1
|
Huang Z, Ji Y, Wang D, Guo N, Jin L, Zheng S, Liu Y, Shi H, Lin M, Zuo C. The Macular Pigment Optical Density (MPOD) Decrease in Chinese Primary Angle Closure Glaucoma Using the One-Wavelength Reflectometry Method. Curr Eye Res 2024:1-9. [PMID: 39105271 DOI: 10.1080/02713683.2024.2381864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 05/17/2024] [Accepted: 07/01/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE The objective of this study was to observe the macular pigment optical density (MPOD) and the relationship between MPOD and retinal thickness in Chinese primary angle-closure glaucoma (PACG) patients by the one-wavelength reflectometry method. METHODS This study was a prospective comparative observational study, including 39 eyes from 39 PACG patients (15 men and 24 women, mean age 61.89 ± 12.30) and 41 eyes from 41 controls (20 men and 21 women, mean age 63.24 ± 14.02). We measured the MPOD 7-degree area by the one-wavelength reflectometry method and analyzed both the max and mean optical density (OD). The central retinal thickness (CRT) and the total thickness of the macular ganglion cell layer (GCL), and inner plexiform layer (IPL)were measured by spectral-domain-optical coherence tomography (SD-OCT). Statistical methods such as Shapiro-Wilk test, Fisher's exact test, chi-square test, two independent samples test and Spearman's correlation coefficient were used to observe the differences in the MPOD between normal subjects and PACG patients and the correlation between the MPOD and retinal thickness. RESULTS The max optical density (Max OD) (PACG group: 0.302 ± 0.067d.u, control group: 0.372 ± 0.059d.u., p < .001) and mean optical density (Mean OD) (PACG group: 0.124 ± 0.035d.u., control group: 0.141 ± 0.028d.u., p < 0.05) were significantly reduced in PACG patients compared with control subjects. Significant decreases in GCL + IPL thickness (PACG group: 74.71 ± 39.56 μm, control group:113.61 ± 8.14 μm, p < 0.001) and CRT (PACG group: 254.49 ± 41.47 μm, control group:329.10 ± 18.57 μm, p < 0.001) were also observed in PACG eyes. There was no statistically significant correlation between the MPOD and GCL + IPL thickness (p = .639, p = .828). CONCLUSIONS MPOD was significantly lower in Chinese PACG patients than in the control group, potentially due to thinning of the GCL + IPL thickness. This study provides insights for the pathophysiology, assessment of PACG and potential guidance for lifestyle modifications.
Collapse
Affiliation(s)
- Zhihong Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yuying Ji
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Dingqiao Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Ni Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Shaoyang Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yuan Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Huanyang Shi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mingkai Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Chengguo Zuo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
2
|
Hu W, Shankar P, Yao Y, Su X, Kim JE. Effect of xanthophyll-rich food and supplement intake on visual outcomes in healthy adults and those with eye disease: a systematic review, meta-analysis, and meta-regression of randomized controlled trials. Nutr Rev 2023; 82:34-46. [PMID: 37094947 DOI: 10.1093/nutrit/nuad037] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
CONTEXT Xanthophyll intake is known to improve eye health; however, its benefits on visual outcomes have not been systematically studied, particularly in a population with eye diseases. OBJECTIVE A systematic review, meta-analysis, and meta-regression were conducted to investigate the effect of xanthophyll intake on visual outcomes, and further subgroup analysis was performed on the basis of eye disease status. DATA SOURCES The PubMed, Scopus, Embase, CINAHL, Cochrane, and Web of Science databases were searched, and relevant randomized controlled trials were identified. DATA EXTRACTION For systematic review, meta-analysis, and meta-regression, 43, 25, and 21 articles were selected, respectively. DATA ANALYSIS Xanthophyll intake enhanced macular pigment optical density (MPOD) for both heterochromatic flicker photometry (weighted mean difference [WMD], 0.05; 95% confidence interval [CI], 0.03-0.07) and autofluorescence imaging (WMD, 0.08; 95%CI, 0.05-0.11) measurements and decreased photostress recovery time (WMD, -2.35; 95%CI, -4.49 to -0.20). While enhancement in visual acuity logarithm of the minimum angle of resolution was observed in response to the xanthophyll-rich food and supplement intake only for patients with eye disease (WMD, -0.04; 95%CI, -0.07 to -0.01). Meta-regression showed a positive correlation between change in MPOD (heterochromatic flicker photometry) and the corresponding change in serum lutein levels (regression coefficient = 0.068; P = 0.00). CONCLUSION Intake of xanthophyll-rich food or supplements can improve eye health. Additional improvement in visual acuity was observed in patients with eye disease. A positive association between MPOD and serum lutein level, while absent with dietary xanthophyll intake, suggests the importance of bioavailability when examining the effect of xanthophyll on eye health. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021295337.
Collapse
Affiliation(s)
- Weili Hu
- are with the Department of Food Science and Technology, National University of Singapore, Singapore, Singapore
| | - Pavitra Shankar
- are with the Department of Food Science and Technology, National University of Singapore, Singapore, Singapore
| | - Yuanhang Yao
- are with the Department of Food Science and Technology, National University of Singapore, Singapore, Singapore
| | - Xinyi Su
- is with the Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jung Eun Kim
- are with the Department of Food Science and Technology, National University of Singapore, Singapore, Singapore
| |
Collapse
|
3
|
Jain S, Wienold J, Eandi C, Gisselbaek S, Kawasaki A, Andersen M. Influence of macular pigment on the sensitivity to discomfort glare from daylight. Sci Rep 2023; 13:18551. [PMID: 37899478 PMCID: PMC10613614 DOI: 10.1038/s41598-023-45785-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/24/2023] [Indexed: 10/31/2023] Open
Abstract
Understanding the factors that influence the human perception of glare is necessary to properly address glare risks in buildings and achieve comfortable visual environments, especially in the workplace. Yet large inter-individual variabilities in glare perception remain unexplained and thus uncovered by the current empirical glare models. We hypothesize that this variability has an origin in the human retina, in particular in the density of macular pigments present in its central area, which varies between individuals. Macular pigments are known to absorb blue light and attenuate chromatic aberration, thus reducing light scatter. This study presents the outcomes of the first experiment ever conducted in a daylit office environment, in which glare sensitivity and macular pigment density were measured and compared for 110 young healthy individuals, along with other ocular parameters. The participants were exposed to different glare conditions induced by the sun filtered through either color-neutral or blue-colored glazing. In neutral daylight conditions with sun disc in the near periphery, neither macular pigment nor any other investigated ocular factors have an impact on discomfort glare perception whereas glare perception in conditions with the blue-colored sun disc in the near periphery was found to be correlated with macular pigment optical density.
Collapse
Affiliation(s)
- Sneha Jain
- Laboratory of Integrated Performance in Design (LIPID), École Polytechnique Fédérale de Lausanne (EPFL), 1015, Lausanne, Switzerland.
| | - Jan Wienold
- Laboratory of Integrated Performance in Design (LIPID), École Polytechnique Fédérale de Lausanne (EPFL), 1015, Lausanne, Switzerland
| | - Chiara Eandi
- Hôpital Ophtalmique Jules-Gonin, Lausanne, Switzerland
- Faculty of Biology and Medicine, Université de Lausanne (UNIL), Lausanne, Switzerland
| | | | - Aki Kawasaki
- Hôpital Ophtalmique Jules-Gonin, Lausanne, Switzerland
- Faculty of Biology and Medicine, Université de Lausanne (UNIL), Lausanne, Switzerland
| | - Marilyne Andersen
- Laboratory of Integrated Performance in Design (LIPID), École Polytechnique Fédérale de Lausanne (EPFL), 1015, Lausanne, Switzerland
| |
Collapse
|
4
|
Macular Pigment and Open-Angle Glaucoma in the Elderly: The Montrachet Population-Based Study. J Clin Med 2022; 11:jcm11071830. [PMID: 35407436 PMCID: PMC8999647 DOI: 10.3390/jcm11071830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/23/2022] [Indexed: 02/05/2023] Open
Abstract
(1) Background: To compare macular pigment optical density (MPOD) and its spatial distribution between eyes with primary open-angle glaucoma (POAG) and control eyes in an elderly population. (2) Methods: The Montrachet study (Maculopathy Optic Nerve and nutrition neurovAsCular and HEarT) is a population-based study including participants aged 75 years and over. All participants had a slit lamp examination, fundus photographs, and a questionnaire about their medical past history and smoking status. Optic disc spectral domain optical coherence tomography was also performed. All glaucoma-suspected patients were convocated to have a new full examination. We only retained one eye with POAG for analysis in the glaucoma group and one eye without optic neuropathy in the control participants group. MPOD measurements were performed with the two-wavelength autofluorescence method (488 and 514 nm). (3) Results: Overall, 601 eyes had MPOD measurements among 1153 participants. Among the 601 eyes, 48 had POAG. The mean age for the glaucoma and control participants was 84.01 ± 4.22 years and 81.94 ± 3.61 years, respectively (p < 0.001). In the multivariable analysis, we could not find any association between POAG and MPOD at 0.5° (p = 0.336). We found no significant difference regarding MP spatial distribution between the two groups (p = 0.408). (4) Conclusion: In this elderly population-based study, eyes with POAG and control eyes without optic neuropathy did not differ in terms of MPOD and MP spatial distribution.
Collapse
|
5
|
Evaluation of the association between macular damage and disability glare in patients with advanced glaucoma. Graefes Arch Clin Exp Ophthalmol 2022; 260:2971-2980. [PMID: 35192030 DOI: 10.1007/s00417-022-05593-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/01/2022] [Accepted: 02/10/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE This study aimed to investigate the factors associated with disability glare in patients with advanced glaucoma and evaluate the impact of disability glare on the vision-related quality of life. METHODS We prospectively studied 225 eyes (225 patients) with advanced glaucoma. The visual function was evaluated using the 10-2 and 24-2 Humphrey visual field (VF) (Dublin, California) and contrast sensitivity test. Structural parameters were obtained using RTVue optical coherence tomography and angiography (Fremont, California). Significant loss of macular vessel density (mVD) was defined as VD < 30%. Each participant completed the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25) and questions regarding subjective symptoms of glare. RESULTS Fifty-six patients (24.9%) experienced glare and had a lower NEI-VFQ-25 composite score (P = 0.017). The average retinal nerve fiber layer and ganglion cell complex thickness and mean deviation (MD) in the 24-2 VF test were not associated with glare. Significant superior or inferior mVD loss (P < 0.001; odds ratio [OR], 3.45; and 95% confidence interval [CI], 1.83-6.55), lower logarithmic contrast sensitivity at 0.75 cycles/degree (P < 0.001; OR, 0.27; and 95% CI, 0.13-0.56), and worse MD in the 10-2 VF test (P < 0.001; OR, 0.93; and 95% CI, 0.89-0.97) showed an association with glare. CONCLUSION In advanced glaucoma, central VF defect and mVD loss are associated with disability glare, which negatively impacts vision-related quality of life.
