results In 88 eyes of 88 subjects (age, 74.9 ± 5.8 years) with normal eyes (n = 32), early AMD (n = 23), or intermediate AMD (n = 33), foveal and perifoveal MPOD and MPOV were higher in the AMD eyes than in the normal eyes. At the RMDA test location, higher MPOD was unrelated to AMD severity but was associated with faster RMDA. Conclusions In older adults with and without AMD, higher macular xanthophyll concentrations are associated with better best-corrected visual acuity and RMDA. Data are consistent with a model of cone resilience and rod vulnerability in aging and AMD and can be further explored in a larger sample study.
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Zouache MA, Silvestri G, Amoaku WM, Silvestri V, Hubbard WC, Pappas C, Akafo S, Lartey S, Mastey RR, Carroll J, Hageman GS. Comparison of the Morphology of the Foveal Pit Between African and Caucasian Populations. Transl Vis Sci Technol 2020; 9:24. [PMID: 32821496 PMCID: PMC7401974 DOI: 10.1167/tvst.9.5.24] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 02/24/2020] [Indexed: 01/01/2023] Open
Abstract
Purpose The purpose of this study was to characterize foveal pit morphology in an African (Ghanaian) population, to compare it to that of a Caucasian group and to determine if it varied with age in the two populations. Methods The depth, diameter, slope, and volume of the foveal pit were interpolated from optical coherence tomography volume scans recorded in 84 Ghanaian and 37 Caucasian individuals. Their association with age, sex, and ethnicity was investigated using multilevel regression models. Results The foveal pit differed significantly in width, slope, and volume between Ghanaian men and women (P < 0.001), but only in width and volume between Caucasian men and women (P < 0.01). In Ghanaians, age was associated with a narrowing of the foveal depression and a reduction of its volume. Overall, these changes were more pronounced in women as compared to men and were largely absent from the Caucasian group. When controlled for age, the foveal pit of Ghanaians was significantly wider and larger in volume as compared to the Caucasian group (P < 0.001). Conclusions The morphology of the foveal pit differs between African and Caucasian individuals. These anatomic differences should be considered when examining differences in prevalence and clinical features of vitreoretinal disorders involving the fovea between the two populations. Translational Relevance Differences in retinal anatomy may partly explain variations in the prevalence and clinical features of retinal diseases between Africans and Caucasians. Such differences should be adequately considered in diagnoses and monitoring of ocular diseases in patients with African ancestry.
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Affiliation(s)
- Moussa A Zouache
- Steele Center for Translational Medicine, John A. Moran Eye Center, Department of Ophthalmology & Visual Sciences, University of Utah, Salt Lake City, UT, USA
| | - Giuliana Silvestri
- Ophthalmology Department, Belfast Health and Social Care Trust, Belfast, UK
| | - Winfried M Amoaku
- Academic Ophthalmology and Visual Sciences, DCN, University of Nottingham and University Hospitals, Nottingham, UK
| | | | - William C Hubbard
- Steele Center for Translational Medicine, John A. Moran Eye Center, Department of Ophthalmology & Visual Sciences, University of Utah, Salt Lake City, UT, USA
| | - Christian Pappas
- Steele Center for Translational Medicine, John A. Moran Eye Center, Department of Ophthalmology & Visual Sciences, University of Utah, Salt Lake City, UT, USA
| | - Stephen Akafo
- Unit of Ophthalmology, Department of Surgery, University of Ghana Medical School, Korle Bu, Accra, Ghana
| | - Seth Lartey
- Eye Unit, Eye Ear Nose and Throat Department, Komfo Anokye Teaching Hospital and Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Rebecca R Mastey
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin Eye Institute, Milwaukee, WI, USA
| | - Joseph Carroll
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin Eye Institute, Milwaukee, WI, USA
| | - Gregory S Hageman
- Steele Center for Translational Medicine, John A. Moran Eye Center, Department of Ophthalmology & Visual Sciences, University of Utah, Salt Lake City, UT, USA
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Obana A, Gohto Y, Sasano H, Gellermann W, Sharifzadeh M, Seto T, Bernstein PS. Spatial distribution of macular pigment estimated by autofluorescence imaging in elderly Japanese individuals. Jpn J Ophthalmol 2020; 64:160-170. [PMID: 31989400 DOI: 10.1007/s10384-020-00716-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 10/31/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine the spatial distribution types of macular pigment (MP) in elderly Japanese individuals and to consider their origin. STUDY DESIGN Observational case series. METHODS Local MP optical density (MPOD) at some eccentricities and MP volume were measured using the MPOD module of a MultiColor Spectralis in 96 pseudophakic eyes of 96 participants (age range, 52-86 years; mean age, 72.8 ± 8.3 years). The MP distribution types were determined from the MP spatial profiles. The retinal thickness (RT) at the foveal center, at both 0.5° and 0.9° eccentricities, and the foveal width were measured using optical coherence tomography. RESULTS The mean local MPOD at the foveal center was 0.79. Spatial distribution was classified into four types: central peak (24.0%), ring-like (40.6%), intermediate (22.9%), and central dip (12.5%). The ring-like type was the most frequent in these Japanese participants. The central-peak type showed lower MPOD than did the other types in the area outside 0.9°. The ring-like type occurred frequently in eyes with small RT at 0.5° and wider foveal width. A rough contour of the Müller cell cone was found more frequently in the central-dip type than in the other types. CONCLUSIONS The present characteristics of the different distribution patterns could be explained by the hypothesis that MP presents mainly in the Müller cell cone within 0.5° and in Müller cells in the outer and inner plexiform layers in the area outside 0.5°. The anatomic characteristics of Müller cells at the fovea and parafovea likely affect the MP distribution.
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Affiliation(s)
- Akira Obana
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka, 430-8558, Japan. .,Hamamatsu BioPhotonics Innovation Chair, Institute for Medical Photonics Research, Preeminent Medical Photonics Education and Research Center, Hamamatsu University School of Medicine, Hamamatsu, Japan.
| | - Yuko Gohto
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka, 430-8558, Japan
| | - Hiroyuki Sasano
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka, 430-8558, Japan
| | | | | | - Takahiko Seto
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka, 430-8558, Japan
| | - Paul S Bernstein
- Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, Salt Lake City, USA
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Green-Gomez M, Bernstein PS, Curcio CA, Moran R, Roche W, Nolan JM. Standardizing the Assessment of Macular Pigment Using a Dual-Wavelength Autofluorescence Technique. Transl Vis Sci Technol 2019; 8:41. [PMID: 31867142 PMCID: PMC6922273 DOI: 10.1167/tvst.8.6.41] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/03/2019] [Indexed: 12/24/2022] Open
Abstract
PURPOSE It is essential to have an appropriate measure to assess macular pigment (MP) that can provide an accurate, valid, and reliable representation of the MP within the macula. The aim of this study was to describe and introduce MP optical volume (MPOV) as an optimal value for reporting MP. METHODS Three hundred ninety-three subjects were analyzed using the Heidelberg Spectralis with the investigational MP optical density (MPOD) module to measure MPOV and MPOD at four foveal eccentricities (0.23°, 0.51°, 0.98°, 1.76° [7° as reference point]). Lutein (L) and zeaxanthin (Z) dietary intake and serum concentrations were evaluated. RESULTS MPOV mean was 5094 (95%CI, 4877-5310); range: 527 to 10,652. MPOV was inversely correlated with body mass index and positively correlated with education (r = -0.156, P = 0.002 and r = 0.124, P = 0.014, respectively). Serum concentrations of L and Z were positively correlated with MPOV (r = 0.422, P < 0.001 and r = 0.285, P < 0.001, respectively). MPOV was positively correlated to MPOD at all measured eccentricities, with the strongest agreement at 1.76° (r = 0.906, P < 0.001). Serum concentrations of L and Z, BMI, education, and age (P < 0.001) were found to be significant predictors of MPOV. CONCLUSIONS The Spectralis MPOV measurement provided a comprehensive and detailed evaluation of the MP profile. The Spectralis MPOV should be considered a preferred metric for the assessment of MP. TRANSLATIONAL RELEVANCE Applying a standardized method for the assessment and report of MP will allow to fully derive meaning from observational studies and to successfully implement this MP measurement technique in research and clinical settings.
