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Srinivasan R, Teussink MM, Sloan KR, Bharat RPK, Narayanan R, Raman R. Distribution of macular pigments in macular telangiectasia type 2 and correlation with optical coherence tomography characteristics and visual acuity. BMC Ophthalmol 2022; 22:264. [PMID: 35698056 PMCID: PMC9195394 DOI: 10.1186/s12886-022-02483-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/24/2022] [Indexed: 11/24/2022] Open
Abstract
Background To estimate macular pigment values in macular telangiectasia (MacTel) Type 2 in comparison with healthy subjects in the South Indian population across different spatial profiles and to quantify the regional differences of macular pigment optical density (MPOD) in MacTel Type 2. Methods In this prospective cross-sectional study, healthy controls and patients diagnosed with various stages of MacTel Type 2 underwent MPOD measurement using dual-wavelength autofluorescence technique with Spectralis HRA + OCT. Results Sixty eyes of 31 healthy subjects and 41 eyes of 22 MacTel type 2 patients were included. We found an overall decrease in MPOD values in MacTel type 2 patients (-0.109, -0.11, -0.001) in comparison with healthy subjects (0.38, 0.23, 0.06) at 1°, 2° & 6° foveal eccentricities (P < 0.001). In various stages of MacTel type 2, the mean MPOD was found to be higher in the peripheral region compared to the central region. We found a significantly lower mean MPOD in the central region in association with specific optical coherence tomography (OCT) parameters like inner retinal cavities (P = 0.035) and ellipsoid zone disruption (P = 0.034). Conclusions In MacTel type 2, MPOD distribution varies in different spatial profiles with higher MPOD levels in the peripheral region compared to the central region. The macular pigment levels are associated with inner retinal cavities and ellipsoid zone disruption seen on OCT.
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Affiliation(s)
- Ramyaa Srinivasan
- Shri Bhagwan Mahavir Department of Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | | | - Kenneth R Sloan
- Department of Ophthalmology & Visual Science, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rekha Priya Kalluri Bharat
- Shri Bhagwan Mahavir Department of Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | | | - Rajiv Raman
- Shri Bhagwan Mahavir Department of Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.
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Lutein and Zeaxanthin Distribution in the Healthy Macula and Its Association with Various Demographic Factors Examined in Pseudophakic Eyes. Antioxidants (Basel) 2021; 10:antiox10121857. [PMID: 34942960 PMCID: PMC8698861 DOI: 10.3390/antiox10121857] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 02/06/2023] Open
Abstract
The macular pigment consisting of lutein (L) and zeaxanthin (Z) protects photoreceptors via its antioxidative and barrier activities. This study aimed to determine L and Z distribution in the healthy macula and their association with various demographic factors. Macular pigment optical density (MPOD) was measured using fundus autofluorescence spectroscopy in 352 pseudophakic eyes with no fundus diseases. Pseudophakia was chosen to avoid the influence of cataract in the measurement of fundus autofluorescence. The mean patient age was 72.3 ± 8.6 years. MPOD was analyzed separately in three zones, i.e., A: a central area within a radius of 0.5°, mainly containing Z; B: a ring area with radii from 0.5° to 1.3°, containing Z and L; C: a ring area with radii from 1.3° to 9°, containing L. Multivariate analyses were performed with MPOD as the dependent variable and sex, supplement intake, smoking habits, glaucoma, diabetes, age, body mass index (BMI), skin carotenoid levels, retinal thickness, retinal volume, axial length as the independent variables. The mean total MPOD volume within 9° eccentricity was 20,121 ± 6293. Age was positively associated with MPOD in all zones. Supplement and BMI were positively and negatively associated with MPOD in zones B and C. Smoking was negatively associated with MPOD in zone A. This study revealed the standard MP values of aged Japanese, which resulted to be higher than the previously reported values in other races. Age was found to have a positive association with MP values. L in the outer foveola was affected by BMI and supplements, but Z in the foveola was not. The amount of Z in the Müller cell cone may not be changed easily by factors such as hunger and satiety in the context of preservation of homeostasis in the human body, but tobacco had a negative effect on Z.
