Longitudinal Long-term Study of Progression of ARM to ARMD in Patients with High vs. Low Density of Macular Pigment

Abstract

 

Purpose

 

Studies speculate about protective properties of macular pigment (MP) against age-related macular degeneration (ARMD). Up to now there are no long-term studies with MP density (MPD) measurements in patients with age-related maculopathy (ARM) available. The purpose of this study was to assess the influence of MPD on the progression of ARM to late ARMD.

 

Methods

 

586 patients were included in this prospective study. Inclusion criteria:clear optical media, , age above 50 years, undus alterations stage 2 or 3 of the Rotterdam Classification at BL, follow-up time of at least 5 years. Patients underwent comprehensive ophthalmic examination and MPD measurement at BL and follow-up every 12 month. We selected patients with low MPD (1st quintile: MPD ≤ 0.36 density units [D.U.]) and patients with high MPD (5th quintile: MPD ≥ 0.70 D.U.). The aim of tanalysis was to evaluate the progression of ARM to ARMD.

 

Results

 

We included in total 586 eyes of 586 patients. The subgroup analyses (Group MPD low vs. Group MPD high) were performed in 234 patients (184 male, 150 female) with mean age of 71.7 ± 10.9 years. At baseline 118 patients of the subgroup analysis had low MPD values (Group MPD low: 0.27 ± 0.08 D.U.) and 116 patients had high MPD values (Group MPD high: 0.81 ± 0.09 D.U.). The mean age did not differ significantly between both groups (Group MPD low: 72 ± 10 years vs. Group MPD high: 7743.7 ± 11 years). After 60 month progression to ARMD was found in total in 37 patients. 17 patients (9x MPDlow vs. 8x MPDhigh) developed exudative ARMD. 20 patients (9x MPDlow vs. 11x MPDhigh) showed geographic atrophies. We found no significant difference in the incidence of progression between the group of high MPD at BL and the group of low MPD at BL.

 

Conclusions

 

A high value of MPD in patients showing fundus alterations according to stage 2 or 3 of the Rotterdam Classification seems not to be protective against disease progression. The association of different values and patterns of MP density and distribution and their relevance as a possible prognostic factor for ARM needs further studies.

 

Keywords: 412 age-related macular degeneration • 585 macula/fovea • 688 retina