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Eileen Hwang, Christopher D. Conrady, Jim Bell, Paul S Bernstein; Macular Pigment and Carotenoid Supplementation in Patients with Pattern Dystrophy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4446.
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The role of nutritional supplementation in pattern dystrophy is not known, yet many patients with pattern dystrophy are taking carotenoid supplements. We performed a case-control study comparing patients with pattern dystrophy to controls to determine whether pattern dystrophy was associated with a deficiency in macular pigment. We also studied macular pigment levels in pattern dystrophy patients with and without supplementation to assess whether oral supplementation resulted in higher levels of carotenoids.
Nine patients were identified with pattern dystrophy. Diagnostic criteria included a fundus appearance consistent with adult vitelliform dystrophy or butterfly dystrophy and a subretinal hyperreflective lesion on optical coherence tomography. Patients with drusen were excluded. Nine age-matched control patients were selected from the retina clinic population. The Heidelberg Spectralis with macular pigment optical density software was utilized to measure macular pigment by dual wavelength autofluorescence.
The mean macular pigment volume under the curve (MPVUC) within 2 degrees of the fovea in patients with pattern dystrophy was 2700 +/- 1300 (optical density * pixels +/- standard error). In the control population, the value was 2900 +/- 1400. There was no significant difference between the two groups (p = 0.66). MPVUC measurements ranged widely from 1172 to 4945 in the pattern dystrophy population, but this did not appear to depend on supplement intake. The mean MPVUC for the four pattern dystrophy patients not on carotenoid supplements was 2239 +/- 1247, and the mean MPVUC for the five pattern dystrophy patients on supplements was 2999 +/- 1339 (p=0.41). None of the control patients were taking supplements.
Pattern dystrophy did not appear to be associated with low MPVUC as measured by two-wavelength autofluorescence. Patients with pattern dystrophy taking carotenoid supplements may not have higher MPVUC than pattern dystrophy patients not taking supplements. This suggests that carotenoid supplementation may not be useful in pattern dystrophy, but larger studies are needed to determine whether supplementation is clinically beneficial in this population.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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