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Srinivasan R, Teussink MM, Sloan KR, Surya J, Raman R. Evaluation of Macular Pigment Optical Density in Healthy Eyes Based on Dual-Wavelength Autofluorescence Imaging in South Indian Population. Transl Vis Sci Technol 2020; 9:40. [PMID: 32855886 PMCID: PMC7422903 DOI: 10.1167/tvst.9.8.40] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/23/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose To estimate macular pigment optical density (MPOD) values across different age groups in the South Indian population across various spatial profiles using dual-wavelength autofluorescence. Methods Sixty eyes of 31 healthy subjects underwent MPOD measurement with Spectralis HRA+OCT. The average MPOD and macular pigment optical volume (MPOV) at 1°, 2°, and 6° radii, the mean MPOD in the classical Early Treatment Diabetic Retinopathy Study (ETDRS) grid, and the spatial profiles of two different age groups across 12 plots covering the radial sectors were recorded. Results The mean age was 39.1 ± 12.7 years. The mean MPOD and MPOV values were 0.38 ± 0.11 and 787.95 ± 225.13 at 1° eccentricity, 0.23 ± 0.08 and 2000 ± 708.24 at 2° eccentricity, and 0.05 ± 0.02 and 4335 ± 2007.71 at 6° eccentricity, respectively. In the ETDRS grid, the mean MPOD was found to be highest in the central sector and lowest in the inferior peripheral ring. We also found that along the radial sectors the lower quadrants tended to have low MPOD as compared to the upper quadrants. Subjects 40 years of age or older had significantly higher averaged MPOD in certain areas (–15° to 15° and 75° to 105°) along the radial sectors than subjects less than 40 years of age. Conclusions This study establishes a reference value for future studies of diseased eyes in the South Indian population. Translational Relevance Our study is unique in that it reports MPOD among the South Indian population across different age groups, as well as the distribution of MPOD in all nine zones of the classical ETDRS grid and various spatial profiles covering the 30° radial sectors centered on the fovea.
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Affiliation(s)
- Ramyaa Srinivasan
- Shri Bhagwan Mahavir Department of Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | | | - Kenneth R Sloan
- Department of Ophthalmology & Visual Science, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Janani Surya
- Shri Bhagwan Mahavir Department of Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Rajiv Raman
- Shri Bhagwan Mahavir Department of Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
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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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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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Sauer L, Andersen KM, Li B, Gensure RH, Hammer M, Bernstein PS. Fluorescence Lifetime Imaging Ophthalmoscopy (FLIO) of Macular Pigment. Invest Ophthalmol Vis Sci 2018; 59:3094-3103. [PMID: 30025128 PMCID: PMC6009392 DOI: 10.1167/iovs.18-23886] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 05/04/2018] [Indexed: 02/04/2023] Open
Abstract
Purpose To describe different patterns of macular pigment (MP) seen in fluorescence lifetime imaging ophthalmoscopy (FLIO) and to analyze ex vivo fluorescence characteristics of carotenoids. Methods A total of 31 eyes of young healthy subjects, 4 eyes from patients with albinism, 36 eyes with macular telangiectasia type 2 (MacTel), 24 eyes with retinitis pigmentosa, and 1 eye with a macular hole were included in this clinic-based, cross-sectional study. All subjects underwent Heidelberg Engineering FLIO and MP measurements (dual-wavelength autofluorescence). Fundus autofluorescence (FAF) lifetimes of a 30° retinal field were detected in two spectral channels (SSC: 498-560 nm; LSC: 560-720 nm), and amplitude-weighted mean fluorescence lifetimes (τm) were calculated. Additionally, autofluorescence lifetimes of known dilutions of lutein and zeaxanthin were measured in a cuvette in free- and protein-associated states. Results MP shows a significant inverse correlation to foveal FAF lifetimes measured with FLIO (SSC: r = -0.608; P < 0.001). Different distribution patterns can be assigned to specific disease-related changes. Two patients with albinism, who did not have MP, were found to be missing short FAF lifetimes. In solvent, lutein and zeaxanthin show very short autofluorescence lifetimes (∼50-60 ps; SSC), as do their respective binding proteins (∼40-50 ps; SSC). When combining carotenoids with their specific binding proteins, the decay times shift to longer means (∼70-90 ps; SSC). Conclusions This study expands upon previous findings of an impact of MP on short FAF lifetimes by describing ex vivo autofluorescence lifetimes of carotenoids and different in vivo autofluorescence patterns that can be associated with certain diseases.
