June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
The Impact of Intermittent Fasting on Lipofuscin Accumulation in Healthy Adult Subjects
Author Affiliations & Notes
  • Arwa Arrashoud
    Vision Science, Pacific University, Forest Grove, Oregon, United States
  • Footnotes
    Commercial Relationships   Arwa Arrashoud None
  • Footnotes
    Support  Pacific University Research Award
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 3516. doi:
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      Arwa Arrashoud; The Impact of Intermittent Fasting on Lipofuscin Accumulation in Healthy Adult Subjects. Invest. Ophthalmol. Vis. Sci. 2023;64(8):3516.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Some data suggest that intermittent fasting is a simple, harmless and inexpensive technique to promote the autophagy process in cortical neurons and cerebellar Purkinje cells. We perform a prospective cohort study to identify the effect of intermittent fasting on retinal lipofuscin accumulation.

Methods : We recruited 40 healthy subjects fasting for Ramadan, and 20 non-fasting observational control subjects (age range 18-53 years). All subjects with healthy systemic and ocular status were included. A VISUCAM 244 Zeiss fundus camera was used to quantify RPE lipofuscin. Spherical equivalent, pupil size, macular pigment ocular density (MPOD), ß-ketone and blood glucose were collected in three visits; a week before Ramadan, the second at the end of Ramadan and the last two weeks after Ramadan. Axial length was recorded to evaluate the contribution of this factor to lipofuscin accumulation. A modification for the fundus camera instrument was made to add a reference point. GIMP image manipulation program (manual) and R program (automated) were used to analyze the entire image luminance threshold, and categorize the brightness range of dark components (blood vessels, macula and optic nerve), light lipofuscin and reference point. The statistical method includes regression, t-test and ANCOVA.

Results : The manual method to quantify fundus autofluorescence (FAF) brightness and the automated technique can be used interchangeably since the agreement value was 97.9%. Age-related changes in FAF brightness were clearly illustrated where the regression line showed a significant increase in FAF values with aging (r2 = 0.818, P <0.001). Myopic eyes had a higher mean value of FAF brightness (40.14± 1.76), whereas the mean for hyperopes was 33.71± 1.89 (p < .001). From the correlation analysis, baseline pupil size showed a stronger negative correlation than dilated pupil size with the mean of the fundus brightness. Other factors such as ketone/ glucose index and MPOD were inspected to test their influence on image brightness. Neither of these variables affected FAF intensity values. There was no difference in FAF brightness values between the fasting group and the controls.

Conclusions : This data confirms the reliability and validity of the fundus brightness measure (lipofuscin proxy) using VISUCAM 244 Zeiss fundus camera and R program. Three weeks of intermittent fasting did not show any difference in FAF brightness values.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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