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K. Gallaher, M. Mura, J. Armstrong, W.A. Todd, S. Satterfield, E. Kenyon, T. Harris, K.C. Johnson, S.B. Kritchevsky, A. Iannaccone; Macular Pigment Optical Density in Age–Related Maculopathy: Findings From the Health ABC Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5668.
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© ARVO (1962-2015); The Authors (2016-present)
To report the macular pigment optical density (MPOD) characteristics and test–retest reliability in subjects with age–related maculopathy (ARM).
MPOD was estimated with a heterochromatic flicker photometry–based method at 0.5 degrees of eccentricity from the fovea in a sample of 110 subjects with ARM [mean age: 79.4 yo, 56% females, 48% lutein supplement users (LSUs)] participating in ARMA, an investigation on aging and ARM ancillary to the Health ABC Study. Fundus features were graded in a blinded fashion according to the original AREDS classification system. MPOD test–retest variability was assessed in 14 subjects with early ARM (AREDS category 3) who had successfully completed a baseline MPOD session.
MPOD estimates could be obtained in 79 (72%) of the affected participants, but only few AREDS category 4 (advanced ARM) subjects had sufficient visual acuity to complete testing. The mean MPOD was 0.36±0.21, which is not significantly different from our previously reported normal values (0.34 ± 0.21) in elderly subjects in the same age range (n=228), even after controlling for LSU status. However, unlike normal subjects, the MPOD of ARM subjects showed a bimodal distribution, with one peak below and one above the mean. This distribution remained apparent also after stratifying subjects by LSU. LSUs did not have higher MPOD than non–LSUs, which is also different from what we have reported for healthy subjects. Test–retest reliability was good (Pearson’s r: 0.71), with a coefficient of variation (CV) of 17% (12% without two obvious outliers), which compares favorably with our previous experience in normal subjects (Pearson’s r: 0.76; CV: 17.1%; n=39).
In this sample, average MPOD was not per se reduced in ARM compared to normal subjects. However, the identification of subsets of subjects with low MPOD suggests that reduced MPOD may be a feature of only some cases of ARM. Confounding from LSU (e.g., dosage), other related (e.g., diet) or otherwise yet unaccounted for variables cannot be presently ruled out. MPOD estimates appear to be a suitable outcome measure for longitudinal observational studies and lutein supplementation trials of ARM, especially in patients without advanced disease.
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