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Affiliation(s)
- Marina Green-Gomez
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland
| | | | - Christine A. Curcio
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rachel Moran
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland
| | - Warren Roche
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland
| | - John M. Nolan
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland
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12
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Christaras D, Ginis H, Pennos A, Mompean J, Artal P. Objective method for measuring the macular pigment optical density in the eye. BIOMEDICAL OPTICS EXPRESS 2019; 10:3572-3583. [PMID: 31467794 PMCID: PMC6706042 DOI: 10.1364/boe.10.003572] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 06/11/2019] [Accepted: 06/11/2019] [Indexed: 06/10/2023]
Abstract
Macular pigment is a yellowish pigment of purely dietary origin, which is thought to have a protective role in the retina. Recently, it was linked to age-related macular degeneration and improved visual function. In this work, we present a method and a corresponding optical instrument for the rapid measurement of its optical density. The method is based on fundus reflectometry and features a photodetector for the measurement of reflectance at different wavelengths and retinal locations. The method has been tested against a commercially available instrument on a group of healthy volunteers and has shown good correlation. The proposed instrument can serve as a rapid, non-midriatic, low-cost tool for the measurement of macular pigment optical density.
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Affiliation(s)
- Dimitrios Christaras
- Laboratorio de Óptica, Instituto Universitario de Investigación en Óptica y Nanofísica, Universidad de Murcia, Campus de Espinardo, E-30100 Murcia,
Spain
- Department of Research, Athens Eye Hospital, Leof. Vouliagmenis 45, Glifada 166 75,
Greece
| | - Harilaos Ginis
- Department of Research, Athens Eye Hospital, Leof. Vouliagmenis 45, Glifada 166 75,
Greece
| | - Alexandros Pennos
- Laboratorio de Óptica, Instituto Universitario de Investigación en Óptica y Nanofísica, Universidad de Murcia, Campus de Espinardo, E-30100 Murcia,
Spain
| | - Juan Mompean
- Laboratorio de Óptica, Instituto Universitario de Investigación en Óptica y Nanofísica, Universidad de Murcia, Campus de Espinardo, E-30100 Murcia,
Spain
| | - Pablo Artal
- Laboratorio de Óptica, Instituto Universitario de Investigación en Óptica y Nanofísica, Universidad de Murcia, Campus de Espinardo, E-30100 Murcia,
Spain
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13
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Ctori I, Mahroo OA, Williams KM, Hammond CJ, Huntjens B. Repeatability of the macular pigment spatial profile: A comparison of objective versus subjective classification. Acta Ophthalmol 2018; 96:e797-e803. [PMID: 30156017 PMCID: PMC6282784 DOI: 10.1111/aos.13725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 01/21/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Classification of macular pigment (MP) spatial profile phenotypes varies and is often based on subjective visualisation. We investigated repeatability of MP optical density (MPOD) comparing an objective versus subjective profiling system. METHODS The coefficient of repeatability (CoR) was calculated for point MPOD values (0-3.8°) obtained by dual-wavelength fundus autofluorescence (FAF) from two scans obtained in a single visit of 40 healthy individuals (39 ± 9 years). For each individual's dataset, the MP profile was classified as exponential, ring-like or central dip using an objective method (based on deviations away from an exponential fit), as well as by subjective visual profiling. Existing FAF images of 88 monozygotic (MZ) and 69 dizygotic (DZ) twin pairs were reanalysed using the objective profiling method and concordance and heritability of ring-like profiles determined. RESULTS The CoR was 0.23 at 0° and 0.06 at 0.8°. Agreement of objective profiling between scans was excellent (κ = 0.85, 95% CI 0.69 to 1.00; p < 0.0005). Subjective profiling showed moderate agreement between scans (κ = 0.48, 95% CI 0.23 to 0.73; p < 0.0005). Agreement between objective and subjective classification was low (κ = 0.23, 95% CI 0.04 to 0.42; p = 0.02). Concordance for the ring-like profile using objective profiling was 0.74 for MZ compared to 0.36 for DZ twins. Heritability was calculated as 81.5% (95% confidence interval 61.1-93.1%). CONCLUSION Compared to visual assessment, objective MP profiling is a more reliable method and should be considered in future observational and interventional studies. In addition, MP profile phenotypes showed high heritability.
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Affiliation(s)
- Irene Ctori
- Applied Vision Research CentreCity, University of LondonNorthampton SquareLondonUK
| | - Omar A. Mahroo
- Department of Twin Research and Genetic EpidemiologyKing's College LondonSt Thomas’ Hospital CampusLondonUK
- Department of OphthalmologyKing's College LondonSt Thomas’ Hospital CampusLondonUK
- Retinal ServiceMoorfields Eye HospitalLondonUK
- UCL Institute of OphthalmologyLondonUK
| | - Katie M. Williams
- Department of Twin Research and Genetic EpidemiologyKing's College LondonSt Thomas’ Hospital CampusLondonUK
- Department of OphthalmologyKing's College LondonSt Thomas’ Hospital CampusLondonUK
| | - Christopher J. Hammond
- Department of Twin Research and Genetic EpidemiologyKing's College LondonSt Thomas’ Hospital CampusLondonUK
- Department of OphthalmologyKing's College LondonSt Thomas’ Hospital CampusLondonUK
| | - Byki Huntjens
- Applied Vision Research CentreCity, University of LondonNorthampton SquareLondonUK
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14
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Romano MR, Cennamo G, Grassi P, Sparnelli F, Allegrini D, Cennamo G. Changes in macular pigment optical density after membrane peeling. PLoS One 2018; 13:e0197034. [PMID: 29758035 PMCID: PMC5951543 DOI: 10.1371/journal.pone.0197034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 04/25/2018] [Indexed: 12/03/2022] Open
Abstract
Introduction To highlight the differences in macular pigment optical density (MPOD) between eyes with vitreoretinal interface syndrome and healthy control eyes, to assess the changes in MPOD in eyes treated with macular peeling, to investigate the relationships between MPOD changes and measures of retinal sensitivity such as best corrected visual acuity (BCVA) and microperimetry. Methods In this cross-sectional comparative study, 30 eyes affected by idiopathic epiretinal membrane (iERM, 15eyes) or full-thickness macular hole (FTMH, 15eyes) were compared with 60 eyes from 30 healthy age-matched patients. MPOD values (mean MPOD, maximum MPOD, MPOD area, and MPOD volume) were measured in a range of 4°–7° of eccentricity around the fovea, using the one-wavelength reflectometry method (Visucam 200, Carl-Zeiss Meditec). Patients affected by iERM and FTMH were treated with vitrectomy and epiretinal membrane-inner limiting membrane (ERM-ILM) peeling, with follow-up examinations performed preoperatively and 6 months postoperatively. The main outcome measures were the differences in MPOD between eyes with vitreoretinal interface syndrome and healthy eyes, changes in MPOD after ERM-ILM peeling, and relationships between MPOD and functional changes. Results Mean MPOD differed significantly between control eyes and those with iERM (P = .0001) or FTMH (P = .0006). The max MPOD and MPOD area increased, but not significantly. After peeling, the only significant change in MPOD was in MPOD volume (P = .01). In the ERM group, postoperative mean MPOD correlated significantly with best-corrected visual acuity (r = .739, P = .002). Conclusions MPOD was reduced in patients with iERM or FTMH compared with healthy eyes. We found a significant correlation between the mean postoperative MPOD and postoperative BCVA, hypothesizing that the postoperative increase in mean MPOD could be due to a change in distribution for unfolding and expansion of the fovea after the peeling. MOPD may be considered as a prognostic factor associated with a good visual prognosis in patients with iERM.
