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Lea Benoudis, Olivier Lichtwitz, Julie Jeau, Pierre Ingrand, Michèle Boissonnot, Nicolas Leveziel; Relationships between macular pigment optical density and lacquer cracks in high myopic patients.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2954.
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© ARVO (1962-2015); The Authors (2016-present)
Reduced macular carotenoid pigment density (lutein and zeaxanthin) is a significant risk factor of macular degeneration. This study aims to investigate the relationship between the macular pigment optical density (MPOD) and lacquer cracks(LC) in high myopia.
Prospective monocentric double arms observational study (ClinicalTrials.gov Identifier: NCT02205632) including high myopic patients with or without LC. All patients underwent logMAR visual acuity, fundus examination, SD-OCT centered on the macular area, autofluorescence and multicolor imaging (Spectralis Heidelberg) or color photographs (Topcon TRC) and axial length measurment. Patients with other retinal diseases (diabetic retinopathy, age-related macular degeneration, macular hole, epiretinal membrane, macular hemorrhage, central chorioretinal atrophy) were excluded. MPOD was calculated with the MPSII screening device (Macular Pigment Screener II, Horus company) using the Heterochromatic Flicker Photometry. Group 1 was defined as eyes without LC and group 2 was defined as eyes with LC. MPOD was ranged from 1 (highest level) to 0 (lowest).
Forty four patients (F/M=30/14) with a mean age of 50.3 years-old (range 23 to 69) were included in group 1 and 16 patients (F/M=14/2) aged 50.6 on average (range 34 to 74) were included in group 2 (p=0.9).<br /> The mean spherical equivalent refraction of the patients was -10.71 diopters (between -6 and -21) in group 1 and -15.5 (between -7.5 and -24.75) in group 2 (p=0.0004).<br /> Mean best corrected visual acuity in group 1 was 0 logMAR (range +0.9 to -0.8) and +0.1 logMAR in group 2 (range +0.7 to -0.1) (p=0.5).<br /> The mean central macular thickness measured by SD-OCT did not differ between group 1 (294 µ) and group 2 (305µ) (p=0.1). The mean choroidal macular thickness was lower in group 2 (92µ) than in group 1 (154µ) (p=0.004). Mean axial length was 27.7 mm in group 1 and 29.1 in group 2 (p=0.01).<br /> The mean MPOD in group 2 was 0.52 and of 0.63 in group 1 (p=0.03).
A low rate of macular pigment density was observed in case of lacquer cracks in high myopic patients. If confirmed by other studies, dietary supplementation with carotenoids or nutritional recommendations could make sense to reduce the risk of lacquer cracks in high myopic patients.
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