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Tomas S. Aleman, Jacque L. Duncan, Michelle L. Bieber, Elaine de Castro, Daniel A. Marks, Leigh M. Gardner, Janet D. Steinberg, Artur V. Cideciyan, Maureen G. Maguire, Samuel G. Jacobson; Macular Pigment and Lutein Supplementation in Retinitis Pigmentosa and Usher Syndrome. Invest. Ophthalmol. Vis. Sci. 2001;42(8):1873-1881.
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purpose. To determine macular pigment (MP) in patients with inherited retinal
degeneration and the response of MP and vision to supplementation of
methods. Patients with retinitis pigmentosa (RP) or Usher syndrome and normal
subjects had MP optical density profiles measured with heterochromatic
flicker photometry. Serum carotenoids, visual acuity, foveal
sensitivity, and retinal thickness (by optical coherence tomography[
OCT]) were quantified. The effects on MP and central vision of 6
months of lutein supplementation at 20 mg/d were determined.
results. MP density in the patients as a group did not differ from normal. Among
patients with lower MP, there was a higher percentage of females,
smokers, and light-colored irides. Disease expression tended to be more
severe in patients with lower MP. Inner retinal thickness by OCT
correlated positively with MP density in the patients. After
supplementation, all participants showed an increase in serum lutein.
Only approximately half the patients showed a statistically significant
increase in MP. Retinal nonresponders had slightly greater disease
severity but were otherwise not distinguishable from responders.
Central vision was unchanged after supplementation.
conclusions. Factors previously associated with lower or higher MP density in normal
subjects showed similar associations in RP and Usher syndrome. In
addition, MP in patients may be affected by stage of retinal disease,
especially that leading to abnormal foveal architecture. MP could be
augmented by supplemental lutein in many but not all patients. There
was no change in central vision after 6 months of lutein
supplementation, but long-term influences on the natural history of
these retinal degenerations require further study.
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