Macular Pigment And Lutein Supplementation In Macular Diseases

Abstract

Abstract: : Purpose: To determine macular pigment (MP) in patients with maculopathy and the response of MP and vision to supplementation with lutein. Methods: Patients with inherited macular disease (n=25) and documented foveal fixation had MP optical density (MPOD) measured with heterochromatic flicker photometry (1° diameter stimulus). Serum carotenoids, visual acuity, foveal sensitivity and retinal thickness (by optical coherence tomography, OCT) were quantified. In a subset of these patients, the effects on MP and central vision of 6 months of lutein supplementation at 20 mg/day were determined. Results in the patients were compared to results from normal subjects. Results: MP density in the patients, as a group, was significantly lower than normals, but there was a large range of MPOD (undetectable to >0.5). Patients with lower MP tended to have more severe disease expression. Foveal retinal thickness by OCT was positively correlated with MP density in the patients. After 6 months of supplementation, a subset of patients showed a statistically significant increase in MP; all participants showed an increase in serum lutein. Central vision was unchanged 6 months post–supplementation. Conclusions: As a group, patients with inherited maculopathies showed lower MP levels than normals. MP in patients may be affected by stage of retinal disease, especially that leading to abnormal foveal architecture. MP could be augmented with 6 months of lutein supplementation in some patients. There was no change in central vision in the short–term. The long–term influence of lutein supplementation on the natural history of macular disease is worthy of further study.

Keywords: retinal degenerations: hereditary • degenerations/dystrophies