Correlation analysis of macular microvascular structure and macular pigment opticaldensity in retinal vein occlusion / 中华眼底病杂志

Objective:To observe the changes of macular microvascular structure and macular pigment density (MPOD) in eyes with macular edema (ME) secondary to retinal vein occlusion (RVO), and preliminarily analyze their correlation.Methods:A prospective clinical study. A total of 62 eyes of 62 patients with monocular RVO secondary ME (RVO-ME) diagnosed in the Ophthalmology Hospital of Xi'an No.1 Hospital from July 2020 to May 2021 were included in this study. There were 33 males with 33 eyes, 29 females with 29 eyes. The age was 58.30±12.15 years. The course of disease from the onset of symptoms to medical treatment was 12.29±7.65 days. All patients underwent best corrected visual acuity (BCVA), optical coherence tomography angiography (OCTA) and MPOD test. BCVA examination was performed using a standard logarithmic visual acuity chart, which was converted to logarithm of minimum angle of resolution (logMAR). The vascular density (VD), vascular skeletal density (SD), foveal avascular area (FAZ) and central macular thickness (CMT) of the superficial retinal capillary plexus (SCP) in the range of 3 mm×3 mm in the macular area of bilateral eyes were measured by OCTA. MPOD was measured by heterochromatic scintillation photometry. Bilateral eyes passed examination in 37 cases. The eyes of 25 patients failed to pass the test. The changes of macular VD, SD, FAZ area, CMT and MPOD between the affected eyes and the contralateral eyes were compared. The MPOD of the affected eye and the contralateral eye was compared by paired t test. FAZ area, CMT, VD, SD, and logMAR BCVA were tested by paired Wilcoxon signed rank sum test. Spearman rank correlation test was used to analyze the correlation between macular blood flow density (VD, SD) and foveal morphology (FAZ area, CMT) with logMAR BCVA and MPOD. Results:Compared with contralateral eyes, VD ( Z=-5.981) and SD ( Z=-6.021) were decreased, FAZ area ( Z=-2.598) and CMT ( Z=-6.206) were increased, and the differences were statistically significant ( P<0.05). In 37 patients who passed MPOD test in bilateral eyes, the MPOD value of the affected eye was lower than that of the contralateral eye, and the difference was statistically significant ( t=-2.930, P<0.05). Compared with the affected eye which failed to pass the MPOD detection, macular VD ( Z=-2.807) and SD ( Z=-2.460) were increased, FAZ area ( Z=-4.297) and CMT ( Z=-3.796) were decreased in the affected eye which passed the MPOD test, and the differences were statistically significant ( P<0.05). Correlation analysis showed that logMAR BCVA in the affected eye was negatively correlated with macular VD and SD ( r=-0.298, -0.461; P<0.05), which was positively correlated with FAZ area and CMT ( r=0.487, 0.789; P<0.05). MPOD in the affected eye was negatively correlated with logMAR BCVA ( r=-0.344, P<0.05). MPOD in the contralateral eye was positively correlated with CMT ( r=0.358, P<0.05). Conclusions:The VD and SD of macular SCP are decreased, FAZ area is enlarged, CMT is thickened, and MPOD is decreased in RVO-ME eyes. MPOD is negatively correlated with logMAR BCVA.

An observational study of macular optical density in patients with obstructive sleep apnea hypopnea syndrome / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the change of macular pigment optical density(MPOD)in the patients of obstructive sleep apnea-hypopnea syndrome(OSAHS). <p>METHODS: Totally 70 OSAHS patients as observation group and 32 healthy subjects as control group with their right eyes were enrolled from Chongqing Emergency Medical Center during January to December of 2019. All the subjects used Visucam 200 to measure the mean/max MPOD. <p>RESULTS: Both mean/max MPOD(0.0916±0.0149, 0.2675±0.0419Log unit)of OSAHS group are significantly lower than the control group(0.1193±0.0159, 0.3235±0.0400Log unit, <i>P</i><0.001).There are significant difference of mean/max MPOD between mild(<i>n</i>=12)/moderate(<i>n</i>=17)/severe(<i>n</i>=41)groups divided by AHI(<i>P</i><0.001). The increasing severity of OSAHS lead to lower mean/max MPOD.Furthermore there is negative correlation between mean/max MPOD and AHI(<i>r</i>=-0.685, -0.492; <i>P</i><0.001).<p>CONCLUSION: Our study results suggest that the mean/max MPOD were reduced in the patients of OSAHS. Moreover, the decreased degree of mean/max MPOD is positively related to the severity of OSAHS. It shows that the MPOD of OSAHS have already changed before they feel the significant syndrome. The reducing of MPOD may cause dysfunction of macular and finally rise up to macular disease.