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Affiliation(s)
- Mario R. Romano
- Eye Clinic, Department of Bioscience, Humanitas University, Rozzano, Milan, Italy
- Eye Clinic, Department of Neuroscience, University Federico II, Naples, Italy
| | - Gilda Cennamo
- Eye Clinic, Department of Neuroscience, University Federico II, Naples, Italy
| | - Piergiacomo Grassi
- Eye Clinic, Department of Neuroscience, University Federico II, Naples, Italy
| | - Federica Sparnelli
- Eye Clinic, Department of Neuroscience, University Federico II, Naples, Italy
| | - Davide Allegrini
- Eye Clinic, Department of Bioscience, Humanitas University, Rozzano, Milan, Italy
- * E-mail:
| | - Giovanni Cennamo
- Eye Clinic, Department of Neuroscience, University Federico II, Naples, Italy
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15
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Zarubina AV, Huisingh CE, Clark ME, Sloan KR, McGwin G, Crosson JN, Curcio CA, Owsley C. Rod-Mediated Dark Adaptation and Macular Pigment Optical Density in Older Adults with Normal Maculas. Curr Eye Res 2018; 43:913-920. [PMID: 29634370 DOI: 10.1080/02713683.2018.1460380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To examine the association between macular pigment optical density (MPOD) and rod-mediated dark adaptation (RMDA) in persons ≥60 years old with normal maculas as determined by an accepted color fundus photography grading system. METHODS This cross-sectional analysis used baseline data from eyes in the Alabama Study on Early Age-Related Macular Degeneration. Eyes at step 1 in the AREDS 9-step grading system were considered normal. Eyes were additionally assessed by spectral domain optical coherence tomography (SD-OCT). Foveal MPOD was estimated via heterochromatic flicker photometry, and RMDA was assessed with a computerized dark adaptometer. The association between RMDA and MPOD was examined via Spearman correlation coefficients adjusted for age. RESULTS In 306 eyes from 306 persons (mean age 68.2 years) in normal macular health, MPOD was not associated with RMDA (age-adjusted rank correlation = 0.043, p = 0.45). After 81 eyes with incidental macular findings by SD-OCT evaluation were excluded, the association between MPOD and RMDA remained null (N = 225, age-adjusted r = 0.015, p = 0.82). CONCLUSION In a large sample of normal aged eyes, RMDA, a visual function that is rate limited by retinoid availability to photoreceptors across the complex of retinal pigment epithelium, Bruch's membrane, and choriocapillaris, is not related to MPOD in the neurosensory retina.
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Affiliation(s)
- Anna V Zarubina
- a Department of Ophthalmology , School of Medicine, University of Alabama at Birmingham , Birmingham , AL , USA
| | - Carrie E Huisingh
- a Department of Ophthalmology , School of Medicine, University of Alabama at Birmingham , Birmingham , AL , USA
| | - Mark E Clark
- a Department of Ophthalmology , School of Medicine, University of Alabama at Birmingham , Birmingham , AL , USA
| | - Kenneth R Sloan
- a Department of Ophthalmology , School of Medicine, University of Alabama at Birmingham , Birmingham , AL , USA.,b Department of Computer Science , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Gerald McGwin
- a Department of Ophthalmology , School of Medicine, University of Alabama at Birmingham , Birmingham , AL , USA.,c Department of Epidemiology , School of Public Health, University of Alabama at Birmingham , Birmingham , AL , USA
| | - Jason N Crosson
- a Department of Ophthalmology , School of Medicine, University of Alabama at Birmingham , Birmingham , AL , USA.,d Retina Consultants of Alabama , Birmingham , AL , USA
| | - Christine A Curcio
- a Department of Ophthalmology , School of Medicine, University of Alabama at Birmingham , Birmingham , AL , USA
| | - Cynthia Owsley
- a Department of Ophthalmology , School of Medicine, University of Alabama at Birmingham , Birmingham , AL , USA
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16
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De Moraes CG, Muhammad H, Kaur K, Wang D, Ritch R, Hood DC. Interindividual Variations in Foveal Anatomy and Artifacts Seen on Inner Retinal Probability Maps from Spectral Domain OCT Scans of the Macula. Transl Vis Sci Technol 2018; 7:4. [PMID: 29576928 PMCID: PMC5846440 DOI: 10.1167/tvst.7.2.4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 12/18/2017] [Indexed: 12/20/2022] Open
Abstract
Purpose We tested the hypothesis that variations in foveal morphology can account for artifacts seen on optical coherence tomography (OCT) retinal ganglion cell (RGC) layer probability maps. Methods A total of 126 healthy subjects were tested with spectral domain (sd) OCT. Thickness and probability maps of the macular RGC plus inner plexiform layer (RGC+) were obtained with customized software. Macular b-scans were analyzed to derive three foveal anatomic parameters: width, depth, and slope. The distribution of these parameters was compared between eyes with and without circumfoveal artifacts seen in the central 4° of macular RGC+ probability maps. Results Of 126 healthy subjects, 12 (9.5%) had an abnormal circumfoveal region (artifact) on RGC+ probability maps. Based upon the normal distribution of the three anatomic parameters, only three of the 12 eyes (25%) fell outside the 95% confidence interval of one or more of the three foveal morphologic parameters. Multivariable logistic regression revealed that the parameter slope was significantly associated with the presence of these artifacts (odds ratio = 0.26; P = 0.019). However, the combination of these parameters and age explained only 11% of the total variance of these artifacts. Conclusions Fovea morphology, as measured based upon width, depth, and slope, has a minor role in explaining artifacts seen on macular scans. Variations in the distribution of RGC+ thickness that are not reflected in our measures warrant further investigation as potential sources of artifacts. Translational Relevance A small proportion of circumfoveal artifacts seen on RGC+ probability maps can be explained by variations in foveal anatomy.
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Affiliation(s)
| | - Hassan Muhammad
- Department of Physiology, Biophysics, and Systems Biology, Weill Cornell Medicine, New York, NY, USA.,Computational and Systems Biology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Khushmit Kaur
- Department of Psychology, Columbia University, New York, NY, USA
| | - Diane Wang
- Department of Psychology, Columbia University, New York, NY, USA
| | - Robert Ritch
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA
| | - Donald C Hood
- Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Department of Psychology, Columbia University, New York, NY, USA
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17
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The Association between Foveal Morphology and Macular Pigment Spatial Distribution: An Ethnicity Study. PLoS One 2017; 12:e0169520. [PMID: 28068388 PMCID: PMC5221785 DOI: 10.1371/journal.pone.0169520] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 12/18/2016] [Indexed: 11/25/2022] Open
Abstract
Purpose Macular pigment (MP) spatial distribution varies considerably among individuals. We investigated ethnic variations in MP spatial distribution in relation to foveal architecture. Methods We measured MP optical density (MPOD) using heterochromatic flicker photometry (MAP test, City, University of London) in 76 white, 80 South Asian and 70 black volunteers (18 to 39 years). MPOD spatial profiles were classified objectively as exponential, ring-like or central dip, based on deviations away from an exponential fit. Measurements including total retinal thickness (RT), inner retinal layer (IRL), inner and outer plexiform layer (IPL and OPL) thickness, foveal width and foveal pit slope were taken from Spectralis SD-OCT (Heidelberg, Germany) scans. Results Integrated MPOD up to 1.8° (MPODint) was higher in South Asian (0.84±0.26) and black (0.84±0.31) than whites (0.63±0.24, P<0.0005). Ethnicity explained around 10% of the variance while gender played no significant role. MPOD profile phenotypes were associated with ethnicity: 58% with ring profiles were South Asian and 43% with dip profiles were black (χ2(4,226) = 13.4, P = 0.009). MPODint was lower in exponential (0.66±0.21) compared to ring-like (0.96±0.26) and central dip (1.00±0.32, P<0.0005) groups. White subjects had thicker IRL at 0° (130±21μm) than South Asian (123±16μm) and blacks (116±14μm; F(2) = 12.4, P<0.0005), with comparable results for IPL (P<0.0005) and OPL (P = 0.03). There was no significant difference in IRL, IPL or OPL (from 0 to 3.8° retinal eccentricity) or foveal width between MP profile groups (P>0.05). Conclusion We report a significant difference in the amount and distribution of MP between ethnicities that is not explained by variations in foveal morphology.
