Longitudinal Study on the Progression of ARM to AMD in High vs. Low Macular Pigment Density

Abstract

Purpose: : To assess the influence of macular pigment density (MPD) on the progression of age-related maculopathy (ARM).

Methods: : We investigated the progression of ARM to age-related macular degeneration (AMD) in relation to MPD in a prospective study. Inclusion criteria were an age above 50 years, fundus alterations according to stage 2 or 3 of the Rotterdam Classification and MPD = 0.60 D.U. All patients underwent ophthalmologic examination, fundus photography and MPD measurement at baseline and follow-up every 12 month. MPD measurement was carried out by a confocal scanning laser ophthalmoscope following a standard operating procedure.

Results: : We included in total 241 eyes of 241 patients (99 male, 142 female) with mean age of 59.3 ± 2.9 years. At baseline 53 patients had low MPD values (0.22 ± 0.7 D.U.) and 60 patients had high MPD values (0.72 ± 0.12 D.U.).After 12 month progression to AMD was found in 5 patients. 3 patients (2x MPD_low vs. 1x MPD_high) developed exsudative AMD. Two patients (1x MPD_low vs. 1x MPD_high) showed geographic atrophies.After 24 month progression to AMD was found in another 4 patients. Two patients developed exsudative AMD (1x MPD_low vs. 1x MPD_high) and two patients showed areolar atrophies.After 24 month progression to AMD was occurring in 9.4% of patients with low MPD values at baseline and 6.6% of patients with high MPD values at baseline.We found no significant difference in the incidence of progression between the group of high MPD at baseline and the group of low MPD at baseline.After 36 month of follow-up 12.7% of patients with low MPD at baseline and 13.1% of patients with high MPD at baseline showed progression to endstage disease.Even after 3 years of follow-up we found no significant difference in the group of low MPD at baseline and the group of high MPD at baseline.

Conclusions: : In patients showing fundus alterations according to stage 2 or 3 of the Rotterdam Classification progression of ARM appears not to be dependent on the level of MPD.

Clinical Trial: : www.clinicaltrials.gov NCT00494325 Ethikkommission Bern 73/05

Keywords: age-related macular degeneration • macular pigment