Efficacy of Diacetate Esters of Macular Carotenoids: Effect of Supplementation on Macular Pigment.

The accumulation of the carotenoids lutein, zeaxanthin, and mesozeaxanthin in the center of the human retina, and known as the macula lutea or macular pigment, is believed to protect the retina from age-related macular degeneration. Since the macular pigment is of dietary origin, supplements containing the relevant carotenoids are readily available. In this study, we compared the changes in macular pigment over a 24-week supplementation period for two groups of 24 subjects each assigned to either of two supplement formulations, 20 mg/day of lutein or 20 mg equivalent free carotenoids of a combination of diacetate esters of the macular carotenoids. The latter group responded with a larger increase (0.0666 ± 0.0481) in macular pigment optical density than the former group (0.0398 ± 0.0430), driven largely by the older subjects. The difference was statistically significant (p=0.0287). There was a general trend towards smaller increases in macular pigment for those subjects whose baseline value was high. However, the trend was only significant (p < 0.05) for subjects in the diacetate group. No differences in response could be attributed to the gender of the subjects. We also observed no indication that the use of statin drugs by a few of the older subjects influenced their responses.

Lens density measurements by two independent psychophysical techniques.

BACKGROUND: Cataract, a leading cause of vision impairment, is due to the lens becoming excessively optically dense. Change in the lens optical density (LOD) could be a useful indicator of incipient nuclear cataract and would necessitate the development of accurate measurement techniques. Mapcat sf™ is a heterochromatic flicker photometer for measuring macular pigment optical density (MPOD) under photopic conditions. In the process, it also measures LOD that is needed in the calculation of MPOD. LOD is then converted by the instrument to "lens equivalent age" (LEA). However, varying cone photoreceptor ratios among individuals could affect the LEA measurement. Scotopic vision is mediated by rod photoreceptors; therefore, LEA measurement under scotopic conditions potentially provides a reliable standard for assessing other methods. The study was conducted to test the level of agreement between the LEA data obtained under photopic and scotopic conditions for a sample population. We also comment on factors that might contribute to any disagreement. METHODS: LEAs were obtained by Mapcat sf for 25 subjects and compared with those obtained under absolute scotopic threshold conditions. RESULTS: The mean scotopic LEA for the subjects was 2.7 years higher than the mean photopic LEA, but this difference was not statistically significant. Measurements by the two methods were reasonably correlated (r(2) = 0.59, p < 0.0001). Significant individual differences in LEA by the two methods were found for six of the 25 subjects. Although our calculations included a standard long- to medium-wavelength-sensitive cone ratio, we found that different ratios could be found that rendered the differences in LEA insignificant for two of these six subjects. Variability in pupil diameter during scotopic measurements was considered another potential source of discrepancy between LEAs by the two methods. CONCLUSION: The absolute threshold technique, with long adaptation times, is probably impractical for routine lens density measurement, whereas Mapcat sf provided a rapid, straightforward test that may find its application in optometric/ophthalmic practice.

Innovative Troxler-free measurement of macular pigment and lens density with correction of the former for the aging lens.

Simplified measurement of macular pigment optical density (MPOD) is important because of the ocular health benefits that are attributed to these retinal carotenoids. Here, we describe a novel instrument designed for this purpose, based on heterochromatic flicker photometry (HFP), which removes a number of difficulties that subjects often experience with traditional HFP. The instrument generates 1.5- and 15-deg diameter, centrally viewed stimuli that alternate between blue and green colors generated by light emitting diodes (LED). The 15 deg stimulus replaces the small, eccentrically viewed stimulus used in traditional HFP. Subjects adjust the blue LED intensity until flicker is eliminated in the case of the 1.5 deg stimulus and eliminated around the periphery in the case of the 15 deg stimulus. A microprocessor computes the subject's MPOD, in addition to the lens OD, and uses the latter to correct the MPOD. Good repeatability was confirmed through test-retest measurements on 52 subjects. The overwhelming majority of them stated that they found the test easy. The importance of the lens correction on MPOD measurements was confirmed in a simulation study. The study showed that, without the correction, MPOD would show an apparent age-related decline in a population for whom there was no real age dependence.

Light distributions on the retina: relevance to macular pigment photoprotection.

Light exposure has been implicated in age-related macular degeneration (AMD). This study was designed to measure cumulative light distribution on the retina to determine whether it peaked in the macula. An eye-tracker recorded the subject's field of view and pupil size, and superimposed the gaze position. Fifteen naïve subjects formed a test group; 5 formed a control group. In phase 1, all subjects viewed a sequence of photographic images. In phase 2, the naïve subjects observed a video; in phase 3, they performed computer tasks; in phase 4, the subjects walked around freely. In phase 1, control subjects were instructed to gaze at bright features in the field of view and, in a second test, at dark features. Test group subjects were allowed to gaze freely for all phases. Using the subject's gaze coordinates, we calculated the cumulative light distribution on the retina. As expected for control subjects, cumulative retinal light distributions peaked and dipped in the fovea when they gazed at bright or dark features respectively in the field of view. The light distribution maps obtained from the test group showed a consistent tendency to peak in the macula in phase 3, a variable tendency in phase 4, but little tendency in phases 1 and 2. We conclude that a tendency for light to peak in the macula is a characteristic of some individuals and of certain tasks. In these situations, risk of AMD could be increased but, at the same time, mitigated by the presence of macular carotenoids.