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Affiliation(s)
- Lydia Sauer
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, United States
- Department of Experimental Ophthalmology, University Hospital Jena, Jena, Germany
| | - Karl M. Andersen
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, United States
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, United States
| | - Binxing Li
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, United States
| | - Rebekah H. Gensure
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, United States
| | - Martin Hammer
- Department of Experimental Ophthalmology, University Hospital Jena, Jena, Germany
| | - Paul S. Bernstein
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, United States
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Obana A, Gellermann W, Gohto Y, Seto T, Sasano H, Tanito M, Okazaki S. Reliability of a two-wavelength autofluorescence technique by Heidelberg Spectralis to measure macular pigment optical density in Asian subjects. Exp Eye Res 2018; 168:100-106. [DOI: 10.1016/j.exer.2017.12.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 11/09/2017] [Accepted: 12/28/2017] [Indexed: 01/28/2023]
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Putnam CM. Clinical imaging of macular pigment optical density and spatial distribution. Clin Exp Optom 2016; 100:333-340. [PMID: 27885710 DOI: 10.1111/cxo.12500] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 09/14/2016] [Accepted: 09/20/2016] [Indexed: 11/29/2022] Open
Abstract
Clinical research continues to provide an increasing number of studies that reveal an association between macular pigment optical density (MPOD) and both visual function and ocular health. As a result, there is a growing need for repeatable, accurate measures of MPOD that can describe peak optical density as well as spatial distribution. Measurement of MPOD in a research setting has an established history encompassing a number of both objective and subjective techniques. Transition of these techniques to a clinical setting has produced an array of commercial devices using three primary methods: heterochromatic flicker photometry, fundus autofluorescence and fundus reflectometry. The inherent differences among the techniques create difficulty in making direct comparisons between MPOD measurement devices. Understanding the limitations of each technique is critical in the clinical interpretation of MPOD results. Here, both the objective and subjective methods of MPOD measurement are reviewed with emphasis on the commercially available devices used in clinical settings.
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Lima VC, Rosen RB, Farah M. Macular pigment in retinal health and disease. Int J Retina Vitreous 2016; 2:19. [PMID: 27847637 PMCID: PMC5088450 DOI: 10.1186/s40942-016-0044-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 07/21/2016] [Indexed: 12/16/2022] Open
Abstract
Lutein and zeaxanthin, two carotenoid pigments of the xanthophyll subclass, are present in high concentrations in the retina, especially in the macula. They work as a filter protecting the macula from blue light and also as a resident antioxidant and free radical scavenger to reduce oxidative stress-induced damage. Many observational and interventional studies have suggested that lutein and zeaxanthin may reduce the risk of various eye diseases, especially late forms of AMD. In vitro and in vivo studies indicate that they could protect various ocular cells against oxidative damage. Recent research has shown that in addition to traditional mechanisms, lutein and zeaxanthin can influence the viability and function of cells through various signal pathways or transcription factors: for instance, they can affect immune responses and inflammation, and have anti-angiogenic and anti-tumor properties. This review covers the basic aspects and results of recent studies regarding the effects of lutein, zeaxanthin and other carotenoids, such as meso-zeaxanthin, on the eye in different clinical and experimental models and the management of various ocular diseases using these molecules.