A randomized controlled trial on the effect of Lutein Supplementation on Macular Pigment Optical Density and Macular Function in Pseudophakic Patients

Objective@#To evaluate the efficacy of oral lutein supplementation on macular pigment optical density (MPOD) levels and macular function in pseudophakic eyes that underwent phacoemulsification. @*Methods@#This was a prospective, randomized, parallel-arm, single-masked study comparing oral lutein supplement 20 mg/tablet (Lutax 20) with non-supplementation in pseudophakic eyes. We assessed MPOD, low-luminance deficit (LLD), visual recovery time (VRT) using photostress test, and adverse events. One hundred twenty-eight (128) eyes were enrolled and randomized 1:1 to active treatment (lutein supplementation) or no treatment (no supplementation). The supplementation period was 12 weeks and patients were assessed every 4 weeks over a period of 16 weeks.@*Results@#Sixty-four (64) eyes in each group completed the study. A significant increase in MPOD (p<0.001) was observed in the lutein supplemented group, from 0.36 DU at baseline to 0.55 DU at week 12, with a mean increase of 6.32 ± 1.72% per 4 weeks of supplementation compared with a mean MPOD decrease rate of 0.63 ± 0.48% in the non-supplementation group. A significant reduction in LLD was observed in the lutein-treated group, from LogMAR 0.063 at baseline to LogMAR 0.023 at Week 12 (p=0.003). VRT was also significantly shorter in the treatment from a baseline of 83.06 to 68.80 seconds at Week 12 (p<0.001).@*Conclusion@#Lutein supplementation (20 mg/tablet; Lutax 20) demonstrated a significant degree of MPOD augmentation, and reductions in LLD and VRT among patients who underwent phacoemulsification with lens implantation.

Macular Pigment Optical Density in the Korean Population: a Cross Sectional Study

50 years) showed lower MPOD than younger (30–49 years) subjects. But, in the healthy population, the estimated MPOD values exhibited a decreasing trend with age, but there were no significant differences according to age, after excluding patients with AMD. MPOD was significantly lower in patients with AMD than in aged healthy controls. Furthermore, hypertension, dyslipidemia, and smoking were identified as risk factors for AMD.CONCLUSION: MPOD measured with MPSII® reflects the MP density in healthy individuals and patients with dry AMD. Aging was not significantly associated with low MPOD in healthy population, but the presence of dry AMD was significantly associated with low MPOD. Then, low MPOD may be a risk factor for development of dry AMD. Furthermore, routine screening with MPS II® for ages 50 and older is thought to help detect early low MPOD and identify individuals who should take supplements.

Effects of ubiqutin-proteasome system in retinopathy and their mechanism / 中华实验眼科杂志

Ubiquitin-proteasome system (UPS) is the important protein degradation system in eukaryotic cells, participates in cell cycle, gene transcription, antigen-presenting, cell proliferation and differentiation, signal transduction and many other physiological processes.UPS dysfunction relates to pathogenic mechanisms in a variety of diseases such as cancer, neurodegenerative diseases and cardiovascular disease.In recent years, more and more researches confirmed that UPS exists in the retina, some retinal damage appeared in patients with neurodegenerative conditions.UPS is involved in the pathogenesis of diabetic retinopathy, age-related macular degeneration, macular pigment degeneration and other retinal diseases by regulating retinal oxidative stress, inflammation, angiogenesis, nerve damage, signal transduction and so on.Some signaling pathways, such as nuclear factor κB (NF-κB), transforming growth factor-β (TGF-β) and reactive oxygen species (ROS) play an important role.Their proteins degradation and synthesis of imbalances have a significant impact on the pathophysiological process of retinal diseases.Proteasome inhibitors can reduce inflammation pathological changes in retinal lesions.This review focused on the research progress of UPS in the development of retinopathy.