Collapse
|
6
|
Lem DW, Davey PG, Gierhart DL, Rosen RB. A Systematic Review of Carotenoids in the Management of Age-Related Macular Degeneration. Antioxidants (Basel) 2021; 10:1255. [PMID: 34439503 PMCID: PMC8389280 DOI: 10.3390/antiox10081255] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 01/14/2023] Open
Abstract
Age-related macular degeneration (AMD) remains a leading cause of modifiable vision loss in older adults. Chronic oxidative injury and compromised antioxidant defenses represent essential drivers in the development of retinal neurodegeneration. Overwhelming free radical species formation results in mitochondrial dysfunction, as well as cellular and metabolic imbalance, which becomes exacerbated with increasing age. Thus, the depletion of systemic antioxidant capacity further proliferates oxidative stress in AMD-affected eyes, resulting in loss of photoreceptors, neuroinflammation, and ultimately atrophy within the retinal tissue. The aim of this systematic review is to examine the neuroprotective potential of the xanthophyll carotenoids lutein, zeaxanthin, and meso-zeaxanthin on retinal neurodegeneration for the purpose of adjunctive nutraceutical strategy in the management of AMD. A comprehensive literature review was performed to retrieve 55 eligible publications, using four database searches from PubMed, Embase, Cochrane Library, and the Web of Science. Epidemiology studies indicated an enhanced risk reduction against late AMD with greater dietary consumption of carotenoids, meanwhile greater concentrations in macular pigment demonstrated significant improvements in visual function among AMD patients. Collectively, evidence strongly suggests that carotenoid vitamin therapies offer remarkable synergic protection in the neurosensory retina, with the potential to serve as adjunctive nutraceutical therapy in the management of established AMD, albeit these benefits may vary among different stages of disease.
Collapse
Affiliation(s)
- Drake W. Lem
- College of Optometry, Western University of Health Sciences, Pomona, CA 91766, USA;
| | | | | | - Richard B. Rosen
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| |
Collapse
|
7
|
Macular Pigment Reflectometry: Developing Clinical Protocols, Comparison with Heterochromatic Flicker Photometry and Individual Carotenoid Levels. Nutrients 2021; 13:nu13082553. [PMID: 34444721 PMCID: PMC8399813 DOI: 10.3390/nu13082553] [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: 06/04/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 12/26/2022] Open
Abstract
The study was designed to: (1) Analyze and create protocols of obtaining measurements using the Macular Pigment Reflectometry (MPR). (2) To assess the agreement of MPOD measurements obtained using the heterochromatic flicker photometry (MPS II) and MPR. (3) To obtain the lutein and zeaxanthin optical density obtained using the MPR in the central one-degree of the macula. The measurements were performed using the MPR and heterochromatic flicker photometry. The MPR measurements were performed twice without pupillary dilation and twice following pupillary dilation. The MPR measurements were performed for a 40-s period and the spectrometer signal was parsed at different time points: 10–20, 10–30, 10–40, 20–30, 20–40, and 30–40 s. The MPR analyzes the high-resolution spectrometer signal and calculates MPOD, lutein optical density and zeaxanthin optical density automatically. The MPR-MPOD data was compared with MPPS II-MPOD results. The MPR-MPOD values are highly correlated and in good agreement with the MPS II-MPOD. Of the various parsing of the data, the data 10–30 interval was the best at obtaining the MPOD, lutein, and zeaxanthin values (8–12% coefficient of repeatability). The lutein to zeaxanthin ratio in the central one-degree of the macula was 1:2.40. Dilation was not needed to obtain the MPOD values but provided better repeatability of lutein and zeaxanthin optical density. MPR generates MPOD measurements that is in good agreement with MPS II. The device can produce lutein and zeaxanthin optical density which is not available from other clinical devices.
Collapse
|
8
|
Lem DW, Gierhart DL, Davey PG. A Systematic Review of Carotenoids in the Management of Diabetic Retinopathy. Nutrients 2021; 13:2441. [PMID: 34371951 PMCID: PMC8308772 DOI: 10.3390/nu13072441] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 12/21/2022] Open
Abstract
Diabetic retinopathy, which was primarily regarded as a microvascular disease, is the leading cause of irreversible blindness worldwide. With obesity at epidemic proportions, diabetes-related ocular problems are exponentially increasing in the developed world. Oxidative stress due to hyperglycemic states and its associated inflammation is one of the pathological mechanisms which leads to depletion of endogenous antioxidants in retina in a diabetic patient. This contributes to a cascade of events that finally leads to retinal neurodegeneration and irreversible vision loss. The xanthophylls lutein and zeaxanthin are known to promote retinal health, improve visual function in retinal diseases such as age-related macular degeneration that has oxidative damage central in its etiopathogenesis. Thus, it can be hypothesized that dietary supplements with xanthophylls that are potent antioxidants may regenerate the compromised antioxidant capacity as a consequence of the diabetic state, therefore ultimately promoting retinal health and visual improvement. We performed a comprehensive literature review of the National Library of Medicine and Web of Science databases, resulting in 341 publications meeting search criteria, of which, 18 were found eligible for inclusion in this review. Lutein and zeaxanthin demonstrated significant protection against capillary cell degeneration and hyperglycemia-induced changes in retinal vasculature. Observational studies indicate that depletion of xanthophyll carotenoids in the macula may represent a novel feature of DR, specifically in patients with type 2 or poorly managed type 1 diabetes. Meanwhile, early interventional trials with dietary carotenoid supplementation show promise in improving their levels in serum and macular pigments concomitant with benefits in visual performance. These findings provide a strong molecular basis and a line of evidence that suggests carotenoid vitamin therapy may offer enhanced neuroprotective effects with therapeutic potential to function as an adjunct nutraceutical strategy for management of diabetic retinopathy.
Collapse
Affiliation(s)
- Drake W. Lem
- College of Optometry, Western University of Health Sciences, 309 E Second St, Pomona, CA 91766, USA;
| | | | - Pinakin Gunvant Davey
- College of Optometry, Western University of Health Sciences, 309 E Second St, Pomona, CA 91766, USA;
| |
Collapse
|
9
|
Zeki Fikret C, Ucgun NI. Macular pigment optical density change analysis in primary open-angle glaucoma and pseudoexfoliation glaucoma. Int Ophthalmol 2021; 41:2235-2240. [PMID: 33759069 DOI: 10.1007/s10792-021-01784-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/06/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE We aimed to investigate whether macular pigment optical density (MPOD) has a diagnostic value by comparing MPOD and retinal nerve fiber layer (RNFL), ganglion cell layer++ (GCL++) of patients with primary open-angle glaucoma (POAG) and pseudoexfoliation (PEX) glaucoma and normal individuals. METHODS We included in the study 54 eyes of 34 patients with diagnosis POAG, 40 eyes of 25 patients with PEX glaucoma and 40 eyes of 20 normal individuals. The MPOD measurements of the cases were performed in the MPOD mode of the fundus fluorescein angiography (Carl Zeiss Visucam Meditec, Germany) device while the pupils were in dilated status. RNFL and GCL++ measurements of all individuals included in the study were done by swept source optical coherence tomography (DRI Triton swept source optical coherence tomography; Topcon, Tokyo, Japan). Intraocular pressures of all three groups were measured by Applanation tonometer. The relationship between MPOD, RNFL and GCL++ values were examined. Patients with additional ophthalmic disease, intraocular surgery, history of chronic drug use, and smokers were excluded in the study. RESULTS MPOD mean and MPOD max values were significantly higher in patients with PEX glaucoma than POAG and control group (p < 0.05). MPOD mean and MPOD max measurements were not different when compared to POAG patients and control group (p > 0.05). RNFL and GCL++ measurements were found significantly thinner in patients with POAG and PEX glaucoma compared to the control group (p < 0.001). There was no correlation between MPOD values and RNFL or GCL++. MPOD max values show a very high correlation with age in a statistically significant positive direction (r = 0.90, p < 0.001). The average age of PEX glaucoma group was higher than the control group (p = 0.006). There was no age difference between the PEX glaucoma group and the POAG group (p > 0.05). Also, there was no difference in age between POAG and control groups. In POAG and PEX glaucoma groups, mean intraocular pressure values are significantly higher than the control group. CONCLUSIONS In our study, no MPOD change was observed in the POAG group, while a statistically significant increase in MPOD was found in the PEX glaucoma group. As a result of these findings, we think that PEX syndrome also affects the posterior segment. Well-organized, large, prospective, and randomized studies should be developed for preventive treatment to the negative effects of PEX syndrome on all eye tissues.
Collapse
Affiliation(s)
| | - Nil Irem Ucgun
- Ophthalmology Department, Ankara City Hospital, Ankara, Turkey.
| |
Collapse
|
10
|
Polat Gultekin B, Sahli E. Macular pigment optical density in central serous chorioretinopathy. Ther Adv Ophthalmol 2021; 13:2515841421997195. [PMID: 33738428 PMCID: PMC7934065 DOI: 10.1177/2515841421997195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 01/27/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose The aim of our study was to evaluate the macular pigment optical density in patients with acute and chronic central serous chorioretinopathy and to describe the association between central retinal thickness and choroidal thickness with the macular pigment optical density. Materials and Methods Eyes with acute central serous chorioretinopathy and chronic central serous chorioretinopathy (patients, who were diagnosed as having disease activity for 6 months) were included in this study. Macular pigment was measured using the heterochromatic flicker technique of the MPS II device for both eyes in patients with acute and chronic central serous chorioretinopathy and in control subjects. Results Twenty-seven eyes with acute central serous chorioretinopathy, 23 eyes with chronic central serous chorioretinopathy, and 25 control eyes were enrolled. The mean macular pigment optical density in chronic central serous chorioretinopathy (0.480 ± 0.16 density unit (95% confidence interval: 0.390-0.570) was found to be significantly lower than in the control eyes (0.571 ± 0.128 density unit) (95% confidence interval: 0.480-0.670) (p = 0.007). In correlation analysis, no significant association was detected between the central retinal thickness, choroidal thickness, and macular pigment optical density values in central serous chorioretinopathy group (p = 0.31, p = 0.71). Conclusion Macular pigment optical density levels were significantly lower in chronic central serous chorioretinopathy patients than in controls, possibly due to degeneration of the neurosensorial retina, as a result of the long-term persistence of subretinal fluid. There was not a significant correlation between choroidal thickness and macular pigment optical density levels in central serous chorioretinopathy group.
Collapse
Affiliation(s)
- Burcu Polat Gultekin
- Department of Ophthalmology, Ministry of Health Ankara City Hospital, Ankara 06800, Turkey
| | - Esra Sahli
- Department of Ophthalmology, Ankara University Medical Faculty, Ankara, Turkey
| |
Collapse
|
11
|
Wilson MR, Sandberg KA, Foutch BK. Macular pigment optical density and visual quality of life. JOURNAL OF OPTOMETRY 2021; 14:92-99. [PMID: 32868244 PMCID: PMC7753046 DOI: 10.1016/j.optom.2020.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/16/2020] [Accepted: 07/30/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE There is robust evidence that higher macular pigment concentrations help reduce both veiling and discomfort glare in patients with or without ocular disease. We investigated whether there was also a relationship between macular pigment optical density (MPOD) and patient surveys about glare or ocular discomfort. METHODS We measured MPOD psychophysically in 23 healthy subjects and administered the National Eye Institute Visual Functioning Questionnaire (VFQ-25). Responses for each survey question were sorted from low (no limitation) to high (very severe limitation). The median response for each question was determined, and independent t-tests were performed on the mean MPOD values for survey responses above and below the median. We also performed a non-parametric correlation analysis between MPOD and survey responses. RESULTS While the median response was "no limitation" for most (22 of 25) survey questions, responses were slightly higher for two questions concerning ocular discomfort and one question related to driving at night. MPOD levels were significantly higher in subjects that reported no discomfort in or around their eyes than in those that reported mild discomfort. There was also a trend toward higher MPOD levels in subjects who reported that pain in or around their eyes never limited their activity as well as in subjects who reported no difficulty driving at night. CONCLUSION These preliminary findings are consistent with the well-established discomfort and glare hypotheses for MPOD. The current findings on subjective ocular discomfort in the absence of glare deserve further study.