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Affiliation(s)
- Verônica Castro Lima
- Retina Service, Hospital Humberto Castro Lima (IBOPC), Salvador, Bahia Brazil ; Retina Service, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - Richard B Rosen
- Icahn School of Medicine at Mount Sinai, New York, NY USA ; Retina Service, Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai, 310 East 14th Street, New York, NY 10003 USA
| | - Michel Farah
- Retina Service, Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
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Crosby-Nwaobi R, Hykin P, Peto T, Sivaprasad S. An exploratory study evaluating the effects of macular carotenoid supplementation in various retinal diseases. Clin Ophthalmol 2016; 10:835-44. [PMID: 27274188 PMCID: PMC4869621 DOI: 10.2147/opth.s102798] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Purpose The aim of this study was to assess the impact of daily oral supplementation with Macushield (10 mg/d meso-zeaxanthin, 10 mg/d lutein, and 2 mg/d zeaxanthin) on eye health in patients with retinal diseases by assessing the macular pigment (MP) profile, the visual function, and the quality of life. Methods Fifty-one patients with various retinal diseases were supplemented daily and followed up for 6 months. The MP optical density was measured using the customized heterochromatic flicker photometry and dual-wavelength autofluorescence. Visual function was evaluated by assessing the change in best corrected visual acuity, contrast sensitivity, and glare sensitivity in mesopic and photopic conditions. Vision-related and general quality of life changes were determined using the National Eye Insititute- Visual Function Questionnaire-25 (NEI-VFQ-25) and EuroQoL-5 dimension questionnaires. Results A statistically significant increase in the MP optical density was observed using the dual-wavelength autofluorescence (P=0.04) but not with the customized heterochromatic flicker photometry. Statistically significant (P<0.05) improvements in glare sensitivity in low and medium spatial frequencies were observed at 3 months and 6 months. Ceiling effects confounded other visual function tests and quality of life changes. Conclusion Supplementation with the three carotenoids enhances certain aspects of visual performance in retinal diseases.
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Affiliation(s)
- Roxanne Crosby-Nwaobi
- NIHR Clinical Research Facility, NIHR Moorfields Biomedical Research Centre, London, UK
| | - Philip Hykin
- NIHR Clinical Research Facility, NIHR Moorfields Biomedical Research Centre, London, UK
| | - Tunde Peto
- NIHR Clinical Research Facility, NIHR Moorfields Biomedical Research Centre, London, UK
| | - Sobha Sivaprasad
- NIHR Clinical Research Facility, NIHR Moorfields Biomedical Research Centre, London, UK
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Bottoni F, Zanzottera E, Carini E, Cereda M, Cigada M, Staurenghi G. Re-accumulation of macular pigment after successful macular hole surgery. Br J Ophthalmol 2015; 100:693-8. [PMID: 26338959 DOI: 10.1136/bjophthalmol-2015-307153] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 08/15/2015] [Indexed: 11/04/2022]
Abstract
AIMS To investigate macular pigment optical density (MPOD) during follow-up of sealed macular holes and to study correlations of MPOD with progressive changes in spectral-domain optical coherence tomography (SD-OCT) and functional results. METHODS Consecutive patients (n=18) who had undergone successful vitrectomies for idiopathic macular holes were evaluated postoperatively at 1, 3, 6 and 9 months. At each follow-up visit, MPOD was measured with a modified confocal scanning laser ophthalmoscope and the outer retina evaluated by SD-OCT. The changes of MPOD postoperatively and the relationship of MPOD and SD-OCT findings to best corrected visual acuity were examined. RESULTS MPOD did not change significantly throughout follow-up, from 0.49±0.22 (mean±SD) at month 1 to 0.42±0.18 at month 9. There was a tendency towards a significant association between amount of MPOD and recovery of external limiting membrane during follow-up (p=0.068). Best corrected visual acuity increased significantly from 0.24±0.12 before surgery to 0.65±0.25 at month 9. Recovery of the ellipsoid zone determined most of visual acuity improvement (p=0.024). MPOD was not associated with visual acuity changes (p=0.394). CONCLUSIONS Revisualisation of macular pigment after successful macular hole surgery is not associated with improved visual acuity and may merely be an accompanying sign of the reapposition of the edges of the hole.