Effects of ubiqutin-proteasome system in retinopathy and their mechanism / 中华实验眼科杂志

Ubiquitin-proteasome system ( UPS ) is the important protein degradation system in eukaryotic cells,participates in cell cycle, gene transcription, antigen-presenting, cell proliferation and differentiation, signal transduction and many other physiological processes. UPS dysfunction relates to pathogenic mechanisms in a variety of diseases such as cancer, neurodegenerative diseases and cardiovascular disease. In recent years, more and more researches confirmed that UPS exists in the retina,some retinal damage appeared in patients with neurodegenerative conditions. UPS is involved in the pathogenesis of diabetic retinopathy, age-related macular degeneration, macular pigment degeneration and other retinal diseases by regulating retinal oxidative stress,inflammation,angiogenesis,nerve damage,signal transduction and so on. Some signaling pathways,such as nuclear factor κB (NF-κB),transforming growth factor-β ( TGF-β) and reactive oxygen species ( ROS) play an important role. Their proteins degradation and synthesis of imbalances have a significant impact on the pathophysiological process of retinal diseases. Proteasome inhibitors can reduce inflammation pathological changes in retinal lesions. This review focused on the research progress of UPS in the development of retinopathy.

Correlations among macular pigment optical density, central macular thickness and body mass index / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To determine the relationship among the macular pigment optical density(MPOD), central macular thickness and body mass index(BMI).<p>METHODS: This is a comparative cross-sectional study performed in a single institution. Totally 210 volunteers who met the inclusion criteria were included in this study. The subject's MPOD was measured using Macula Pigment Screener II(MPS II, by Electron Technology). Central macular thickness was measured with Spectral Domain Cirrus Optical Coherence Tomography(OCT), Cirrus(Model 4000, Carl Zeiss Meditec). The information of both MPOD and OCT from both eyes were recorded. The data was analysed using Microsoft© Excel \〖Version 15.12.3(150724)℃2015 Microsoft\〗, SPSS(IBM© SPSS© Statistics Version 2.2), and R(version 3.2.1; R Core Team 2015).<p>RESULTS: There was significant positive correlation between MPOD and central macular thickness(<i>r</i>=0.42, <i>P</i><0.01)and a significant negative correlation between MPOD and BMI(<i>r</i>=-0.23, <i>P</i><0.01).<p>CONCLUSION: Our study showed a significant positive correlation between MPOD and central macular thickness. Further study is needed to look at the detailed structure of the fovea and its relationship with MPOD. Our study also found a significant negative correlation between MPOD and BMI, suggesting that a reduction in BMI may increase the density of macula pigment, which can be helpful in preventing age-retinal pigment epitheliitis(ARMD).

Multimodality imaging in macular telangiectasia 2: A clue to its pathogenesis.

Macular telangiectasia type 2 also known as idiopathic perifoveal telangiectasia and juxtafoveolar retinal telangiectasis type 2A is an acquired bilateral neurodegenerative macular disease that manifests itself during the fifth or sixth decades of life. It is characterized by minimal dilatation of the parafoveal capillaries with graying of the retinal area involved, a lack of lipid exudation, right‑angled retinal venules, refractile deposits in the superficial retina, hyperplasia of the retinal pigment epithelium, foveal atrophy, and subretinal neovascularization (SRNV). Our understanding of the disease has paralleled advances in multimodality imaging of the fundus. Optical coherence tomography (OCT) images typically demonstrate the presence of intraretinal hyporeflective spaces that are usually not related to retinal thickening or fluorescein leakage. The typical fluorescein angiographic (FA) finding is a deep intraretinal hyperfluorescent staining in the temporal parafoveal area. With time, the staining may involve the whole parafoveal area but does not extend to the center of the fovea. Long‑term prognosis for central vision is poor, because of the development of SRNV or macular atrophy. Its pathogenesis remains unclear but multimodality imaging with FA, spectral domain OCT, adaptive optics, confocal blue reflectance and short wave fundus autofluorescence implicate Müller cells and macular pigment. Currently, there is no known treatment for this condition.