Collapse
Affiliation(s)
- Molly R Wilson
- University of the Incarnate Word, Rosenberg School of Optometry, United States
| | - Kyle A Sandberg
- University of the Incarnate Word, Rosenberg School of Optometry, United States
| | - Brian K Foutch
- University of the Incarnate Word, Rosenberg School of Optometry, United States.
| |
Collapse
|
12
|
Davey PG, Henderson T, Lem DW, Weis R, Amonoo-Monney S, Evans DW. Visual Function and Macular Carotenoid Changes in Eyes with Retinal Drusen-An Open Label Randomized Controlled Trial to Compare a Micronized Lipid-Based Carotenoid Liquid Supplementation and AREDS-2 Formula. Nutrients 2020; 12:nu12113271. [PMID: 33114566 PMCID: PMC7693149 DOI: 10.3390/nu12113271] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/22/2020] [Accepted: 10/22/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose: To compare the changes in visual and ocular parameters in individuals with retinal drusen who were treated with two commercially available nutritional supplements. Methods: An open-label, single-center, randomized, parallel-treatment with an observational control group design was utilized. The treatment groups included individuals with fine retinal drusen sub-clinical age-related macular degeneration (AMD), while the control group consisted of ocular normal individuals. The treatment groups were randomly assigned to the micronized lipid-based carotenoid supplement, Lumega-Z (LM), or the PreserVision Age-Related Eye Disease Study 2 (AREDS-2) soft gel (PV). Visual performance was evaluated using the techniques of visual acuity, dark adaptation recovery and contrast sensitivity, at baseline, three months, and six months. Additionally, the macular pigment optical density (MPOD) was measured. The control group was not assigned any carotenoid supplement. The right eye and left eye results were analyzed separately. Results: Seventy-nine participants were recruited for this study, of which 68 qualified and 56 participants had useable reliable data. Of the individuals who completed this study, 25 participants belonged to the LM group, 16 belonged to the PV group, and 15 to the control group. The LM group demonstrated statistically significant improvements in contrast sensitivity function (CSF) in both eyes at six months (p < 0.001). The LM group displayed a positive linear trend with treatment time in CSF (p < 0.001), with benefits visible after just three months of supplementation. Although there was a trend showing improvement in CSF in the PV group, the change was not significant after a Bonferroni-corrected p-value of p < 0.00625. Visual acuity, dark adaptation recovery and MPOD did not significantly improve in either treatment groups. Conclusion: The LM group demonstrated greater and faster benefits in visual performance as measured by CSF when compared to the PV group. This trial has been registered at clinicaltrials.gov (NCT03946085).
Collapse
Affiliation(s)
- Pinakin Gunvant Davey
- College of Optometry, Western University of Health Sciences, Pomona, CA 91766, USA; (D.W.L.); (S.A.-M.)
- Correspondence: ; Tel.: +1-909-469-8473
| | | | - Drake W. Lem
- College of Optometry, Western University of Health Sciences, Pomona, CA 91766, USA; (D.W.L.); (S.A.-M.)
| | - Rebecca Weis
- Eye Clinic of Austin, Austin, TX 78731, USA; (T.H.); (R.W.)
| | - Stephanie Amonoo-Monney
- College of Optometry, Western University of Health Sciences, Pomona, CA 91766, USA; (D.W.L.); (S.A.-M.)
| | - David W. Evans
- VectorVision/Guardion Health Sciences, San Diego, CA 92128, USA;
| |
Collapse
|
13
|
The association between macular pigment optical density and visual function outcomes: a systematic review and meta-analysis. Eye (Lond) 2020; 35:1620-1628. [PMID: 32792595 DOI: 10.1038/s41433-020-01124-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 07/30/2020] [Accepted: 07/30/2020] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To conduct a systematic review and meta-analysis on data related to macular pigment optical density (MPOD) and visual function in adults with healthy eyes. METHODS MEDLINE®, Cochrane, and Commonwealth of Agriculture Bureau abstracts databases were searched for English-language publications between 1946 and August 2018. Included studies examined correlation of MPOD and visual function in adults with healthy eyes at all timepoints and all designs, except for case-control, case reports, and reviews. Visual function outcomes of interest included photostress recovery, contrast sensitivity, visual acuity, glare sensitivity/disability, and dark adaptation. Random effects model meta-analyses combined study-level correlation (r). RESULTS Twenty-two publications were included. In meta-analysis MPOD was found to be significantly correlated with contrast sensitivity at 30' (two studies, summary r: 0.37; 95% CI 0.15, 0.56), and at 1° eccentricity with a spatial frequency of 7, 11, and 21 cpd (three studies, summary r: 0.31; 95% CI 0.06, 0.52), with photostress recovery at a 1° eccentricity with a moderate background, 10 cpd, and 16% contrast (two studies, summary r: -0.17; 95% CI -0.31, -0.02), and at 30' (four studies, summary r: -0.57; 95% CI -0.78, -0.24), and with glare disability at 30' eccentricity with a log scale at 460 nm (three studies, summary r = 0.47; 95% CI 0.32; 0.59). There were insufficient data for meta-analysis for other visual functions. CONCLUSIONS Our review identifies a link between MPOD and visual function with significant correlations with photostress recovery, glare disability, and contrast sensitivity.
Collapse
|
14
|
Kan J, Wang M, Liu Y, Liu H, Chen L, Zhang X, Huang C, Liu BY, Gu Z, Du J. A novel botanical formula improves eye fatigue and dry eye: a randomized, double-blind, placebo-controlled study. Am J Clin Nutr 2020; 112:334-342. [PMID: 32542334 DOI: 10.1093/ajcn/nqaa139] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 05/15/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND With the frequent use of video display units, eye fatigue is becoming more common globally. An alternative nutritional strategy is needed to prevent the aggravation of eye fatigue symptoms. OBJECTIVES The objective was to evaluate the protective effect of a novel botanical combination of lutein ester, zeaxanthin, and extracts of blackcurrant, chrysanthemum, and goji berry on adults with eye fatigue in a randomized, double-blind, placebo-controlled clinical trial. METHODS We randomly allocated 360 participants into 4 groups to receive placebo and 3 doses of our formula (chewable tablets, containing 6 mg, 10 mg, or 14 mg of lutein) once daily for 90 d. Each participant had 3 visits at baseline (V1), 45 d (V2), and 90 d (V3) during the study. RESULTS Intervention with the formula improved individual scores of eye fatigue symptoms, including eye soreness, blurred vision, dry eye, foreign body sensation, and tearing. Compared with placebo, the formula at all 3 doses significantly decreased the total score of eye fatigue symptoms and increased the visuognosis persistence time at both V2 and V3. According to the Schirmer test, both 10-mg and 14-mg lutein formula groups had improved tear secretion at V3 compared with the placebo. The keratography results indicated that the first tear break-up time, average tear break-up time, and tear meniscus height were significantly increased after formula intervention. The formula at all 3 doses significantly increased the macular pigment optical density at V2 and V3 compared with the placebo, whereas optical coherence tomography showed no significant difference in retinal thickness and retinal volume across all groups at both visits. CONCLUSIONS Our botanical formula improves eye fatigue, dry eye, and macular function without changing the retinal structure, and thus it could serve as an effective nutritional strategy in improving eye fatigue without causing serious side effects.Clinical Trial Registry: chictr.org.cn (ChiCTR1800018987).
Collapse
Affiliation(s)
- Juntao Kan
- Nutrilite Health Institute, Shanghai, China
| | - Min Wang
- Department of Ophthalmology, Aier Eye Hospital, Shanghai, China
| | - Ying Liu
- Vanderbilt Epidemiology Center, Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Liang Chen
- Nutrilite Health Institute, Shanghai, China
| | - Xue Zhang
- Nutrilite Health Institute, Shanghai, China
| | | | - Bryan Y Liu
- College of Biotechnology, East China University of Science and Technology, Shanghai, China
| | - Zhensheng Gu
- Department of Ophthalmology, Xinhua Hospital, Shanghai, China
| | - Jun Du
- Nutrilite Health Institute, Shanghai, China
| |
Collapse
|
15
|
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.
Collapse
|
16
|
Bruns Y, Junker B, Boehringer D, Framme C, Pielen A. Comparison of Macular Pigment Optical Density in Glaucoma Patients and Healthy Subjects - A Prospective Diagnostic Study. Clin Ophthalmol 2020; 14:1011-1017. [PMID: 32308361 PMCID: PMC7140904 DOI: 10.2147/opth.s224259] [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: 07/23/2019] [Accepted: 02/27/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the relationship between macular pigment optical density (MPOD) and glaucoma. Methods Forty-three patients with an established glaucoma diagnosis (25 females, 18 males, mean age 70 (range 34–84)) and 43 healthy controls (28 females, 15 males, mean age 62 (range 30–87)) were included in this prospective diagnostic case-control study. All subjects underwent detailed eye examination including ophthalmoscopy, best-corrected visual acuity, biomicroscopy, measurement of the axial length of the eye, objective refraction, lens status, central foveal thickness on spectral-domain optical coherence tomography (SD-OCT). In all glaucoma patients, a visual field assessment and a measurement of the retinal nerve fibre layer (RNFL) on SD-OCT were done. MPOD was determined using the macula pigment module of the Spectralis HRA+OCT (Heidelberg Engineering GmbH, Heidelberg, Germany) at 0.51°, 1.02° and 1.99° retinal eccentricity using two-wavelength autofluorescence imaging. Results In the glaucoma group, the median of the visual field mean defect was 5.1 db (quartiles 3.0 and 13.5) and the mean RNFL-thickness global was 65.9 µm (SD ± 16.1). Median MPOD measured at 0.51°, 1.02° and 1.99° retinal eccentricity in the glaucoma group was 0.42 DU, 0.34 DU and 0.13 DU, in the control group 0.40 DU, 0.35 DU and 0.12 DU respectively. There was no statistically significant difference of median MPOD between glaucomatous and control eyes (p=0.510, 0.735, 0.481). No significant relation between MPOD at 1.02 retinal eccentricity and the presence of glare symptoms was found (p=0.948). However, age seems to correlate with median MPOD measured at 1.02 retinal eccentricity (p=0.017). Conclusion There was no evidence for lower MPOD levels in our glaucoma patients; lower MPOD was not related to the presence of glare symptoms. However there seems to be a positive correlation between age and MPOD at 1.02° retinal eccentricity. To further investigate the relation between glare reported by glaucoma patients and glare disability linked to lower MPOD levels, additional studies are necessary that include both detailed inquiry of the quality of glare and a glare quantification and precise analysis of MPOD levels in glaucoma patients.