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18
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Gella L, Pal SS, Ganesan S, Sharma T, Raman R. Foveal slope measurements in diabetic retinopathy: Can it predict development of sight-threatening retinopathy? Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study (SN-DREAMS II, Report no 8). Indian J Ophthalmol 2016; 63:478-81. [PMID: 26265635 PMCID: PMC4550977 DOI: 10.4103/0301-4738.162578] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The aim was to assess the foveal slope configuration in subjects with type 2 diabetes in a population-based study. Materials and Methods: A subset of 668 subjects from Sankara Nethralaya Diabetic Retinopathy (DR) Epidemiology and Molecular Genetics Study II, a population-based study, were included in the current study. All the subjects underwent comprehensive ophthalmic evaluation including spectral domain optical coherence tomography. Foveal thickness was assessed in five central early treatment DR study quadrants from the three-dimensional scan and foveal slope was calculated in all the four quadrants. Results: Subjects with sight-threatening DR (STDR) had significantly shallow foveal slope in inferior quadrant (STDR: 7.33 ± 6.26 vs. controls: 10.31 ± 3.44; P = 0.021) when compared to controls and in superior (STDR: 7.62 ± 5.81 vs. no DR: 9.11 ± 2.82; P = 0.033), inferior (STDR: 7.33 ± 6.26 vs. no DR: 8.81 ± 2.81; P = 0.048), and temporal quadrants (STDR: 6.69 ± 5.70 vs. no DR: 7.97 ± 2.33; P = 0.030) when compared to subjects with no DR. Foveal slope was significantly shallow among the older age groups in subjects with no DR (P < 0.001) and non-STDR (P = 0.027). Average foveal slope in the diabetic subjects was independently and significantly correlated with increase in age (r = −0.241; P < 0.001) and central subfield thickness (r = −0.542; P < 0.001). Conclusion: Changes in foveal slope were seen with increasing age; however, in diabetes these segmental slope changes can be seen in late DR (STDR).
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Affiliation(s)
| | | | | | | | - Rajiv Raman
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
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19
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Kelly D, Coen RF, Akuffo KO, Beatty S, Dennison J, Moran R, Stack J, Howard AN, Mulcahy R, Nolan JM. Cognitive Function and Its Relationship with Macular Pigment Optical Density and Serum Concentrations of its Constituent Carotenoids. J Alzheimers Dis 2016; 48:261-77. [PMID: 26401946 PMCID: PMC4923753 DOI: 10.3233/jad-150199] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Macular pigment (MP) levels correlate with brain concentrations of lutein (L) and zeaxanthin (Z), and have also been shown to correlate with cognitive performance in the young and elderly. Objective: To investigate the relationship between MP, serum concentrations of L and Z, and cognitive function in subjects free of retinal disease with low MP (Group 1, n = 105) and in subjects with AMD (Group 2, n = 121). Methods: MP was measured using customized heterochromatic flicker photometry and dual-wavelength autofluorescence; cognitive function was assessed using a battery of validated cognition tests; serum L and Z concentrations were determined by HPLC. Results: Significant correlations were evident between MP and various measures of cognitive function in both groups (r = –0.273 to 0.261, p≤0.05, for all). Both serum L and Z concentrations correlated significantly (r = 0.187, p≤0.05 and r = 0.197, p≤0.05, respectively) with semantic (animal) fluency cognitive scores in Group 2 (the AMD study group), while serum L concentrations also correlated significantly with Verbal Recognition Memory learning slope scores in the AMD study group (r = 0.200, p = 0.031). Most of the correlations with MP, but not serum L or Z, remained significant after controlling for age, gender, diet, and education level. Conclusion: MP offers potential as a non-invasive clinical biomarker of cognitive health, and appears more successful in this role than serum concentrations of L or Z.
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Affiliation(s)
- David Kelly
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Robert F Coen
- Memory Clinic, Mercers Institute for Research on Ageing, St. James's Hospital, Dublin, Ireland
| | - Kwadwo Owusu Akuffo
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Stephen Beatty
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland.,Institute of Vision Research, Whitfield Clinic, Waterford, Ireland
| | - Jessica Dennison
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Rachel Moran
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Jim Stack
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | | | - Riona Mulcahy
- University Hospital Waterford, Age-Related Care Unit, Waterford, Ireland
| | - John M Nolan
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland
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20
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Scheibe P, Zocher MT, Francke M, Rauscher FG. Analysis of foveal characteristics and their asymmetries in the normal population. Exp Eye Res 2016; 148:1-11. [PMID: 27191610 DOI: 10.1016/j.exer.2016.05.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 04/29/2016] [Accepted: 05/10/2016] [Indexed: 11/26/2022]
Abstract
The advance of optical coherence tomography (OCT) enables a detailed examination of the human retina in-vivo for clinical routine and experimental eye research. Only few investigations to date captured human foveal morphology in a large subject group on the basis of a detailed analysis employing mathematical models. However, even for important foveal characteristics unified terminology and clear definitions were not implemented so far. This might be a reason, why to this day the human fovea is considered to be a mostly symmetric and round structure. Therefore, the most important finding of this work is the detailed analysis of the asymmetric structure of the human fovea. We employed five clinically highly relevant foveal characteristics, which are derived from a previously published fovea model. For each, an accurate mathematical description is given. The presented properties include (1) mean retinal thickness inside a defined radius, (2) foveal bowl area, (3) a new, exact definition of foveal radius, (4) maximum foveal slope, and (5) the maximum height of the foveal rim. Furthermore, minimum retinal thickness was derived and analyzed. 220 strictly controlled healthy Caucasian subjects of European decent with an even distribution of age and gender were imaged with an Heidelberg Spectralis OCT. Detailed analysis demonstrated the following general results: (1) significant gender difference regarding the central foveal subfield thickness (CFST) but no significant differences for the minimum central retinal thickness, (2) a strong correlation between right and left eye of the same subject, and, as essential finding, (3) strong structural differences of the fovea form in the different anatomical directions (nasal, temporal, inferior and superior). In the analysis of the foveal asymmetry, it will be demonstrated that the foveal radius is larger in nasal and temporal direction compared to inferior and superior position. Furthermore, it will be shown that the circular fovea rather has an elliptic form with the larger axis along the nasal to temporal direction. Interestingly, the foveal slope shows a divergent behavior as the temporal direction has the smallest slope angle and both, inferior and superior angles are clearly larger than the others. The findings in this work can be used for an exact quantification of changes in early stages of various retinal diseases and as a marker for initial diagnosis.
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Affiliation(s)
- Patrick Scheibe
- Saxonian Incubator for Clinical Translation (SIKT), University Leipzig, Leipzig, Germany; Department of Ophthalmology, Leipzig University Hospital, Leipzig, Germany.