Macular pigment optical density in healthy eyes of Filipino adults

Objective@#To determine the range of macular pigment optical density (MPOD) levels in healthy Filipino adults using both the MPS II and the macuscope and to investigate whether age and sex were related to inter-subject variations in MPOD.@*Methods@#This was a prospective, cross sectional study of 168 healthy Filipino patients who underwent heterochromic filter photometry to measure macular pigment levels using the MPS II and the macuscope. The MPOD levels were averaged per age group and analyzed as to variations among age and gender.@*Results@#One hundred thirty (130) and thirty-eight (38) patients underwent MPS II and macuscope testing respectively. The mean MPOD level for MPS II was 0.39(±0.16) and for macuscope 0.27(±0.07). MPOD values were similar across all age groups and gender, but they were lower when measured with the macuscope.@*Conclusions@#MPOD levels measured among healthy Filipino adults were lower with the macuscope compared to the MPS II. These differences should take into consideration the differences in apparatus and techniques of measurement.

Foveal slope measurements in subjects with high-risk of age-related macular degeneration.

Background: Recent reports indicated that the slope of the foveal depression influences the macular pigment (MP) spatial profile. MP has been shown to confer possible protection against age‑related macular degeneration (ARMD) because of its antioxidant properties. Aims: To study the configuration of foveal slope and the foveal thickness in fellow eyes of subjects with unilateral neovascular ARMD. Settings and design: Case‑control series. Materials and Methods: The study population consisted of 30 cases aged >50, who had unilateral choroidal neovascular membrane (CNVM) or disciform scar in the fellow eye and 29 controls aged >50, who had no sign of ARMD in the either eye. Using spectral‑domain optical coherence tomography, foveal thickness at different locations including the central subfield foveal thickness (CSFT) was noted. The foveal slopes were calculated in the six radial scans (between 0.25° and 1° retinal eccentricity) as well as the 3D scan. Results: Cases had a significantly higher CSFT when compared to controls (215.1 ± 36.19 μ vs. 193.0 ± 17.38 μ, P = 0.004). On the 3D scan, the cases had shallower superior (cases 1.32 ± 0.32 vs. controls 1.45 ± 0.13, P = 0.04) and temporal slopes (cases 1.27 ± 0.21 vs. controls 1.39 ± 0.12, P = 0.01) in comparison to the controls. Conclusions: We noted a shallower superior and temporal foveal slope and a higher CSFT in the fellow eyes of subjects with a unilateral neovascular ARMD. Prospective studies observing the development of CNVM in subjects with altered foveal slope might provide more information on this optical coherence tomography finding.

Antioxidant activity of carotenoid lutein in vitro and in vivo.

Carotenoid lutein was evaluated for its antioxidant potential both in vitro and in vivo. Lutein was found to scavenge superoxide radicals, hydroxyl radicals and inhibited in vitro lipid peroxidation. Concentrations needed for 50 % inhibition (IC50) were 21, 1.75 and 2.2 g/mL respectively. It scavenged 2,2-diphenyl-1-picryl hydrazyl (IC50 35 g/mL) and nitric oxide radicals (IC50 3.8 g/mL) while 2,2-azobis-3-ethylbenzthiozoline-6-sulfonic acid radicals were inhibited at higher concentration. Ferric reducing power (50%) of lutein was found to be equal 0.3μmols/mL of FeSO4.7H2O. Its oral administration inhibited superoxide generation in macrophages in vivo by 34.18, 64.32 and 70.22 % at doses of 50, 100 and 250 mg/kg body weight. The oral administration of lutein in mice for 1 month significantly increased the activity of catalase, superoxide dismutase, glutathione reductase and glutathione in blood and liver while the activity of glutathione peroxidase and glutathione-S-transferase were found to be increased in the liver tissue. Implication of these results in terms of its role in reducing degenerative diseases is discussed.