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H. Wuestemeyer, A. Moessner, C. Jahn, S. Wolf; Macular Pigment Density in Patients with ARM Quantified with a Modified Confocal Scanning Laser Ophthalmoscope . Invest. Ophthalmol. Vis. Sci. 2003;44(13):5024.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: In the industrialized world age-related macular degeneration (AMD) is the leading cause for legal blindness beyond the age of 50 years. Recent studies indicate that the density of the macular pigment (MP) may play a central role in the development and progression of age-related maculopathy (ARM). We present results of patients with age-related maculopathy and compare them with macular pigment density of healthy subjects. Methods: A modified confocal scanning laser ophthalmoscope (Heidelberg Engineering, Heidelberg, Germany) was optimized for fundus reflectance and autofluorescence images at 488 and 514 nm. Both, reflectance and autofluorescence images were used to calculate macular pigment density maps. MP density was evaluated within 2 degrees around the foveal center from reflectance (MPREF) and autofluorescence (MPAF) macular pigment density maps. In this study we included 104 patients with ARM aged from 53 – 83 years (mean: 70 ± 8 years) and 107 healthy subjects aged form 16 – 75 years (mean: 46 ± 18 years). Results: Visual acuity (VA) was better than 20/25 in all healthy subjects. In patients with ARM 25 subjects had a VA of 20/32 and worse. Using the reflectance method mean macular pigment density was MPREF = 0.11±0.04 D.U. in ARM patients and MPREF=0.16±0.06 D.U. in healthy subjects. Using autofluorescence images MP density ranged from MPAF=0.22±0.08 D.U. in patients with ARM to MPAF=0.22±0.06 D.U. in healthy subjects. Conclusions: In healthy subjects as well as in patients with ARM we found higher macular pigment density values calculated from autofluorescence images than from reflectance images. The difference in MP density between healthy subjects and patients with ARM is only statistically significant in the reflectance method and not using autofluorescence images. The differences between MPREF and MPAF could be due to reflectance effects at the inner limiting membrane and the lens. This may be especially relevant for the group of ARM patients who are in average older than the control group. This study demonstrates that the reflectance method has limitations in the quantification of MP density.
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