| | | | - Mike Francke
- Saxonian Incubator for Clinical Translation (SIKT), University Leipzig, Leipzig, Germany; Paul-Flechsig-Institute of Brain Research, Department of Pathophysiology of Neuroglia, University Leipzig, Leipzig, Germany
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Siah WF, Loughman J, O'Brien C. Lower Macular Pigment Optical Density in Foveal-Involved Glaucoma. Ophthalmology 2015; 122:2029-37. [PMID: 26249732 DOI: 10.1016/j.ophtha.2015.06.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 06/11/2015] [Accepted: 06/17/2015] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To evaluate the relationship between macular pigment optical density (MPOD) and structural parameters of the macula and optic nerve head in glaucomatous eyes. DESIGN A cross-sectional analysis of the baseline data collected during the Macular Pigment and Glaucoma Trial (ISRCTN registry number: 56985060). PARTICIPANTS Eighty-eight subjects (48 male, 40 female) with a diagnosis of open-angle glaucoma and a median age of 67 years (interquartile range, 13; range, 36-84 years) were enrolled in this trial. METHODS The MPOD at 0.25°, 0.5°, and 1° retinal eccentricity was measured using a customized heterochromatic flicker photometry technique. Glaucoma-related structural parameters were captured using RTVue Fourier-domain optical coherence tomography (FD-OCT). Statistical significance was set at P < 0.01, and P values ranging from 0.01 to 0.05 were considered borderline significant. MAIN OUTCOME MEASURES The MPOD and its relationship to the macula and optic nerve head topography in glaucomatous eyes. RESULTS The MPOD peaked centrally at 0.25° of retinal eccentricity (mean ± standard deviation, 0.23±0.14) and decreased at more peripheral eccentricities. For the overall group, borderline significant correlations were observed between MPOD and a range of topographic measures, including inferior peripapillary retinal nerve fiber layer (RNFL) thickness, inferior ganglion cell complex (GCC) thickness, foveal inner retinal thickness, cup-to-disc area ratio, and optic disc rim area. Glaucomatous eyes with GCC loss involving the foveal zone on FD-OCT imaging (n = 52) had lower MPOD at 0.25°, 0.5°, and 1° of retinal eccentricity compared with those without foveal GCC involvement (P < 0.001, for all). Those with foveal GCC loss also had greater glaucoma severity, and this was evident by lower GCC and RNFL thickness, greater cup-to-disc area ratio, and lower optic disc rim area (P < 0.001 for all). CONCLUSIONS Our observations indicate that MPOD is lower in glaucomatous eyes with foveal GCC involvement relative to those without foveal involvement. A longitudinal evaluation of MPOD and structural change among patients with glaucoma is required to elucidate the nature of any causal relationship that might exist between MPOD and foveal damage in glaucoma.
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Affiliation(s)
- We Fong Siah
- Institute of Ophthalmology, Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland.
| | - James Loughman
- Optometry Department, School of Physics, College of Sciences and Health, Dublin Institute of Technology, Dublin, Ireland; Faculty of Health Sciences, African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | - Colm O'Brien
- Institute of Ophthalmology, Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland
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Ctori I, Gruppetta S, Huntjens B. The effects of ocular magnification on Spectralis spectral domain optical coherence tomography scan length. Graefes Arch Clin Exp Ophthalmol 2015; 253:733-8. [PMID: 25572356 DOI: 10.1007/s00417-014-2915-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 12/16/2014] [Accepted: 12/22/2014] [Indexed: 10/24/2022] Open
Abstract
PURPOSE The purpose of this study was to assess the effects of incorporating individual ocular biometry measures of corneal curvature, refractive error, and axial length on scan length obtained using Spectralis spectral domain optical coherence tomography (SD-OCT). METHODS Two SD-OCT scans were acquired for 50 eyes of 50 healthy participants, first using the Spectralis default keratometry (K) setting followed by incorporating individual mean-K values. Resulting scan lengths were compared to predicted scan lengths produced by image simulation software, based on individual ocular biometry measures including axial length. RESULTS Axial length varied from 21.41 to 29.04 mm. Spectralis SD-OCT scan lengths obtained with default-K ranged from 5.7 to 7.3 mm, and with mean-K from 5.6 to 7.6 mm. We report a stronger correlation of simulated scan lengths incorporating the subject's mean-K value (ρ = 0.926, P < 0.0005) compared to Spectralis default settings (ρ = 0.663, P < 0.0005). CONCLUSIONS Ocular magnification appears to be better accounted for when individual mean-K values are incorporated into Spectralis SD-OCT scan acquisition versus using the device's default-K setting. This must be considered when taking area measurements and lateral measurements parallel to the retinal surface.
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Affiliation(s)
- Irene Ctori
- Applied Vision Research Centre, The Henry Wellcome Laboratories for Vision Sciences, City University London, Northampton Square, London, EC1V 0HB, UK,
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Shi AJ, Morrissey BM, Durbin-Johnson B, Pilli S, Zawadzki RJ, Cross CE, Park SS. Macular pigment and macular volume in eyes of patients with cystic fibrosis. Free Radic Res 2014; 48:740-8. [DOI: 10.3109/10715762.2014.904043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Raman R, Lahane S, Gupta A, Sandeep D, Sharma T. Foveal slope measurements in subjects with high-risk of age-related macular degeneration. Indian J Ophthalmol 2013; 61:507-10. [PMID: 24104710 PMCID: PMC3831767 DOI: 10.4103/0301-4738.119437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background: Recent reports indicated that the slope of the foveal depression influences the macular pigment (MP) spatial profile. MP has been shown to confer possible protection against age-related macular degeneration (ARMD) because of its antioxidant properties. Aims: To study the configuration of foveal slope and the foveal thickness in fellow eyes of subjects with unilateral neovascular ARMD. Settings and design: Case-control series. Materials and Methods: The study population consisted of 30 cases aged >50, who had unilateral choroidal neovascular membrane (CNVM) or disciform scar in the fellow eye and 29 controls aged >50, who had no sign of ARMD in the either eye. Using spectral-domain optical coherence tomography, foveal thickness at different locations including the central subfield foveal thickness (CSFT) was noted. The foveal slopes were calculated in the six radial scans (between 0.25° and 1° retinal eccentricity) as well as the 3D scan. Results: Cases had a significantly higher CSFT when compared to controls (215.1 ± 36.19 μ vs. 193.0 ± 17.38 μ, P = 0.004). On the 3D scan, the cases had shallower superior (cases 1.32 ± 0.32 vs. controls 1.45 ± 0.13, P = 0.04) and temporal slopes (cases 1.27 ± 0.21 vs. controls 1.39 ± 0.12, P = 0.01) in comparison to the controls. Conclusions: We noted a shallower superior and temporal foveal slope and a higher CSFT in the fellow eyes of subjects with a unilateral neovascular ARMD. Prospective studies observing the development of CNVM in subjects with altered foveal slope might provide more information on this optical coherence tomography finding.
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Affiliation(s)
- Rajiv Raman
- Shri Bhagwan Mahavir Department of Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
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Beirne RO. The macular pigment optical density spatial profile and increasing age. Graefes Arch Clin Exp Ophthalmol 2013; 252:383-8. [PMID: 24081317 DOI: 10.1007/s00417-013-2471-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 08/24/2013] [Accepted: 09/13/2013] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To investigate the relationship between the central spatial profile of macular pigment optical density (MPOD) and increasing age in normal eyes. METHODS Ninety-eight individuals (aged 19-71 years) with good visual acuity, free from ocular disease, and with clear ocular media participated. MPOD was measured at 0.25, 0.50, 1.00, and 1.75° eccentricity from the foveal centre using a heterochromatic flicker photometry based densitometer instrument. RESULTS Linear regression analysis revealed that there was no statistically significant association between MPOD and increasing age for the group as a whole at 0.25, 0.50, and 1.00° eccentricity (p > 0.05 for all eccentricities). There was a small but statistically significant positive association between increasing age and MPOD at 1.75° eccentricity (p = 0.020), but age only accounted for 6 % of the variation in MPOD values. Fifteen percent of all participants had a non-exponential MPOD spatial profile. CONCLUSION There was no statistically significant relationship between MPOD and increasing age for three of the four locations measured. A significant proportion of individuals show an atypical MPOD spatial profile, indicating that studies on MPOD should ideally report information on the MPOD spatial profile rather than estimates from only one retinal location.