Collapse
Affiliation(s)
- Yannick Bruns
- University Eye Hospital, Hannover Medical School, Hannover 30625, Germany
| | - Bernd Junker
- University Eye Hospital, Hannover Medical School, Hannover 30625, Germany
| | - Daniel Boehringer
- Clinic for Ophthalmology, University of Freiburg Faculty of Medicine, Freiburg 79106, Germany
| | - Carsten Framme
- University Eye Hospital, Hannover Medical School, Hannover 30625, Germany
| | - Amelie Pielen
- University Eye Hospital, Hannover Medical School, Hannover 30625, Germany
| |
Collapse
|
17
|
Tavazzi S, Cozza F, Nigrotti G, Braga C, Vlasak N, Larcher S, Zeri F. Improvement or Worsening of Human Contrast Sensitivity Due to Blue Light Attenuation at 450 nm. CLINICAL OPTOMETRY 2020; 12:57-66. [PMID: 32308516 PMCID: PMC7133119 DOI: 10.2147/opto.s242818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/20/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE The work was aimed at comparing contrast sensitivity performance in an indoor environment with two filters, which differ only in the presence of a band at 450±20 nm in the transmittance spectrum. PATIENTS AND METHODS Thirty-nine subjects participated. The filters were the Standard (ST) and Professional (PRO) Drive lenses (Hoya, Japan), the latter showing the attenuation band at 450 nm. Photopic contrast sensitivity (CS) was measured at different spatial frequencies from 1.5 to 18 cpd through Functional Acuity Contrast Test with both lenses (LogCSST and LogCSPRO, respectively). The areas under the curves of LogCSST and LogCSPRO as a function of the spatial frequency were also considered. RESULTS In the range of the measured values of LogCSST for the thirty-nine participants, at each spatial frequency and also for the areas, the difference Δ = LogCSPRO - LogCSST was found to decrease and change sign from positive to negative as a function of LogCSST, thus allowing to deduce a threshold (LogCSthreshold) for LogCSST corresponding to Δ=0. Significant CS worsening was found with the PRO compared to the ST lens for the subjects showing LogCSST > LogCSthreshold. Vice versa, CS improvement was found when LogCSST < LogCSthreshold. CONCLUSION In the choice of a blue-filtering lens, practitioners should take into consideration that the attenuation of light in the range 420-470 nm is expected to produce a CS worsening in subjects showing a relatively high initial CS (higher than a threshold CS). For these subjects, the general reduction of transmitted light intensity prevails on possible advantages. On the contrary, subjects showing a relatively low initial CS are expected to show a CS improvement because the attenuation of light in the range 420-470 nm is expected to reduce intraocular scattering and to mimic the effect as an optical filter of the human macular pigment, advantages which prevail on the reduction of the transmitted light intensity.
Collapse
Affiliation(s)
- Silvia Tavazzi
- Department of Materials Science, University of Milano Bicocca, Milan, Italy
- Research Centre in Optics and Optometry (COMiB), University of Milano Bicocca, Milan, Italy
| | - Federica Cozza
- Department of Materials Science, University of Milano Bicocca, Milan, Italy
- Research Centre in Optics and Optometry (COMiB), University of Milano Bicocca, Milan, Italy
| | - Gabriele Nigrotti
- Research Centre in Optics and Optometry (COMiB), University of Milano Bicocca, Milan, Italy
| | - Chiara Braga
- Research Centre in Optics and Optometry (COMiB), University of Milano Bicocca, Milan, Italy
| | | | | | - Fabrizio Zeri
- Department of Materials Science, University of Milano Bicocca, Milan, Italy
- Research Centre in Optics and Optometry (COMiB), University of Milano Bicocca, Milan, Italy
- Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, UK
| |
Collapse
|
18
|
Beirne RO, McConnell E. Investigation of the relationship between macular pigment levels and rod-mediated dark adaptation in intermediate age-related macular degeneration. Clin Exp Optom 2019; 102:611-616. [PMID: 30791135 DOI: 10.1111/cxo.12882] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 01/09/2019] [Accepted: 01/15/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND It has been shown that rod-mediated dark adaptation is significantly delayed in ageing, a change which is exacerbated in age-related macular degeneration (AMD). Levels of lutein and zeaxanthin, the two main constituents of macular pigment have been found in rod outer segments, indicating that the macular pigment may have an influence on rod-mediated dark adaptation. The aim of this study was to determine if rod-mediated dark adaptation is associated with central macular pigment levels in individuals with intermediate stage AMD. METHODS A cross-sectional observational study included individuals with acuity better than 6/15 Snellen and intermediate stage AMD based on graded fundus photographs using an internationally accepted grading scale. Rod-mediated dark adaptation was assessed at five degrees eccentricity in the superior retina (inferior visual field) using the rod intercept time measure from the MacuLogix AdaptDx. Macular pigment optical density was measured at 0.5 degrees eccentricity using a heterochromatic flicker photometry-based method. RESULTS Twenty-seven individuals (mean age 76.7 years) with intermediate stage AMD and 23 age-matched normal controls (mean age 74.0 years) were recruited. Rod-mediated dark adaptation was significantly delayed in intermediate stage AMD compared with healthy controls (32.9 minutes versus 10.7 minutes, p < 0.01). There was no statistically significant correlation between the rod intercept time and the level of macular pigment in those with intermediate AMD (r = -0.04, p = 0.85). CONCLUSION The results did not support the hypothesis that higher macular pigment is associated with improved rod-mediated performance or that higher levels of macular pigment protect rod-mediated function in intermediate AMD.
Collapse
Affiliation(s)
- Raymond O Beirne
- Vision Science Research Group, Department of Optometry and Vision Science, School of Biomedical Sciences, University of Ulster, Coleraine, Northern Ireland, UK
| | - Emma McConnell
- Vision Science Research Group, Department of Optometry and Vision Science, School of Biomedical Sciences, University of Ulster, Coleraine, Northern Ireland, UK
| |
Collapse
|
19
|
Puell MC, Fernandez-Balbuena AÁ. Abdominal obesity linked to a longer cone-mediated dark-adaptation recovery time in healthy eyes. Exp Eye Res 2019; 181:163-170. [PMID: 30738070 DOI: 10.1016/j.exer.2019.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 01/15/2019] [Accepted: 02/05/2019] [Indexed: 12/16/2022]
Abstract
Obesity has been associated with abnormal lipid metabolism and with tissue hypoxia. Human Bruch's membrane (BrM) lipid deposits have been proposed to create a diffusion barrier to metabolic exchange between the choroid and photoreceptors, delaying the regeneration of photopigments. The speed of retinal dark adaptation (DA) is dependent on the regeneration of these photopigments. While the retina is extremely sensitive to hypoxia, the inner retina, which encodes visual contrast, is more affected by hypoxia than the outer retina. This study examines the association between adiposity measures and the time course of DA measured psychophysically through contrast detection to test the functionality of both the outer and inner retina. Cone-mediated DA recovery of contrast threshold (CT) was measured following near-total photopigment bleach for 6 min in 52 healthy eyes of 52 individuals (42.6 ± 18.3 years). Stimuli were sine-wave gratings of low-spatial frequency (1 cycle-per-degree (cpd)) and low luminance (1 cd/m2) generated at the centre of a CRT monitor. CT recovery functions were fitted to an exponential decay model to determine the time constant (τ, seconds) of cone sensitivity recovery, final cone CT (CTf) and CT elevation (CT0). Weight, height and waist circumference (WC) were measured and body mass index (BMI) and waist-to-height ratio (WHtR) calculated. Relationships were examined through Spearman correlation and through multiple linear regression using age, optical and adiposity measures as independent variables. The repeatability of cone time constant measurements was estimated by the Bland-Altman method and reported as the coefficient of repeatability (CoR). Mean ± SD of time constant and CTf were 57.3 ± 27.7 s and -1.78 ± 0.20 log10 units respectively. Cone time constant showed positive Spearman correlation with WC (p = 0.008) and WHtR (p = 0.023) but not with BMI (p = 0.058). Only WHtR emerged as an independent predictor of time constant (p = 0.001). CTf was not correlated with any adiposity measures. Mean cone time constant was 41 s slower in subjects (25%, n = 13) with abdominal obesity (WHtR≥0.5). Mean CTf was not significantly different in subjects with or without abdominal obesity. CoR for cone time constant was ±16 s. In adult subjects, greater abdominal obesity (WHtR) was related to a longer contrast recovery time for cone-mediated DA (time to dark-adapt) suggesting outer retinal dysfunction. Final contrast threshold, preferentially processed by inner retinal cells, was unaffected by abdominal obesity.
Collapse
Affiliation(s)
- María Cinta Puell
- Applied Vision Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Av. Arcos de Jalón 118, Madrid, 28037, Spain.
| | - Antonio Álvarez Fernandez-Balbuena
- Applied Optics Complutense Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Av. Arcos de Jalón 118, Madrid, 28037, Spain
| |
Collapse
|
20
|
Macular Pigment Distribution as Prognostic Marker for Disease Progression in Macular Telangiectasia Type 2. Am J Ophthalmol 2018; 194:163-169. [PMID: 30053477 DOI: 10.1016/j.ajo.2018.07.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 07/12/2018] [Accepted: 07/15/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate macular pigment distribution pattern as a prognostic marker for disease progression in patients with macular telangiectasia type 2 (MacTel). DESIGN Retrospective cohort study. METHODS In this single-center study, 90 eyes of 47 patients were analyzed. Macular pigment optical density (MPOD) was measured with dual-wavelength fundus autofluorescence. Eyes were graded into MPOD distribution classes 1 to 3 with increasing loss of macular pigment and grading was performed masked by 2 independent graders. Best-corrected visual acuity, reading acuity, total scotoma size in fundus-controlled perimetry (microperimetry), and break of the ellipsoid zone (EZ) in optical coherence tomography (en face measurement) were defined as functional and morphologic outcome parameters and evaluated at baseline and after 60 months. RESULTS After a mean review period of 59.6 months (±standard deviation 5.2 months), no change between MPOD classes was observed compared to baseline. Morphologic and functional deficits were limited to the area of MPOD loss. At last follow-up, a significant mean decrease of visual acuity and reading acuity as well as a significant mean increase of scotoma size and EZ break were observed in eyes assigned to MPOD classes 2 and 3, while outcome parameters remained stable in eyes of class 1. CONCLUSIONS The results indicate that MPOD and its distribution may serve as a prognostic marker for disease progression and functional impairment in patients with MacTel.
Collapse
|
21
|
Olmedilla-Alonso B, Estévez-Santiago R, Silván JM, Sánchez-Prieto M, de Pascual-Teresa S. Effect of Long-Term Xanthophyll and Anthocyanin Supplementation on Lutein and Zeaxanthin Serum Concentrations and Macular Pigment Optical Density in Postmenopausal Women. Nutrients 2018; 10:nu10080959. [PMID: 30044439 PMCID: PMC6116081 DOI: 10.3390/nu10080959] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/16/2022] Open
Abstract
Xanthophylls (lutein, L; zeaxanthin, Z) and anthocyanins are often included in food supplements to improve ocular health. There are no dietary reference intakes for them. The aim was to assess the effects of L, Z and anthocyanin supplementation on short and long-term lutein status markers (serum concentration and macular pigment optical density (MPOD)). Seventy-two postmenopausal women were randomized into a parallel study of 8 months: Group A-anthocyanines (60 mg/day); Group X-xanthophylls (6 mg L + 2 mg Z/day); Group X+A-anthocyanines (60 mg/day) + xanthophylls (6 mg L + 2 mg Z/day). At the beginning of the study, 4 and 8 month serum L and Z concentrations were determined (HPLC), as well as L, Z and anthocyanine dietary intake and MPOD (heterochromic flicker photometry). Baseline concentrations of L (0.35 ± 0.19 μmol/L), Z (0.11 ± 0.05 μmol/L), L+Z/cholesterol/triglycerides (0.07 ± 0.04 μmol/mmol) increased in Group X (2.8- and 1.6-fold in L and Z concentrations) and in group XA (2- and 1.4-fold in L and Z concentrations). MPOD (baseline: 0.32 ± 0.13 du) was not modified in any of the groups at the end of the study. There were no differences in the dietary intake of L+Z and anthocyanin at any point in time in any group. Supplementation of L and Z at a dietary level provoked an increase in their serum concentration that was not modified by simultaneous supplementation with anthocyanins.
