September 2012
Volume 53, Issue 10
Free
Letters to the Editor  |   September 2012
Profiles of Macular Pigment Optical Density and Their Changes Following Supplemental Lutein and Zeaxannthin
Author Affiliations & Notes
  • John Nolan
    Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland; and
    Institute of Vision Research, Whitfield Clinic, Waterford, Ireland.
  • Stephen Beatty
    Macular Pigment Research Group, Department of Chemical and Life Sciences, Waterford Institute of Technology, Waterford, Ireland; and
    Institute of Vision Research, Whitfield Clinic, Waterford, Ireland.
Investigative Ophthalmology & Visual Science September 2012, Vol.53, 6303. doi:10.1167/iovs.12-10674
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    • Get Citation

      John Nolan, Stephen Beatty; Profiles of Macular Pigment Optical Density and Their Changes Following Supplemental Lutein and Zeaxannthin. Invest. Ophthalmol. Vis. Sci. 2012;53(10):6303. doi: 10.1167/iovs.12-10674.

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      © ARVO (1962-2015); The Authors (2016-present)

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  • Supplements
We congratulate Zeimer et al. 1 on their article, entitled “Profiles of macular pigment optical density and their changes following supplemental lutein and zeaxannthin,” which, we believe, represents an important step toward a better understanding of the pathophysiology of macular pigment (MP). 
In brief, Zeimer et al. have shown that supplemental lutein (L) and zeaxanthin (Z) fail to augment MP centrally in the presence of “ring-like structures,” a finding that is consistent with our recent report. 2 Also, we concur that these “ring-like structures,” identified on autofluorescence, are representative of the central “dips” identified on heterochromatic flicker photometry, where the spatial profile does not exhibit a central peak with its typical monotonic decline from the foveal center. It is unsurprising, therefore, that supplementation with all three macular carotenoids (L, Z, and meso-zeaxanthin [MZ]) does augment MP centrally, given that MZ is the dominant carotenoid at this location. 3 The importance of this finding rests on the fact that vision is sharpest centrally, where the dual optical benefits of MP (attenuation of chromatic aberration with consequential enhancement of contrast sensitivity, and attenuation of blue light scatter with enhancement of visual performance under conditions of glare) are of greatest importance. 4  
With respect to the putative protective role of MP for age-related macular degeneration (AMD), 5 however, we would urge a note of caution in Zeimer et al.'s interpretation of Dietzel et al.'s recent study. 6 If MP is protective against AMD, it exerts that protective effect through its passive (filtering) and active (free radical neutralizing, or antioxidant) properties, 7 thereby ameliorating the chronic and cumulative oxidative damage in the central retina, and inflammatory consequences of same (which will be dependent upon genetic background). 8,9 Therefore, MP (and MP profiles), some considerable time before the onset of AMD, should be the subject of interest, prompting our team to conduct a study demonstrating that a relative lack of MP, 10 and spatial profiles exhibiting a central “dip” (equivalent to “ring-like structures”), 11 are each and independently associated with established risk-factors for AMD before disease onset. Furthermore, and given that AMD (even early disease) is associated with loss of photoreceptors, 12 and given that L, Z, and MZ are intracellular compounds, 13 any atypical measurements of MP found in eyes afflicted with AMD are likely to be the consequence of these pathologic changes, and causality certainly cannot be inferred. 
In summary, and once again, we congratulate Zeimer et al. 1 on their excellent contribution to this growing area of interest, but we believe the prevailing current body of evidence indicates that a lack of MP and the presence of “ring-like structures,” before disease onset, are associated with risk for AMD. 
References
Zeimer M Dietzel M Hense HW Heimes B Austermann U Pauleikhoff D. Profiles of macular pigment optical density and their changes following supplemental lutein and zeaxanthin: new results from The LUNA Study. Invest Ophthalmol Vis Sci . 2012;53:4852–4859. [CrossRef] [PubMed]
Nolan JM Akkali MC Loughman J Howard AN Beatty S. Macular carotenoid supplementation in subjects with atypical spatial profiles of macular pigment. Exp Eye Res . 2012;101:9–15. [CrossRef] [PubMed]
Bone RA Landrum JT Friedes LM Distribution of lutein and zeaxanthin stereoisomers in the human retina. Exp Eye Res . 1997;64:211–218. [CrossRef] [PubMed]
Loughman J Davison PA Nolan JM Akkali MC Beatty S. Macular pigment and its contribution to visual performance and experience. J Optom . 2010;74–90.
Sabour-Pickett S Nolan JM Loughman J Beatty S. A review of the evidence germane to the putative protective role of the macular carotenoids for age-related macular degeneration. Mol Nutr Food Res . 2011;56:270–286. [CrossRef] [PubMed]
Dietzel M Zeimer M Heimes B Pauleikhoff D Hense HW. The ringlike structure of macular pigment in age-related maculopathy: results from the Muenster Aging and Retina Study (MARS). Invest Ophthalmol Vis Sci . 2011;52:8016–8024. [CrossRef] [PubMed]
Beatty S Koh HH Henson D Boulton M. The role of oxidative stress in the pathogenesis of age-related macular degeneration. Surv Ophthalmol . 2000;45:115–134. [CrossRef] [PubMed]
Hollyfield JG Bonilha VL Rayborn ME Oxidative damage-induced inflammation initiates age-related macular degeneration. Nat Med . 2008;14:194–198. [CrossRef] [PubMed]
Hughes AE Orr N Patterson C Neovascular age-related macular degeneration risk based on CFH, LOC387715/HTRA1, and smoking. PLoS Med . 2007;4:e355. [CrossRef] [PubMed]
Nolan JM Stack J. O'Donovan O Loane E Beatty S. Risk factors for age-related maculopathy are associated with a relative lack of macular pigment. Exp Eye Res . 2007;84:61–74. [CrossRef] [PubMed]
Kirby ML Beatty S Loane E A central dip in the macular pigment spatial profile is associated with age and smoking. Invest Ophthalmol Vis Sci . 2010;51:6722–6728. [CrossRef] [PubMed]
Curcio CA Medeiros NE Millican CL. Photoreceptor loss in age-related macular degeneration. Invest Ophthalmol Vis Sci . 1996;37:1236–1249. [PubMed]
Snodderly DM Brown PK Delori FC Auran JD. The macular pigment. I. Absorbance spectra, localization, and discrimination from other yellow pigments in primate retinas. Invest Ophthalmol Vis Sci . 1984;25:660–673. [PubMed]
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