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Affiliation(s)
- Raymond O Beirne
- Vision Science Research Group, School of Biomedical Sciences, University of Ulster, Coleraine, BT52 1SA, Northern Ireland, UK,
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Concordance of macular pigment measurements obtained using customized heterochromatic flicker photometry, dual-wavelength autofluorescence, and single-wavelength reflectance. Exp Eye Res 2013; 116:190-8. [PMID: 24007642 DOI: 10.1016/j.exer.2013.08.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 08/21/2013] [Accepted: 08/22/2013] [Indexed: 11/21/2022]
Abstract
This study compares in vivo measurements of macular pigment (MP) obtained using customized heterochromatic flicker photometry (cHFP; Macular Metrics Densitometer(™)), dual-wavelength fundus autofluorescence (Heidelberg Spectralis(®) HRA + OCT MultiColor) and single-wavelength fundus reflectance (Zeiss Visucam(®) 200). MP was measured in one eye of 62 subjects on each device. Data from 49 subjects (79%) was suitable for analysis. Agreement between the Densitometer and Spectralis was investigated at various eccentricities using a variety of quantitative and graphical methods, including: Pearson correlation coefficient to measure degree of scatter (precision), accuracy coefficient, concordance correlation coefficient (ccc), paired t-test, scatter and Bland-Altman plots. The relationship between max MP from the Visucam and central MP from the Spectralis and Densitometer was investigated using regression methods. Agreement was strong between the Densitometer and Spectralis at all central eccentricities (e.g. at 0.25° eccentricity: accuracy = 0.97, precision = 0.90, ccc = 0.87). Regression analysis showed a very weak relationship between the Visucam and Densitometer (e.g. Visucam max on Densitometer central MP: R(2) = 0.008, p = 0.843). Regression analysis also demonstrated a weak relationship between MP measured by the Spectralis and Visucam (e.g. Visucam max on Spectralis central MP: R(2) = 0.047, p = 0.348). MP values obtained using the Heidelberg Spectralis are comparable to MP values obtained using the Densitometer. In contrast, MP values obtained using the Zeiss Visucam are not comparable with either the Densitometer or the Spectralis MP measuring devices. Taking cHFP as the current standard to which other MP measuring devices should be compared, the Spectralis is suitable for use in a clinical and research setting, whereas the Visucam is not.
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The relationship between foveal short-wavelength-sensitive visual function and macular pigment optical density in the ageing age. Vision Res 2013; 86:81-6. [DOI: 10.1016/j.visres.2013.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 12/20/2012] [Accepted: 04/02/2013] [Indexed: 11/21/2022]
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Lima VC, Rosen RB, Prata TS, Dorairaj S, Spielberg L, Maia M, Sallum JM. Association of age and macular pigment optical density using dual-wavelength autofluorescence imaging. Clin Ophthalmol 2013; 7:685-90. [PMID: 23589675 PMCID: PMC3622437 DOI: 10.2147/opth.s42549] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background Several lines of evidence suggest that macular pigment may play a protective role against age-related macular degeneration, but the influence of age on macular pigment density levels remains unclear. This study was designed to investigate the relationship between age and the normal distribution of macular pigment optical density (MPOD) values surrounding the fovea. Methods Consecutive healthy subjects with no evidence of ocular disease were enrolled in this study. After inclusion, MPOD values were measured at specific eccentricities (0.5, 1, and 2 degrees) from the foveal center using a dual-wavelength autofluorescence method employing a modified confocal scanning laser ophthalmoscope. Whenever both eyes were eligible, one was randomly selected for analysis. The correlation between age and MPOD values was investigated using regression analysis. Results Thirty subjects (30 eyes) were included (mean age 48.6 ± 16.4 [range 23–77] years). Significant differences were found between MPOD values measured at 0.5, 1, and 2 degrees from the center of the fovea (0.49 ± 0.12 density units, 0.37 ± 0.11 density units, and 0.13 ± 0.05 density units, respectively, P < 0.05). Significant correlations between age and MPOD values at 0.5 and 1 degree were found (P ≤ 0.02). Values measured at 2 degrees did not correlate significantly with age (P = 0.06). Conclusion In healthy subjects, MPOD values were highest near the foveal center. These values appeared to increase during adulthood (peak at 45–50 years), followed by a gradual reduction after 60 years of age.
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Affiliation(s)
- Verônica Castro Lima
- Retina Service, Department of Ophthalmology, The New York Eye and Ear Infirmary, New York, NY ; Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
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Adaptation of the central retina for high acuity vision: cones, the fovea and the avascular zone. Prog Retin Eye Res 2013; 35:63-81. [PMID: 23500068 DOI: 10.1016/j.preteyeres.2013.01.005] [Citation(s) in RCA: 169] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 01/25/2013] [Accepted: 01/25/2013] [Indexed: 12/31/2022]
Abstract
Presence of a fovea centralis is directly linked to molecular specification of an avascular area in central retina, before the fovea (or 'pit') begins to form. Modelling suggests that mechanical forces, generated within the eye, initiate formation of a pit within the avascular area, and its later remodelling in the postnatal period. Within the avascular area the retina is dominated by 'midget' circuitry, in which signals are transferred from a single cone to a single bipolar cell, then a single ganglion cell. Thus in inner, central retina there are relatively few lateral connections between neurons. This renders the region adaptable to tangential forces, that translocate of ganglion cells laterally/centrifugally, to form the fovea. Optical coherence tomography enables live imaging of the retina, and shows that there is greater variation in the morphology of foveae in humans than previously thought. This variation is associated with differences in size of the avascular area and appears to be genetically based, but can be modified by environmental factors, including prematurity. Even when the fovea is absent (foveal hypoplasia), cones in central retina adopt an elongated and narrow morphology, enabling them to pack more densely to increase the sampling rate, and to act as more effective waveguides. Given these findings, what then is the adaptive advantage of a fovea? We suggest that the advantages of having a pit in central retina are relatively few, and minor, but together work to enhance acuity.
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Improving the repeatability of heterochromatic flicker photometry for measurement of macular pigment optical density. Graefes Arch Clin Exp Ophthalmol 2012; 251:871-80. [PMID: 22899455 DOI: 10.1007/s00417-012-2127-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 07/12/2012] [Accepted: 07/24/2012] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Heterochromatic flicker photometry (HFP) is a psychophysical technique used to measure macular pigment optical density (MPOD). We used the MPS 9000 (MPS) HFP device. Our aim was to determine if the repeatability of the MPS could be improved to make it more suitable for monitoring MPOD over time. METHODS Intra-session repeatability was assessed in 25 participants (aged 20-50 years). The resulting data was explored in detail, e.g., by examining the effect of removal and adjustment of data with less than optimal quality parameters. A protocol was developed for improved overall reliability, which was then tested in terms of inter-session repeatability in a separate group of 27 participants (aged 19-52 years). RESULTS Removal and adjustment of data reduced the intra-session coefficient of repeatability (CR) by 0.04, on average, and the mean individual standard deviation by 0.004. Raw data observation offered further insight into ways of improving repeatability. The proposed protocol resulted in an inter-session CR of 0.08. CONCLUSIONS Removal and adjustment of less than optimal data improved repeatability, and is therefore recommended. To further improve repeatability, in brief we propose that each patient perform each part of the test twice, and a third time where necessary (described in detail by the protocol). Doing so will make the MPS more useful in research and clinical settings.
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Comparison of macular pigment in three types of macular telangiectasia. Graefes Arch Clin Exp Ophthalmol 2012; 251:689-96. [PMID: 22790309 DOI: 10.1007/s00417-012-2088-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 05/31/2012] [Accepted: 06/06/2012] [Indexed: 10/28/2022] Open
Abstract
PURPOSE To compare macular pigment in three types of macular telangiectasia (MacTel). METHODS Twenty-six eyes of 16 patients (mean age, 62 years) with MacTel were examined. The macular pigment optical density (MPOD) was obtained by autofluorescence spectrometry using two wavelengths (488 nm, 514 nm). The density of the central macular pigment within 0.5 degree around the foveal center (MPODc) was measured from a MPOD map. RESULTS Eight eyes of seven patients were classified as type 1, 16 eyes of eight patients as type 2, and two eyes of one patient as type 3. The macular pigment signal was seen in the area of fluorescein leakage in type 1 and the occlusive area in type 3; the macular pigment signal decreased in the area of fluorescein leakage in type 2. The mean MPODc (± standard deviation) was 0.40 ± 0.16 density unit (DU) (range, 0.17-0.57) in type 1; -0.08 ± 0.15 DU (range, -0.29-0.25) in type 2; and 0.32 ± 0.08 DU (range, 0.26-0.37) in type 3. Significant differences were seen between types 1 and 2 (P < 0.001) and types 2 and 3 (P = 0.007). There was no significant difference between types 1 and 3 (P = 0.765). In 30 age-matched normal eyes, the MPODc was 0.58 ± 0.11 DU (range, 0.38-0.79). There were significant differences between normal eyes and each MacTel subtype (type 1, P = 0.007; type 2, P < 0.001; type 3, P = 0.043). CONCLUSIONS The macular pigment values and distributions, including leakage or occlusion, differed in each MacTel type compared with fluorescein angiography findings. The capillary occlusion in type 3 is not associated with reduced MPOD.