Collapse
Affiliation(s)
- Begoña Olmedilla-Alonso
- Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN-CSIC), C/José Antonio Novais, 10, 28040 Madrid, Spain.
| | - Rocío Estévez-Santiago
- Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN-CSIC), C/José Antonio Novais, 10, 28040 Madrid, Spain.
| | - José-Manuel Silván
- Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN-CSIC), C/José Antonio Novais, 10, 28040 Madrid, Spain.
| | - Milagros Sánchez-Prieto
- Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN-CSIC), C/José Antonio Novais, 10, 28040 Madrid, Spain.
| | - Sonia de Pascual-Teresa
- Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN-CSIC), C/José Antonio Novais, 10, 28040 Madrid, Spain.
| |
Collapse
|
22
|
Erkan Turan K, Cankaya AB, Taylan Sekeroglu H, Inam O, Karahan S. Is macular pigment optical density really involved in fixation preference? Eur J Ophthalmol 2018; 28:454-458. [PMID: 29973073 DOI: 10.1177/1120672117747019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate macular pigment optical density in healthy children and to compare the values with those of strabismic children with respect to fixation preference. METHODS The study recruited 54 healthy and 41 strabismic children. Two groups were matched in terms of gestational age, birth weight, and body mass index. All participants underwent complete ophthalmological evaluation and macular pigment optical density measurement and filled a self-reported food frequency questionnaire. Strabismic children were categorized according to fixation preference. RESULTS The mean age was 9.87 ± 2.39 years in healthy children and 9.07 ± 2.07 years in children with strabismus (p = 0.091). Mean macular pigment optical density was 0.23 ± 0.25 in healthy eyes and 0.25 ± 0.27 in non-preferred eyes of strabismic children (p = 0.964). Macular pigment optical density was significantly higher in preferred eyes of strabismic children (0.43 ± 0.34) compared to non-preferred eyes (p = 0.004) and healthy eyes (p = 0.001). There was a difference of macular pigment optical density between both eyes in patients with grades 1, 2, and 3 fixation preference, whereas patients with grade 4 preference had similar macular pigment optical density in both eyes (p = 0.008). There was a statistically significant positive correlation between macular pigment optical density in preferred eyes and body mass index (r = 0.354, p = 0.023). CONCLUSION Preferred eyes of children with strabismus seem to have higher macular pigment optical density readings. This difference may emerge from the higher tendency of recognizing the flicker stimulus while preferred eye is under testing. Similar macular pigment optical density in healthy and non-preferred eyes and the fact that both lower than preferred eyes remain unexplained. It should be kept in mind that macular pigment optical density results should be carefully interpreted and macular pigment optical density in cases with strabismus should be further investigated.
Collapse
Affiliation(s)
- Kadriye Erkan Turan
- 1 Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ali Bulent Cankaya
- 1 Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Hande Taylan Sekeroglu
- 1 Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Onur Inam
- 1 Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Sevilay Karahan
- 2 Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|
23
|
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.
Collapse
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
| |
Collapse
|
24
|
Siah WF, O'Brien C, Loughman JJ. Macular pigment is associated with glare-affected visual function and central visual field loss in glaucoma. Br J Ophthalmol 2017; 102:929-935. [PMID: 28982957 DOI: 10.1136/bjophthalmol-2017-310215] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 09/03/2017] [Accepted: 09/21/2017] [Indexed: 11/03/2022]
Abstract
AIM To evaluate the relationship between macular pigment optical density (MPOD) and glare disability in open-angle glaucoma. METHODS A cross-sectional analysis of baseline data (88 subjects; median age, 67 (range 36-84) years) collected during the Macular Pigment and Glaucoma Trial (ISRCTN registry number: 56985060). MPOD at 0.25°, 0.5° and 1° of retinal eccentricity was measured using customised heterochromatic flicker photometry. Mesopic contrast sensitivity with glare (mCSg), photostress recovery time (PRT) and self-reported glare symptoms were evaluated. Fourier-domain optical coherence tomography was used to analyse ganglion cell complex (GCC) and identify foveal involvement. RESULTS Low spatial frequency (f) mCSg was significantly correlated with MPOD at 0.25°(3 cycles per degree (cpd): r=0.25, p=0.04) and 0.5° (3 cpd: r=0.23, p=0.04) of retinal eccentricity. Those with foveal GCC loss exhibited lower MPOD, had worse low spatial fmCSg (1.5 cpd and 3 cpd, p=0.02 each) and prolonged PRT (p=0.02) in comparison with those without foveal involvement. The depth of central 10° field loss was related to MPOD at all eccentricities (p<0.01 for all). Those who reported glare symptoms had a significantly lower MPOD at all retinal eccentricities (0.25° and 1°: p=0.05 each; 0.5°: p=0.04), including those with foveal involvement (0.25°: p=0.05; 0.5°: p<0.01; 1°: p=0.01). CONCLUSIONS Macular pigment level may be an important consideration among those experiencing disability glare in glaucoma, including those with foveal involvement. TRIAL REGISTRATION NUMBER ISRCTN56985060, Post-results.
Collapse
Affiliation(s)
- We Fong Siah
- Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Colm O'Brien
- Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - James J Loughman
- School of Physics, Clinical and Optometric Sciences, 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
| |
Collapse
|
25
|
Li X, Kelly D, Nolan JM, Dennison JL, Beatty S. The evidence informing the surgeon's selection of intraocular lens on the basis of light transmittance properties. Eye (Lond) 2016; 31:258-272. [PMID: 27935597 PMCID: PMC5306461 DOI: 10.1038/eye.2016.266] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 09/27/2016] [Indexed: 01/01/2023] Open
Abstract
In recent years, manufacturers and distributors have promoted commercially available intraocular lenses (IOLs) with transmittance properties that filter visible short-wavelength (blue) light on the basis of a putative photoprotective effect. Systematic literature review. Out of 21 studies reporting on outcomes following implantation of blue-light-filtering IOLs (involving 8914 patients and 12 919 study eyes undergoing cataract surgery), the primary outcome was vision, sleep pattern, and photoprotection in 9 (42.9%), 9 (42.9%), and 3 (14.2%) respectively, and, of these, only 7 (33.3%) can be classed as high as level 2b (individual cohort study/low-quality randomized controlled trials), all other studies being classed as level 3b or lower. Of the level 2b studies, only one (14.3%) found in favor of blue-light-filtering IOLs vs ultraviolet (UV)-only filtering IOLs on the basis of an association between better post-operative contrast sensitivity (CS) at select frequencies with the former; however, that study did not measure or report CS preoperatively in either group, and the finding may simply reflect better preoperative CS in the eyes scheduled to be implanted with the blue-light-filtering IOL; moreover, that study failed to measure macular pigment, a natural preceptoral filter of blue-light, augmentation of which is now known to improve CS. In terms of photoprotection, there is no level 2b (or higher) evidence in support of blue filtering IOLs vs UV-only filtering IOLs. On the basis of currently available evidence, one cannot advocate for the use of blue-light-filtering IOLs over UV-only filtering IOLs.
Collapse
Affiliation(s)
- X Li
- Pharmaceutical & Molecular Biotechnology Research Centre, Department of Chemical & Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - D Kelly
- Nutrition Research Centre Ireland, Macular Pigment Research Group, School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | - J M Nolan
- Nutrition Research Centre Ireland, Macular Pigment Research Group, School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | - J L Dennison
- Nutrition Research Centre Ireland, Macular Pigment Research Group, School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | - S Beatty
- Nutrition Research Centre Ireland, Macular Pigment Research Group, School of Health Science, Waterford Institute of Technology, Waterford, Ireland.,Institute of Vision Research, Whitfield Clinic, Waterford, Ireland
| |
Collapse
|
26
|
Stringham JM, O'Brien KJ, Stringham NT. Macular carotenoid supplementation improves disability glare performance and dynamics of photostress recovery. EYE AND VISION 2016; 3:30. [PMID: 27857944 PMCID: PMC5106769 DOI: 10.1186/s40662-016-0060-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 10/25/2016] [Indexed: 11/10/2022]
Abstract
Background The so-called macular carotenoids (MC) lutein (L), zeaxanthin (Z), and meso-zeaxanthin (MZ) comprise the diet-derived macular pigment (MP). The purpose of this study was to determine effects of MC supplementation on the optical density of MP (MPOD), repeated-exposure photostress recovery (PSR), and disability glare (DG) thresholds. Methods This was a double-blind, placebo-controlled trial. Fifty-nine young (mean age = 21.7), healthy volunteers participated in this study. Subjects supplemented their daily diet with either 10 mg L + 2 mg total Z (1 mg Z + 1 mg MZ; n = 24), 20 mg L + 4 mg total Z (2 mg Z + 2 mg MZ; n = 25), or placebo (n = 10) for 12 months. The primary outcome was a composite measure of visual performance in glare, defined by change in DG and PSR. Secondary outcomes included MPOD and visual fatigue. The primary endpoint for outcomes was 12 months. MPOD was assessed with customized heterochromatic flicker photometry. PSR times for an 8 cycle /degree, 15 % contrast Gabor patch target were determined after each of five successive exposures to intense LED lights. DG threshold was defined as the intensity of a ring of lights through which subjects were able to maintain visibility of the aforementioned target. Measures of all parameters were conducted at baseline, 6 months, and 12 months. Repeated-measures ANOVA, and Pearson product-moment correlations were used to determine statistically significant correlations, and changes within and between groups. Results MPOD for subjects in both supplementation groups increased significantly versus placebo at both 6- and 12-month visits (p < 0.001 for all). Additionally, PSR times and DG thresholds improved significantly from baseline compared to placebo at 6- and 12-month visits (p < 0.001 for all). At baseline, MPOD was significantly related to both DG thresholds (r = 0.444; p = 0.0021) and PSR times (r = -0.56; p < 0.001). As a function of MPOD, the repeated-exposure PSR curves became more asymptotic, as opposed to linear. The change in subjects’ DG thresholds were significantly related to changes in PSR times across the study period (r = -0.534; p < 0.001). Conclusions Increases in MPOD lead to significant improvements in PSR times and DG thresholds. The asymptotic shape of the repeated-exposure PSR curves suggests that increases in MPOD produce more consistent steady-state visual performance in bright light conditions. The mechanism for this effect may involve both the optical filtering and biochemical (antioxidant) properties of MP. Trial registration ISRCTN trial registration number: ISRCTN54990825. Data reported in this manuscript represent secondary outcome measures from the registered trial.