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Affiliation(s)
- Ferdinando Bottoni
- Eye Clinic, Department of Clinical Science 'Luigi Sacco', Sacco Hospital, University of Milan, Milan, Italy
| | - Emma Zanzottera
- Eye Clinic, Department of Clinical Science 'Luigi Sacco', Sacco Hospital, University of Milan, Milan, Italy
| | - Elisa Carini
- Eye Clinic, Department of Clinical Science 'Luigi Sacco', Sacco Hospital, University of Milan, Milan, Italy
| | - Matteo Cereda
- Eye Clinic, Department of Clinical Science 'Luigi Sacco', Sacco Hospital, University of Milan, Milan, Italy
| | - Mario Cigada
- Eye Clinic, Department of Clinical Science 'Luigi Sacco', Sacco Hospital, University of Milan, Milan, Italy
| | - Giovanni Staurenghi
- Eye Clinic, Department of Clinical Science 'Luigi Sacco', Sacco Hospital, University of Milan, Milan, Italy
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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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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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Tong N, Zhang W, Zhang Z, Gong Y, Wooten B, Wu X. Inverse relationship between macular pigment optical density and axial length in Chinese subjects with myopia. Graefes Arch Clin Exp Ophthalmol 2012; 251:1495-500. [PMID: 23224230 DOI: 10.1007/s00417-012-2225-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 11/03/2012] [Accepted: 11/20/2012] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Macular pigment (MP) has been the focus of much attention in recent years, due to its protective effect against macular degenerations. In this study, we investigated the association between macular pigment optical density (MPOD) and axial length (AL) in Chinese subjects with myopia. METHODS In total, 173 myopes (mean spherical equivalent [MSE] ≤-1.00D) were recruited for this prospective observational study. MPOD was measured in both eyes of each subject using a macular metrics densitometer. AL was measured in eyes using an IOL-Master. A raw coefficient of correlation analysis and a partial correlation analysis were used to investigate the relationship between MPOD and AL. RESULTS The age of the subjects ranged from 18 to 67 years. The overall mean MPOD for the cohort was 0.412 ± 0.119 (range, 0.105-0.812). The mean AL was 25.18 ± 1.08 mm (range, 23.14-28.19 mm). Using a raw coefficient of correlation, a significant inverse correlation was found between MPOD and AL (r= -0.134, p=0.012). When using a partial correlation analysis to eliminate the impact of covariant, a significant inverse correlation was also found between MPOD and AL (r= -0.142, p=0.008). Furthermore, when AL was divided into two groups: AL>26 mm and AL ≤ 26 mm, a significant inverse correlation was observed between MPOD and AL in the former (r= -0.253, p=0.029), but no significant relationship was observed between these in the latter (r=0.104, p=0.067). CONCLUSIONS MPOD correlated inversely with AL in this sample of Chinese subjects with myopia.
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Affiliation(s)
- Nianting Tong
- Department of Ophthalmology, Shanghai Jiaotong University Affiliated Shanghai First People's Hospital, No.85 Wujin Road, Hongkou District, Shanghai, China
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Macular pigment density changes in Japanese individuals supplemented with lutein or zeaxanthin: quantification via resonance Raman spectrophotometry and autofluorescence imaging. Jpn J Ophthalmol 2012; 56:488-96. [PMID: 22699751 DOI: 10.1007/s10384-012-0157-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 03/26/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE Our purpose was to determine whether either lutein or zeaxanthin supplementation affects macular pigment concentration/optical density (MPOD) in healthy Japanese individuals. METHODS Twenty-two healthy volunteers were randomized to either 10 mg of orally administered lutein or zeaxanthin daily for up to 3 months. MPOD levels were measured by resonance Raman spectrophotometry (RRS) and one-wavelength autofluorescence imaging (AFI) at baseline and 1, 2, and 3 months after the start of supplementation. RESULTS MPOD levels measured with each method were correlated significantly at all time points. MPOD(RRS) and MPOD(AFI) levels increased >20 % from baseline at 2 and 3 months after lutein supplementation. By multiple regression analyses, the refractive error was correlated positively with MPOD(RRS) levels at baseline, whereas age and sex were not significant. In the lutein group, MPOD(RRS) levels significantly increased from baseline at all time points in individuals without high myopia exceeding -4 diopters, whereas the increase was not observed in individuals with high myopia. In the zeaxanthin group, MPOD(RRS) levels remained unchanged in those with and without high myopia. CONCLUSIONS MPOD(RRS) and MPOD(AFI) levels correlated significantly with each other. In normal healthy Japanese individuals without high myopia, lutein supplementation increased MPOD levels within the fovea more effectively than did zeaxanthin.
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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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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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