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Hogg RE, Ong EL, Chamberlain M, Dirani M, Baird PN, Guymer RH, Fitzke F. Heritability of the spatial distribution and peak density of macular pigment: a classical twin study. Eye (Lond) 2012; 26:1217-25. [PMID: 22744384 DOI: 10.1038/eye.2012.98] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To elucidate the heritability of peak density and spatial width of macular pigment (MP) using a Classical Twin Study. METHODS Fundus autofluorescence images were obtained at 488 nm from 86 subjects or 43 twin pairs (21 monozygotic (MZ) and 22 dizygotic (DZ)) (27 male, 59 female) aged from 55 to 76 years (mean 62.2 ± 5.3 years). The relative topographic distribution of MP was measured using a grey scale of intensity (0-255 units) in a 7° eccentricity around the fovea. Relative peak MP density (rPMPD) and relative spatial distribution of MP (rSDMP) were used as the main outcome measure in the statistical analysis. RESULTS A significantly higher correlation was found within MZ pairs as compared with that within DZ pairs for rPMPD, (r=0.99, 95% confidence interval (95% CI) 0.93 to 1.00) and 0.22, 95% CI -0.34 to 0.71), respectively, suggesting strong heritability of this trait. When rSDMP was compared, there was no significant difference between the correlations within MZ pairs (r=0.48, 95% CI -0.02 to 0.83) and DZ pairs (r=0.63, 95% CI 0.32 to 0.83), thus rSDMP is unlikely to have a considerable heritable component. In addition, there was no difference between any MP parameter when normal maculae were compared with early age-related macular degeneration (AMD) (rPMPD 0.36 vs 0.34, t=1.18 P=0.243, rSDMP 1.75 vs 1.75, t=0.028 P=0.977). CONCLUSIONS rPMPD is a strongly heritable trait whereas rSDMP has minimal genetic influence and a greater influence by environmental factors. The presence of macular changes associated with early AMD did not appear to influence any of these pigment parameters.
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Affiliation(s)
- R E Hogg
- Centre for Vision and Vascular Science, Queen's University, Belfast, UK.
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Nolan JM, Akkali MC, Loughman J, Howard AN, Beatty S. Macular carotenoid supplementation in subjects with atypical spatial profiles of macular pigment. Exp Eye Res 2012; 101:9-15. [PMID: 22652506 DOI: 10.1016/j.exer.2012.05.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Revised: 05/16/2012] [Accepted: 05/18/2012] [Indexed: 10/28/2022]
Abstract
This study was designed to investigate the impact of macular carotenoid supplementation on the spatial profile of macular pigment (MP) in subjects where the profile does not exhibit the typical central peak (i.e. peaked MP at foveal epicentre). Thirty one healthy subjects with such atypical MP spatial profiles were assigned to one of three intervention groups: Group 1: (n = 10), 20 mg/day lutein (L), 2 mg/day zeaxanthin (Z); Group 2: (n = 10), 10 mg/day meso-zeaxanthin (MZ), 10 mg/day L, 2 mg/day Z; Group 3: (n = 10), 17 mg/day MZ, 3 mg/day L, 2 mg/day Z. Subjects were instructed to take one capsule daily over an 8-week period. MP at 0.25°, 0.5°, 1°, 1.75° and 3° was measured using customized-heterochromatic flicker photometry at baseline, four weeks and 8 weeks. Over the study period, we report no statistically significant increase in MP at any eccentricity in Group 1 (p > 0.05, for all eccentricities). There was a trend towards an increase in MP at all eccentricities in Group 2, with a significant increase found at 0.25° and 0.50° (p = 0.000 and p = 0.016, respectively). There was a statistically significant increase evident in MP at 0.25° in Group 3 (p = 0.005), but at no other eccentricity (p > 0.05, for all other). We report that the typical central peak of MP can be realised in subjects with atypical spatial profiles, following supplementation with a preparation containing all three macular carotenoids, but not with a supplement lacking MZ. The implications of our findings, in terms of visual performance and/or a (photo)-protective effect, warrant additional study.
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Affiliation(s)
- John M Nolan
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland.
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Dubis AM, Hansen BR, Cooper RF, Beringer J, Dubra A, Carroll J. Relationship between the foveal avascular zone and foveal pit morphology. Invest Ophthalmol Vis Sci 2012; 53:1628-36. [PMID: 22323466 DOI: 10.1167/iovs.11-8488] [Citation(s) in RCA: 123] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To assess the relationship between foveal pit morphology and size of the foveal avascular zone (FAZ). METHODS Forty-two subjects were recruited. Volumetric images of the macula were obtained using spectral domain optical coherence tomography. Images of the FAZ were obtained using either a modified fundus camera or an adaptive optics scanning light ophthalmoscope. Foveal pit metrics (depth, diameter, slope, volume, and area) were automatically extracted from retinal thickness data, whereas the FAZ was manually segmented by two observers to extract estimates of FAZ diameter and area. RESULTS Consistent with previous reports, the authors observed significant variation in foveal pit morphology. The average foveal pit volume was 0.081 mm(3) (range, 0.022 to 0.190 mm(3)). The size of the FAZ was also highly variable between persons, with FAZ area ranging from 0.05 to 1.05 mm(2) and FAZ diameter ranging from 0.20 to 1.08 mm. FAZ area was significantly correlated with foveal pit area, depth, and volume; deeper and broader foveal pits were associated with larger FAZs. CONCLUSIONS Although these results are consistent with predictions from existing models of foveal development, more work is needed to confirm the developmental link between the size of the FAZ and the degree of foveal pit excavation. In addition, more work is needed to understand the relationship between these and other anatomic features of the human foveal region, including peak cone density, rod-free zone diameter, and Henle fiber layer.
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Affiliation(s)
- Adam M Dubis
- Department of Cell Biology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
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The association between macular pigment optical density and CFH, ARMS2, C2/BF, and C3 genotype. Exp Eye Res 2011; 93:592-8. [PMID: 21816153 DOI: 10.1016/j.exer.2011.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 06/18/2011] [Accepted: 07/18/2011] [Indexed: 11/21/2022]
Abstract
Age-related macular degeneration (AMD) is the most common cause of blindness in older people in developed countries, and risk for this condition may be classified as genetic or environmental, with an interaction between such factors predisposing to this disease. This study investigated the relationship between AMD risk genes, macular pigment optical density (MPOD), which may protect against AMD, and serum concentrations of the macular carotenoids, lutein (L) and zeaxanthin (Z). This was a cross-sectional study of 302 healthy adult subjects. Dietary intake of L and Z was assessed by food frequency questionnaire, and MPOD was measured by customized heterochromatic flicker photometry. We also calculated MPOD Area as the area of MP under the spatial profile curve, to reflect MP across the macula. Serum L and Z were measured by HPLC. Genotyping of tag SNPs in the genes CFH, ARMS2, C3, C2 and BF was undertaken with multiplex polymerase chain reaction (PCR) and primer extension methodology (ABI Snapshot, ABI Warrington UK) on DNA extracted from peripheral blood. The mean ± SD (range) age of the subjects in this study was 48 ± 11 (21-66) years. There was a statistically significant association between CFH genotype and family history of AMD, with subjects having two non-risk CFH haplotypes (n = 35), or one non-risk and one protective CFH haplotype (n = 33), being significantly more likely to have a negative family history of AMD (Pearson Chi square: p = 0.001). There was no significant association between the AMD risk genes investigated and either MPOD (One way ANOVA: p > 0.05) or serum concentrations of L or Z (One way ANOVA: p > 0.05, for both). Subjects who were homozygous for risk alleles of both CFH and ARMS2 (n = 4) had significantly lower MPOD at 0.5° and 1° retinal eccentricity (Independent samples t test: p < 0.05) and lower MPOD Area which approached statistical significance (Independent samples t test: p = 0.058), compared to other subjects (n = 291). In conclusion, this study did not detect an association between individual AMD risk genotypes and the putatively protective MP, or serum concentrations of its constituent carotenoids. However, the combination of homozygous risk alleles at both CFH and ARMS2 loci was associated with significantly lower MPOD centrally, despite comparable serum concentrations of the macular carotenoids. These findings suggest that the maculae of subjects at very high genetic risk of AMD represent a hostile environment for accumulation and/or stabilization of MP.