Collapse
Affiliation(s)
- James M Stringham
- Nutritional Neuroscience Laboratory, Department of Physiology and Pharmacology, University of Georgia, Athens, GA 30602 USA
| | - Kevin J O'Brien
- Vision Sciences Laboratory, Department of Psychology, University of Georgia, Athens, GA 30602 USA
| | - Nicole T Stringham
- Nutritional Neuroscience Laboratory, Department of Physiology and Pharmacology, University of Georgia, Athens, GA 30602 USA ; Interdisciplinary Neuroscience Program, Biomedical Health Sciences Institute, University of Georgia, Athens, GA 30602 USA
| |
Collapse
|
27
|
Peng ML, Chiu HF, Chou H, Liao HJ, Chen ST, Wong YC, Shen YC, Venkatakrishnan K, Wang CK. Influence/impact of lutein complex (marigold flower and wolfberry) on visual function with early age-related macular degeneration subjects: A randomized clinical trial. J Funct Foods 2016. [DOI: 10.1016/j.jff.2016.04.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
28
|
Akuffo KO, Nolan JM, Peto T, Stack J, Leung I, Corcoran L, Beatty S. Relationship between macular pigment and visual function in subjects with early age-related macular degeneration. Br J Ophthalmol 2016; 101:190-197. [PMID: 27091854 PMCID: PMC5293853 DOI: 10.1136/bjophthalmol-2016-308418] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/11/2016] [Accepted: 03/15/2016] [Indexed: 12/03/2022]
Abstract
Purpose To investigate the relationship between macular pigment (MP) and visual function in subjects with early age-related macular degeneration (AMD). Methods 121 subjects with early AMD enrolled as part of the Central Retinal Enrichment Supplementation Trial (CREST; ISRCTN13894787) were assessed using a range of psychophysical measures of visual function, including best corrected visual acuity (BCVA), letter contrast sensitivity (CS), mesopic and photopic CS, mesopic and photopic glare disability (GD), photostress recovery time (PRT), reading performance and subjective visual function, using the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). MP was measured using customised heterochromatic flicker photometry. Results Letter CS, mesopic and photopic CS, photopic GD and mean reading speed were each significantly (p<0.05) associated with MP across a range of retinal eccentricities, and these statistically significant relationships persisted after controlling for age, sex and cataract grade. BCVA, NEI VFQ-25 score, PRT and mesopic GD were unrelated to MP after controlling for age, sex and cataract grade (p>0.05, for all). Conclusions MP relates positively to many measures of visual function in unsupplemented subjects with early AMD. The CREST trial will investigate whether enrichment of MP influences visual function among those afflicted with this condition. Trial registration number ISRCTN13894787.
Collapse
Affiliation(s)
- Kwadwo Owusu Akuffo
- Nutrition Research Centre Ireland, Macular Pigment Research Group, School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - John M Nolan
- Nutrition Research Centre Ireland, Macular Pigment Research Group, School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Tunde Peto
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Jim Stack
- Nutrition Research Centre Ireland, Macular Pigment Research Group, School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Irene Leung
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Laura Corcoran
- Nutrition Research Centre Ireland, Macular Pigment Research Group, School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - Stephen Beatty
- Nutrition Research Centre Ireland, Macular Pigment Research Group, School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland
| |
Collapse
|
29
|
Estévez-Santiago R, Olmedilla-Alonso B, Beltrán-de-Miguel B. Assessment of lutein and zeaxanthin status and dietary markers as predictors of the contrast threshold in 2 age groups of men and women. Nutr Res 2016; 36:719-30. [PMID: 27262538 DOI: 10.1016/j.nutres.2016.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 02/12/2016] [Accepted: 02/18/2016] [Indexed: 02/06/2023]
Abstract
Lutein and zeaxanthin (L + Z) status is associated with the macular pigment (MP). The relationship between MP and visual function is controversial. We hypothesized that, within the framework of nutrition, visual function was related to MP and nutritional and/or/dietary factors influencing it. A cross-sectional study was performed in 108 volunteers divided into 2 age groups (20-35 years; 45-65 years), each 27 women and 27 men, to assess the relationship between MP optical density (MPOD) and contrast threshold (CT), considering the influence of L + Z and, fruit and vegetable (F + V) intake. MPOD, L + Z in serum and dietary intake were determined using heterochromatic flicker photometry, high-performance liquid chromatography and 3-day food records, respectively. CT was measured with the CGT-1000 Contrast Glaretester at 6 stimulus sizes, with and without glare. Spearman correlation coefficient and a generalized linear model were used for the statistical study. MPOD and CT were higher and lower, respectively in younger than in elder individuals (P < .000) and were correlated only in the older group. CT were higher under glare conditions, at the intermediate and smaller visual angles, with greater differences in the older (P < .003) than the younger group (P < .014). In the total sample, CT correlated inversely with MPOD (correlation coefficients and P values ranging from -.245 to -.152 and from .000 to .026, respectively) and directly with F + V intake (correlation coefficients and P values ranging from -.265 to -.176 and from .000 to .010, respectively). As predictors of CT in the total sample, MPOD, F + V (every 100 g/d) and sex were identified (β coefficients ranged from -0.01 to -1.86; from 0.01 to 0.08 and from 0.01 to 0.40, respectively). CT revealed age-specific nutritional predictors: MPOD and serum lutein in the 45- to 65-year group, and F + V intake in the 20- to 35-year group.
Collapse
|
30
|
Bernstein PS, Li B, Vachali PP, Gorusupudi A, Shyam R, Henriksen BS, Nolan JM. Lutein, zeaxanthin, and meso-zeaxanthin: The basic and clinical science underlying carotenoid-based nutritional interventions against ocular disease. Prog Retin Eye Res 2016; 50:34-66. [PMID: 26541886 PMCID: PMC4698241 DOI: 10.1016/j.preteyeres.2015.10.003] [Citation(s) in RCA: 314] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 10/04/2015] [Accepted: 10/29/2015] [Indexed: 12/31/2022]
Abstract
The human macula uniquely concentrates three carotenoids: lutein, zeaxanthin, and meso-zeaxanthin. Lutein and zeaxanthin must be obtained from dietary sources such as green leafy vegetables and orange and yellow fruits and vegetables, while meso-zeaxanthin is rarely found in diet and is believed to be formed at the macula by metabolic transformations of ingested carotenoids. Epidemiological studies and large-scale clinical trials such as AREDS2 have brought attention to the potential ocular health and functional benefits of these three xanthophyll carotenoids consumed through the diet or supplements, but the basic science and clinical research underlying recommendations for nutritional interventions against age-related macular degeneration and other eye diseases are underappreciated by clinicians and vision researchers alike. In this review article, we first examine the chemistry, biochemistry, biophysics, and physiology of these yellow pigments that are specifically concentrated in the macula lutea through the means of high-affinity binding proteins and specialized transport and metabolic proteins where they play important roles as short-wavelength (blue) light-absorbers and localized, efficient antioxidants in a region at high risk for light-induced oxidative stress. Next, we turn to clinical evidence supporting functional benefits of these carotenoids in normal eyes and for their potential protective actions against ocular disease from infancy to old age.
Collapse
Affiliation(s)
- Paul S Bernstein
- Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, 65 Mario Capecchi Drive, Salt Lake City, UT, 84132, USA.
| | - Binxing Li
- Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, 65 Mario Capecchi Drive, Salt Lake City, UT, 84132, USA.
| | - Preejith P Vachali
- Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, 65 Mario Capecchi Drive, Salt Lake City, UT, 84132, USA.
| | - Aruna Gorusupudi
- Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, 65 Mario Capecchi Drive, Salt Lake City, UT, 84132, USA.
| | - Rajalekshmy Shyam
- Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, 65 Mario Capecchi Drive, Salt Lake City, UT, 84132, USA.
| | - Bradley S Henriksen
- Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, 65 Mario Capecchi Drive, Salt Lake City, UT, 84132, USA.
| | - John M Nolan
- Macular Pigment Research Group, Vision Research Centre, School of Health Science, Carriganore House, Waterford Institute of Technology West Campus, Carriganore, Waterford, Ireland.
| |
Collapse
|
31
|
Putnam CM, Bassi CJ. Macular pigment spatial distribution effects on glare disability. JOURNAL OF OPTOMETRY 2015; 8:258-65. [PMID: 25697374 PMCID: PMC4591422 DOI: 10.1016/j.optom.2014.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 12/04/2014] [Accepted: 12/07/2014] [Indexed: 05/26/2023]
Abstract
PURPOSE This project explored the relationship of the macular pigment optical density (MPOD) spatial profile with measures of glare disability (GD) across the macula. METHODS A novel device was used to measure MPOD across the central 16° of retina along four radii using customized heterochromatic flicker photometry (cHFP)at eccentricities of 0°, 2°, 4°, 6° and 8°. MPOD was measured as discrete and integrated values at all measured retinal loci. GD was calculated as a difference in contrast sensitivity (CS) between no glare and glare conditions using identical stimuli presented at the same eccentricities. GD was defined as [(CSNo Glare-CSGlare)/CSNo Glare] in order to isolate the glare attenuation effects of MPOD by controlling for CS variability among the subject sample. Correlations of the discrete and integrated MPOD with GD were compared. RESULTS The cHFP identified reliable MPOD spatial distribution maps demonstrating a 1st-order exponential decay as a function of increasing eccentricity. There was a significant negative correlation between both measures of foveal MPOD and GD using 6 cycles per degree (cpd) and 9 cpd stimuli. Significant correlations were found between corresponding parafoveal MPOD measures and GD at 2 and 4° of eccentricity using 9 cpd stimuli with greater MPOD associated with less glare disability. CONCLUSIONS These results are consistent with the glare attenuation effects of MP at higher spatial frequencies and support the hypothesis that discrete and integrated measures of MPOD have similar correlations with glare attenuation effects across the macula. Additionally, peak foveal MPOD appears to influence GD across the macula.
Collapse
Affiliation(s)
| | - Carl J Bassi
- University of Missouri, St Louis College of Optometry, United States
| |
Collapse
|
32
|
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.
Collapse
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
| |
Collapse
|
33
|
Broadhead GK, Grigg JR, Chang AA, McCluskey P. Dietary modification and supplementation for the treatment of age-related macular degeneration. Nutr Rev 2015; 73:448-62. [PMID: 26081455 DOI: 10.1093/nutrit/nuv005] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Age-related macular degeneration (AMD) causes a significant proportion of visual loss in the developed world. Currently, little is known about its pathogenesis, and treatment options are limited. Dietary intake is one of the few modifiable risk factors for this condition. The best-validated therapies remain oral antioxidant supplements based on those investigated in the Age-Related Eye Disease Study (AREDS) and the recently completed Age-Related Eye Disease Study 2 (AREDS2). In this review, current dietary guidelines related to AMD, along with the underlying evidence to support them, are presented in conjunction with current treatment recommendations. Both AREDS and AREDS2 are discussed, as are avenues for further research, including supplementation with vitamin D and saffron. Despite the considerable disease burden of atrophic AMD, few effective therapies are available to treat it, and further research is required.
