Association Between Macular Pigment Optical Density values and Optical Coherence Tomography Parameters in Age-related Macular Degeneration

Abstract

Purpose : Dual wavelength autofluorescence (dwAF) method to determine macular pigment optical density (MPOD) is based on absorption of blue wavelength by the yellow macular pigment. Studies show association of MPOD with age-related macular degeneration (AMD) stage. MPOD association with the optical coherence tomography (OCT) parameters is yet to be shown. We studied the association between Heidelberg dwAF MPOD values and OCT structural parameters in AMD.

Methods : Prospective, cross-sectional IRB approved study. Patients with early and intermediate AMD, and controls (> 50 years) underwent dual-wavelength (488 and 514 nm) auto-fluorescence, macula centered 97 line enhanced depth imaging (EDI) OCT (Spectralis, Heidelberg) and color fundus photographs used for Age-related Eye disease study scale staging. The MPOD sum of volume (SoV) values were calculated within the 1° radius circle centered on the fovea relative to the 6° plateau. OCTs graded by two independent graders. Linear mixed-effects regression models were used to determine the association of OCT abnormalities - presence of central drusen, drusenoid pigment epithelial detachment (dPED), hyperreflective foci, ellipsoid zone disruption, and reticular drusen with MPOD, accounting for age, AMD presence, intra-ocular lens (IOL) presence, smoking history, and the use of AREDS supplements.

Results : We included 286 eyes of 161 participants; 201(70%) eyes with AMD (19 early and 182 intermediate), and 85 controls (30%). Mean ± SD participant age was 71±9 years, with majority female (58%), non-smokers (57%), and AREDS users (51%). IOL present in 30% of AMD eyes and 8% of control eyes. OCT abnormalities were not observed in any of the control eyes. In AMD eyes, 29% had dPED, 54% had central drusen, 41% had reticular drusen, 28% had hyperreflective foci, and 53% had ellipsoid zone disruption. Higher MPOD values were significantly associated with age (β = 6.38, 95% CI: 1.24 – 11.52, p = 0.015), IOL presence (β = 364.01, 95% CI: 268.12 – 459.89, p < 0.001), and the presence of dPED (β = 83.66, 95% CI: 4.93 – 162.39, p = 0.037).

Conclusions : The significant association between the MPOD SoV in central 1° radius and the presence of dPED after accounting for confounders, has potential use in determining the role of dual wavelength autofluorescence MPOD as a biomarker in AMD.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.