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Howells O, Eperjesi F, Bartlett H. Measuring macular pigment optical density in vivo: a review of techniques. Graefes Arch Clin Exp Ophthalmol 2011; 249:315-47. [PMID: 21221629 DOI: 10.1007/s00417-010-1577-5] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Revised: 11/04/2010] [Accepted: 11/15/2010] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Macular pigment has been the focus of much attention in recent years, as a potential modifiable risk factor for age-related macular degeneration. This interest has been heightened by the ability to measure macular pigment optical density (MPOD) in vivo. METHOD A systematic literature search was undertaken to identify all available papers that have used in vivo MPOD techniques. The papers were reviewed, and all relevant information was incorporated into this article. RESULTS Measurement of MPOD is achievable with a wide range of techniques, which are typically categorized into one of two groups: psychophysical (requiring a response from the subject) or objective (requiring minimal input from the subject). The psychophysical methods include heterochromatic flicker photometry and minimum motion photometry. The objective methods include fundus reflectometry, fundus autofluorescence, resonance Raman spectroscopy and visual evoked potentials. Even within the individual techniques, there is often much variation in how data is obtained and processed. CONCLUSION This review comprehensively details the procedure, instrumentation, assumptions, validity and reliability of each MPOD measurement technique currently available, along with their respective advantages and disadvantages. This leads us to conclude that development of a commercial instrument, based on fundus reflectometry or fundus autofluorescence, would be beneficial to macular pigment research and would support MPOD screening in a clinical setting.
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Affiliation(s)
- Olivia Howells
- Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, B4 7ET, UK.
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Changes in macular pigment optical density and serum concentrations of lutein and zeaxanthin in response to weight loss. Br J Nutr 2010; 105:1036-46. [DOI: 10.1017/s0007114510004721] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The objective of the present study was to investigate whether weight loss is associated with changes in serum concentrations of lutein (L) and zeaxanthin (Z), and/or macular pigment optical density (MPOD). We recruited 104 overweight subjects into this randomised controlled weight loss study. For the intervention group (I group), weight was assessed weekly and body composition, including BMI (kg/m2) and body fat (kg and percentage), was assessed at baseline, 6 and 12 months. Weight loss was encouraged using dietary and exercise programmes. MPOD was measured by heterochromatic flicker photometry and serum concentrations of L and Z by HPLC (at baseline, 1, 3, 6 and 12 months). The control (C) group was assessed at baseline and 12 months. Repeated-measures ANOVA (RMA) demonstrated significant weight loss in the I group over the study period (P = 0·000). There was no significant weight change in the C group (P = 0·993). RMA of dietary L and Z, serum L and Z, and MPOD demonstrated no significant time or time × group interaction effect in any of these parameters (P>0·05 for all), with the exception of a significant decrease in the dietary intake of Z seen in both groups, over the study period (P < 0·05). There was a positive and significant relationship between body fat loss (kg) and increase in serum concentrations of L in the I group (r 0·521; P = 0·006). Our finding that a reduction in body composition (e.g. fat mass) is related to increases in serum concentrations of L is consistent with the hypothesis that body fat acts as a reservoir for this carotenoid, and that weight loss can positively influence circulating carotenoid levels.
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Connolly EE, Beatty S, Thurnham DI, Loughman J, Howard AN, Stack J, Nolan JM. Augmentation of macular pigment following supplementation with all three macular carotenoids: an exploratory study. Curr Eye Res 2010; 35:335-51. [PMID: 20373901 DOI: 10.3109/02713680903521951] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE At the macula, the carotenoids meso-zeaxanthin (MZ), lutein (L), and zeaxanthin (Z) are collectively referred to as macular pigment (MP). This study was designed to measure serum and macular responses to a macular carotenoid formulation. MATERIALS AND METHODS Ten subjects were recruited into this study (five normal and five with early age-related macular degeneration [AMD]). Subjects were instructed to consume a formulation containing 7.3 mg of MZ, 3.7 mg of L, and 0.8 mg of Z everyday over an eight-week period. The spatial profile of MP optical density (i.e., MPOD at 0.25 degrees , 0.5 degrees , 1 degrees , and 1.75 degrees ) was measured using customized heterochromatic flicker photometry, and a blood sample was collected at each study visit in order to analyze serum concentrations of MZ, L, and Z. RESULTS There was a significant increase in serum concentrations of MZ and L after two weeks of supplementation (p < 0.05). Baseline serum carotenoid analysis detected a small peak eluting at the same time as MZ in all subjects, with a mean +/- SD of 0.02 +/- 0.01 micromol/L. We report significant increases in MPOD at 0.25 degrees , 0.5 degrees , 1 degree , and average MPOD across its spatial profile after just two weeks of supplementation (p < 0.05, for all). Four subjects (one normal and three AMD) who had an atypical MPOD spatial profile (i.e., central dip) at baseline had the more typical MPOD spatial profile (i.e., highest MPOD at the center) after eight weeks of supplementation. CONCLUSION We report significant increases in serum concentrations of MZ and L following supplementation with MZ, L, and Z and a significant increase in MPOD, including its spatial profile, after two weeks of supplementation. Also, this study has detected the possible presence of MZ in human serum pre-supplementation and the ability of the study carotenoid formulation to rebuild central MPOD in subjects who have atypical profiles at baseline.
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Affiliation(s)
- Eithne E Connolly
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland.
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The relationship between macular pigment and visual performance. Vision Res 2010; 50:1249-56. [PMID: 20394766 DOI: 10.1016/j.visres.2010.04.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Revised: 03/30/2010] [Accepted: 04/08/2010] [Indexed: 11/23/2022]
Abstract
This study was designed to assess whether macular pigment optical density (MPOD) is associated with visual performance. One hundred and forty-two young healthy subjects were recruited. Macular pigment optical density and visual performance were assessed by psychophysical tests including best corrected visual acuity (BCVA), mesopic and photopic contrast sensitivity, glare sensitivity, photostress recovery time (PRT). Measures of central visual function, including BCVA and contrast sensitivity, were positively associated with MPOD (p<0.05, for all). Photostress recovery and glare sensitivity were unrelated to MPOD (p>0.05). A longitudinal, placebo-controlled and randomized supplementation trial will be required to ascertain whether augmentation of MPOD can influence visual performance.
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Bernstein PS, Delori FC, Richer S, van Kuijk FJM, Wenzel AJ. The value of measurement of macular carotenoid pigment optical densities and distributions in age-related macular degeneration and other retinal disorders. Vision Res 2009; 50:716-28. [PMID: 19854211 DOI: 10.1016/j.visres.2009.10.014] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2009] [Revised: 10/08/2009] [Accepted: 10/17/2009] [Indexed: 11/24/2022]
Abstract
There is increasing recognition that the optical and antioxidant properties of the xanthophyll carotenoids lutein and zeaxanthin play an important role in maintaining the health and function of the human macula. In this review article, we assess the value of non-invasive quantification of macular pigment levels and distributions to identify individuals potentially at risk for visual disability or catastrophic vision loss from age-related macular degeneration, and we consider the strengths and weaknesses of the diverse measurement methods currently available.
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Affiliation(s)
- Paul S Bernstein
- Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA.
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