Collapse
Affiliation(s)
- Geoffrey K Broadhead
- G.K. Broadhead, J. Grigg, A.A Chang, and P. McCluskey are with the Save Sight Institute, Department of Ophthalmology, The University of Sydney, Sydney, New South Wales, 2000, Australia. G.K. Broadhead and A.A Chang are with the Sydney Institute of Vision Science, Sydney, New South Wales, 2000, Australia.
| | - John R Grigg
- G.K. Broadhead, J. Grigg, A.A Chang, and P. McCluskey are with the Save Sight Institute, Department of Ophthalmology, The University of Sydney, Sydney, New South Wales, 2000, Australia. G.K. Broadhead and A.A Chang are with the Sydney Institute of Vision Science, Sydney, New South Wales, 2000, Australia
| | - Andrew A Chang
- G.K. Broadhead, J. Grigg, A.A Chang, and P. McCluskey are with the Save Sight Institute, Department of Ophthalmology, The University of Sydney, Sydney, New South Wales, 2000, Australia. G.K. Broadhead and A.A Chang are with the Sydney Institute of Vision Science, Sydney, New South Wales, 2000, Australia
| | - Peter McCluskey
- G.K. Broadhead, J. Grigg, A.A Chang, and P. McCluskey are with the Save Sight Institute, Department of Ophthalmology, The University of Sydney, Sydney, New South Wales, 2000, Australia. G.K. Broadhead and A.A Chang are with the Sydney Institute of Vision Science, Sydney, New South Wales, 2000, Australia
| |
Collapse
|
34
|
Attenuating Photostress and Glare Disability in Pseudophakic Patients through the Addition of a Short-Wave Absorbing Filter. J Ophthalmol 2015; 2015:607635. [PMID: 25838942 PMCID: PMC4370187 DOI: 10.1155/2015/607635] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/19/2015] [Accepted: 02/25/2015] [Indexed: 12/26/2022] Open
Abstract
To evaluate the effects of filtering short wavelength light on visual performance under intense light conditions among pseudophakic patients previously implanted with a clear intraocular lens (IOL). This was a patient-masked, randomized crossover study conducted at 6 clinical sites in the United States between September 2013 and January 2014. One hundred fifty-four bilaterally pseudophakic patients were recruited. Photostress recovery time and glare disability thresholds were measured with clip-on blue-light-filtering and placebo (clear; no blue-light filtration) glasses worn over patients' habitual correction. Photostress recovery time was quantified as the time necessary to regain sight of a grating target after intense light exposure. Glare disability threshold was assessed as the intensity of a white-light annulus necessary to obscure a central target. The order of filter used and test eye were randomized across patients. Photostress recovery time and glare disability thresholds were significantly improved (both P < 0.0001) when patients used blue-light-filtering glasses compared with clear, nonfiltering glasses. Compared with a nonfiltering placebo, adding a clip-on blue-absorbing filter to the glasses of pseudophakic patients implanted with clear IOLs significantly increased their ability to cope with glare and to recover normal viewing after an intensive photostress. This result implies that IOL designs with blue-light-filtering characteristics may be beneficial under intense light conditions.
Collapse
|
35
|
Effect of supplemental lutein and zeaxanthin on serum, macular pigmentation, and visual performance in patients with early age-related macular degeneration. BIOMED RESEARCH INTERNATIONAL 2015; 2015:564738. [PMID: 25815324 PMCID: PMC4359817 DOI: 10.1155/2015/564738] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 09/21/2014] [Accepted: 09/21/2014] [Indexed: 12/15/2022]
Abstract
Purpose. To compare the 2-year effect of multiple doses of lutein/zeaxanthin on serum, macular pigmentation, and visual performance on patients with early age-related macular degeneration (AMD). Methods. In this randomized, double-blinded, and placebo-controlled trial, 112 early AMD patients randomly received either 10 mg lutein, 20 mg lutein, a combination of lutein (10 mg) and zeaxanthin (10 mg), or placebo daily for 2 years. Serum concentration of lutein/zeaxanthin, macular pigment optical density (MPOD), visual functions including best-spectacle corrected visual acuity (BCVA), contrast sensitivity (CS), flash recovery time (FRT), and vision-related quality of life (VFQ25) was quantified. Results. Serum lutein concentration and MPOD significantly increased in all the active treatment groups. Supplementation with 20 mg lutein was the most effective in increasing MPOD and CS at 3 cycles/degree for the first 48 weeks. However, they both significantly increased to the same peak value following supplementation with either 10 mg or 20 mg lutein during the intervention. No statistical changes of BCVA or FRT were observed during the trial. Conclusions. Long-term lutein supplementation could increase serum lutein concentration, MPOD, and visual sensitivities of early AMD patients. 10 mg lutein daily might be an advisable long-term dosage for early AMD treatment.
Collapse
|
36
|
Supplementation with three different macular carotenoid formulations in patients with early age-related macular degeneration. Retina 2015; 34:1757-66. [PMID: 24887490 DOI: 10.1097/iae.0000000000000174] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the impact of three different macular carotenoid formulations on macular pigment optical density and visual performance in subjects with early age-related macular degeneration. METHODS Fifty-two subjects were supplemented and followed for 12 months, 17 of them were in intervention Group 1 (20 mg/day lutein and 2 mg/day zeaxanthin); 21 in Group 2 (10 mg/day meso-zeaxanthin, 10 mg/day lutein, and 2 mg/day zeaxanthin); and 14 in Group 3 (17 mg/day meso-zeaxanthin, 3 mg/day lutein, and 2 mg/day zeaxanthin). The macular pigment optical density was measured using customized heterochromatic flicker photometry, and visual function was assessed using corrected distance visual acuity and by letter contrast sensitivity. RESULTS A statistically significant increase in the macular pigment optical density was observed at all measured eccentricities in Group 2 (P ≤ 0.005) and in Group 3 (P < 0.05, for all), but only at 1.75° in Group 1 (P = 0.018). Statistically significant (P < 0.05) improvements in letter contrast sensitivity were seen at all spatial frequencies (except 1.2 cycles per degree) in Group 3, and at low spatial frequencies in Groups 1 and 2. CONCLUSION Augmentation of the macular pigment optical density across its spatial profile and enhancements in contrast sensitivity were best achieved after supplementation with a formulation containing high doses of meso-zeaxanthin in combination with lutein and zeaxanthin.
Collapse
|
37
|
|
38
|
Li DJ, Song JF, Liu CQ. Stereoisomers Identification and Storage Stability of Microencapsulated Marigold Lutein. INTERNATIONAL JOURNAL OF FOOD PROPERTIES 2014. [DOI: 10.1080/10942912.2013.828748] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
39
|
Akuffo KO, Beatty S, Stack J, Dennison J, O’Regan S, Meagher KA, Peto T, Nolan J. Central Retinal Enrichment Supplementation Trials (CREST): design and methodology of the CREST randomized controlled trials. Ophthalmic Epidemiol 2014; 21:111-23. [PMID: 24621122 PMCID: PMC4002658 DOI: 10.3109/09286586.2014.888085] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 07/25/2013] [Accepted: 09/03/2013] [Indexed: 01/25/2023]
Abstract
PURPOSE The Central Retinal Enrichment Supplementation Trials (CREST) aim to investigate the potential impact of macular pigment (MP) enrichment, following supplementation with a formulation containing 10 mg lutein (L), 2 mg zeaxanthin (Z) and 10 mg meso-zeaxanthin (MZ), on visual function in normal subjects (Trial 1) and in subjects with early age-related macular degeneration (AMD; Trial 2). METHODS CREST is a single center, double-blind, randomized clinical trial. Trial 1 (12-month follow-up) subjects are randomly assigned to a formulation containing 10 mg L, 10 mg MZ and 2 mg Z (n = 60) or placebo (n = 60). Trial 2 (24-month follow-up) subjects are randomly assigned to a formulation containing 10 mg L, 10 mg MZ, 2 mg Z plus 500 mg vitamin C, 400 IU vitamin E, 25 mg zinc and 2 mg copper (Intervention A; n = 75) or 10 mg L and 2 mg Z plus 500 mg vitamin C, 400 IU vitamin E, 25 mg zinc and 2 mg copper (Intervention B; n = 75). Contrast sensitivity (CS) at 6 cycles per degree represents the primary outcome measure in each trial. Secondary outcomes include: CS at other spatial frequencies, MP, best-corrected visual acuity, glare disability, photostress recovery, light scatter, cognitive function, foveal architecture, serum carotenoid concentrations, and subjective visual function. For Trial 2, AMD morphology, reading speed and reading acuity are also being recorded. CONCLUSIONS CREST is the first study to investigate the impact of supplementation with all three macular carotenoids in the context of a large, double-blind, randomized clinical trial.
Collapse
Affiliation(s)
- Kwadwo Owusu Akuffo
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of TechnologyWaterfordIreland
| | - Stephen Beatty
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of TechnologyWaterfordIreland
| | - Jim Stack
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of TechnologyWaterfordIreland
| | - Jessica Dennison
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of TechnologyWaterfordIreland
| | - Sarah O’Regan
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of TechnologyWaterfordIreland
| | - Katherine A. Meagher
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of TechnologyWaterfordIreland
| | - Tunde Peto
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of OphthalmologyLondonUK
| | - John Nolan
- Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of TechnologyWaterfordIreland
| |
Collapse
|
40
|
Feigl B, Morris CP, Voisey J, Kwan A, Zele AJ. The relationship between BCMO1 gene variants and macular pigment optical density in persons with and without age-related macular degeneration. PLoS One 2014; 9:e89069. [PMID: 24586510 PMCID: PMC3929644 DOI: 10.1371/journal.pone.0089069] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 01/13/2014] [Indexed: 12/17/2022] Open
Abstract
Background Recent evidence indicates that gene variants related to carotenoid metabolism play a role in the uptake of macular pigments lutein (L) and zeaxanthin (Z). Moreover, these pigments are proposed to reduce the risk for advanced age-related macular degeneration (AMD). This study provides the initial examination of the relationship between the gene variants related to carotenoid metabolism, macular pigment optical density (MPOD) and their combined expression in healthy humans and patients with AMD. Participants and Methods Forty-four participants were enrolled from a general population and a private practice including 20 healthy participants and 24 patients with advanced (neovascular) AMD. Participants were genotyped for the three single nucleotide polymorphisms (SNPs) upstream from BCMO1, rs11645428, rs6420424 and rs6564851 that have been shown to either up or down regulate beta-carotene conversion efficiency in the plasma. MPOD was determined by heterochromatic flicker photometry. Results Healthy participants with the rs11645428 GG genotype, rs6420424 AA genotype and rs6564851 GG genotype all had on average significantly lower MPOD compared to those with the other genotypes (p<0.01 for all three comparisons). When combining BCMO1 genotypes reported to have “high” (rs11645428 AA/rs6420424 GG/rs6564851 TT) and “low” (rs11645428 GG/rs6420424 AA/rs6564851 GG) beta-carotene conversion efficiency, we demonstrate clear differences in MPOD values (p<0.01). In patients with AMD there were no significant differences in MPOD for any of the three BCMO1 gene variants. Conclusion In healthy participants MPOD levels can be related to high and low beta-carotene conversion BCMO1 genotypes. Such relationships were not found in patients with advanced neovascular AMD, indicative of additional processes influencing carotenoid uptake, possibly related to other AMD susceptibility genes. Our findings indicate that specific BCMO1 SNPs should be determined when assessing the effects of carotenoid supplementation on macular pigment and that their expression may be influenced by retinal disease.
Collapse
Affiliation(s)
- Beatrix Feigl
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
- Queensland Eye Institute, Brisbane, QLD, Australia
- * E-mail:
| | - C. Phillip Morris
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Joanne Voisey
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Anthony Kwan
- Queensland Eye Institute, Brisbane, QLD, Australia
- Faculty of Health Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Andrew J. Zele
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
- School of Optometry and Vision Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| |
Collapse
|
41
|
Patryas L, Parry NRA, Carden D, Aslam T, Murray IJ. The association between dark adaptation and macular pigment optical density in healthy subjects. Graefes Arch Clin Exp Ophthalmol 2014; 252:657-63. [PMID: 24413682 DOI: 10.1007/s00417-014-2564-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 11/26/2013] [Accepted: 12/17/2013] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To investigate whether macular pigment optical density (MPOD) is related to dark adaptation in healthy subjects. METHODS Dark adaptation was measured after a minimum 30 % pigment bleach in 33 subjects (aged 15-68), using a white 1° stimulus presented 11° below fixation on a cathode ray tube monitor. The luminance range of the monitor was extended using neutral density filters. A heterochromatic flicker photometry based instrument (MPS 9000) was used to measure MPOD. RESULTS The average MPOD for the whole group was 0.37 ± 0.21 optical density units. Subjects with lighter irides had on average 40 % lower MPOD compared to those with darker irides (0.3 ± 0.20 vs 0.5 ± 0.19). Group mean MPOD was weakly associated with second (r = 0.32, p = 0.07) and third rod-mediated recovery rates (r = 0.31, p = 0.08) and with the rod threshold (r = -0.24, p = 0.18) 30 min after the onset of bleach. MPOD was unrelated to cone time constant (r = -0.02, p = 0.91), cone threshold (r = -0.01, p = 0.96), rod-cone break (r = 0.13, p = 0.45) or the rod-rod break (r = 0.11, p = 0.52). The second rod-mediated recovery rate (S2) for the lower 10th percentile of MPOD (n = 4) was 0.18 log cd.m(-2).min(-1) and 0.24 log cd.m(-2).min(-1) for the upper 10th percentile (n = 4). The two groups were significantly different (t = -2.67, p = 0.037). CONCLUSIONS We report a statistically significant difference between subjects falling in the 10th percentile extremes of MPOD and rod-mediated but not cone-mediated sensitivity recovery. Further investigation into the relationship between MPOD and rod function is warranted, particularly extending the work to encompass those with low MPOD and poor night vision.
Collapse
Affiliation(s)
- Laura Patryas
- The Vision Centre, Faculty of Life Sciences, University of Manchester, Carys Bannister Building, Manchester, M13 9PL, UK,
| | | | | | | | | |
Collapse
|
42
|
The use of heterochromatic flicker photometry to determine macular pigment optical density in a healthy Australian population. Graefes Arch Clin Exp Ophthalmol 2014; 252:417-21. [PMID: 24390399 DOI: 10.1007/s00417-013-2554-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 12/03/2013] [Accepted: 12/16/2013] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To establish the normal macular pigment density (MPOD) in a healthy adult Australian sample using heterochromatic flicker photometry (HFP). METHODS Macular pigment density was measured using heterochromatic flicker photometry in a total of 201 subjects ranging in age from 21 to 84 years with healthy macula. Fifty-seven of the healthy subjects also completed a food-frequency dietary questionnaire. Best-corrected visual acuity (BCVA) was measured using logMAR, chart and macular morphological profiles were assessed using high-resolution integrated Fourier-domain optical coherence tomography (OCT). RESULTS The average MPOD value was 0.41 ± 0.20 (range 0.07-0.79). There was no statistically significant difference between values in the left and right eye, with good interocular agreement (0.41 vs 0.40, r = 0.893, p < 0.01). Age significantly predicted MPOD score (R (2) = 0.07, p < 0.05). A subgroup analysis of patients who completed the dietary questionnaire revealed a close correlation between higher diet scores and higher MPOD (r = 0.720 p = 0.031). There was no effect of smoking, gender, or iris colour on MPOD values. There was no significant correlation between BCVA, macular OCT profiles, and MPOD. CONCLUSION Given that MPOD values are potentially affected by geographical variation, we have determined a mean MPOD value for healthy subjects in a population south of the equator, providing a reference point for future studies on Caucasian samples.
Collapse
|
43
|
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: 9] [Impact Index Per Article: 0.8] [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.
Collapse
Affiliation(s)
- Raymond O Beirne
- Vision Science Research Group, School of Biomedical Sciences, University of Ulster, Coleraine, BT52 1SA, Northern Ireland, UK,
| |
Collapse
|
44
|
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: 41] [Impact Index Per Article: 3.7] [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.
Collapse
|
45
|
O'Brien A, Leahy C, Dainty C. Imaging system to assess objectively the optical density of the macular pigment in vivo. APPLIED OPTICS 2013; 52:6201-6212. [PMID: 24085078 DOI: 10.1364/ao.52.006201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 06/27/2013] [Indexed: 06/02/2023]
Abstract
This paper presents an optical system called MacPI, which implements a two-color reflectance technique in combination with various hardware and software tools to assess objectively the macular pigment (MP) optical density in vivo. The system consists of a bespoke optical design, a control architecture, driver electronics, a collection of image-processing techniques, and a graphical user interface. The deficiencies of the technique employed and the solutions implemented in the MacPI system to confront those inherent frailties are presented. An overview of the effective interpretation of the acquired data and the techniques employed by MacPI in the acquisition of that data is discussed. The result of a comparison trial with an alternative device is also presented. We suggest that appropriate design of the hardware and an efficient interpretation of the acquired data should produce a system capable of consistent, accurate, and rapid measurements, while retaining the distinction of ease of use, portability, comfort for the subject, and a design that is economic to produce. Its versatility should allow both for a clinical screening application and for further investigation and establishment of the physiological role of the MP in a laboratory-based environment.
Collapse
|
46
|
Biesalski HK, Erdman JW, Hathcock J, Ellwood K, Beatty S, Johnson E, Marchioli R, Lauritzen L, Rice HB, Shao A, Griffiths JC. Nutrient reference values for bioactives: new approaches needed? A conference report. Eur J Nutr 2013; 52 Suppl 1:1-9. [PMID: 23455383 PMCID: PMC3597284 DOI: 10.1007/s00394-013-0503-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Nutrients can be classified as either “essential” or “non-essential,” the latter are also termed bioactive substances. Whereas the absence of essential nutrients from the diet results in overt deficiency often times with moderate to severe physiological decrements, the absence of bioactive substances from the diet results in suboptimal health. Nutrient reference values are set by Codex Alimentarius and regulatory bodies in many countries, mostly for essential nutrients with recommended daily intakes. The IOM in the United States has defined a set of four DRIs that, when data are appropriate, include an EAR, a RDA that is derived from the EAR, an AI for nutrients without appropriate data to identify an EAR, and an UL. From the RDA, the United States derives a labeling value called the DV, which applies to older children and most adults. In Codex, the equivalents of the DVs are the NRVs to be used in calculating percentage values on food labels. Nothing in the IOM documents specifies that labeling values can be set only for what have been defined to date as essential nutrients. Indeed, the US Food and Drug Administration sets a labeling value for dietary fiber based on the IOM AI for this ingredient. This conference explores the definitions, concepts, and data on two of the best examples of bioactive substances that, perhaps, should have NRVs: lutein and zeaxanthin, and n-3 long-chain polyunsaturated fatty acids.
Collapse
|
47
|
Puell MC, Palomo-Alvarez C, Barrio AR, Gómez-Sanz FJ, Pérez-Carrasco MJ. Relationship between macular pigment and visual acuity in eyes with early age-related macular degeneration. Acta Ophthalmol 2013; 91:e298-303. [PMID: 23575039 DOI: 10.1111/aos.12067] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE Today the extent to which MP impacts visual function in early AMD remains unclear. This study examines the relationship between macular pigment optical density (MPOD) and high-contrast visual acuity (HC-VA) and low-contrast visual acuity (LC-VA) in eyes with early age-related macular degeneration (AMD). METHODS Measurements were made in 22 subjects with early AMD and 27 healthy control subjects. Distance best-corrected VA was measured using HC (96%) and LC (10%) Bailey-Lovie logMAR letter charts under photopic luminance conditions. MPOD was determined at the fovea through apparent motion photometry using the cathode ray tube-based Metropsis psychophysical vision test (Cambridge Research Systems). RESULTS No significant differences in foveal MPOD were detected between the control eyes (0.30 ± 0.24 log units) and eyes with early AMD (0.27 ± 0.15 log units). Neither were differences detected between the two groups in mean HC- and LC-VA. Foveal MPOD showed significant correlation with both photopic HC-VA (r = -0.47, p = 0.0008) and LC-VA (r = -0.46, p = 0.0008) such that as MPOD increased, photopic HC-VA and LC-VA improved (lower logMAR values). CONCLUSIONS Low MP levels were related to worse visual function in both healthy eyes and eyes with early AMD. Our findings provide direction for future studies designed to improve retinal function through the use of oral supplements known to increase MP levels, especially in eyes with AMD and a low MPOD.
Collapse
Affiliation(s)
- María C Puell
- Applied Vision Research Group, Complutense University, Madrid, Spain.
| | | | | | | | | |
Collapse
|
48
|
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]
|
49
|
Igras E, Loughman J, Ratzlaff M, O'Caoimh R, O'Brien C. Evidence of lower macular pigment optical density in chronic open angle glaucoma. Br J Ophthalmol 2013; 97:994-8. [DOI: 10.1136/bjophthalmol-2013-303153] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
50
|
Visual performance in patients with neovascular age-related macular degeneration undergoing treatment with intravitreal ranibizumab. J Ophthalmol 2013; 2013:268438. [PMID: 23533703 PMCID: PMC3595676 DOI: 10.1155/2013/268438] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 01/23/2013] [Indexed: 11/30/2022] Open
Abstract
Purpose. To assess visual function and its response to serial intravitreal ranibizumab (Lucentis, Genentech) in patients with neovascular age-related macular degeneration (nv-AMD). Methods. Forty-seven eyes of 47 patients with nv-AMD, and corrected distance visual acuity (CDVA) logMAR 0.7 or better, undergoing intravitreal injections of ranibizumab, were enrolled into this prospective study. Visual function was assessed using a range of psychophysical tests, while mean foveal thickness (MFT) was determined by optical coherence tomography (OCT). Results. Group mean (±sd) MFT reduced significantly from baseline (233 (±59)) to exit (205 (±40)) (P = 0.001). CDVA exhibited no change between baseline and exit visits (P = 0.48 and P = 0.31, resp.). Measures of visual function that did exhibit statistically significant improvements (P < 0.05 for all) included reading acuity, reading speed, mesopic and photopic contrast sensitivity (CS), mesopic and photopic glare disability (GD), and retinotopic ocular sensitivity (ROS) at all eccentricities. Conclusion. Eyes with nv-AMD undergoing intravitreal ranibizumab injections exhibit improvements in many parameters of visual function. Outcome measures other than CDVA, such as CS, GD, and ROS, should not only be considered in the design of studies investigating nv-AMD, but also in treatment and retreatment strategies for patients with the condition.
Collapse
|