Abstract
Purpose
To investigate macular pigment optical density (MPOD) in patients with and without wet age-related macular degeneration (AMD) and to elucidate the association between MPOD and the risk factors for AMD in an Indian population.
Methods
Thirty-three subjects with wet AMD and 29 controls above 50 years old underwent MPOD measurement with the ‘Macular Densitometer’. The subjects were also tested for their smoking history, lifetime ultraviolet (UV) exposure, dietary intake of carotenoids, and body mass index (BMI).
Results
Smokers had a higher risk for AMD than the non-smokers (P=0.032) and a lower MPOD level than non-smokers (mean (95% CI)) (0.16 (0.09–0.23) vs 0.28 (0.22–0.34), adjusted P=0.026). Subjects with lowest UV exposure had higher MPOD than those with the highest (0.46 (0.38–0.54) vs 0.17 (0.01–0.33), P=0.01). MPOD was significantly lower among those with the lowest quartile of dietary intake of carotenoids (0.14 (0.08–0.21) vs 0.25 (0.13–0.36), P=0.012). Smoking, obesity, and UV index showed an inverse association with the MPOD. Low MPOD, smoking, and UV exposure had 5.11 (1.73–15.08), 3.54 (1.08–11.57), and 5.24 (1.06–25.96) odds for AMD, respectively, whereas higher dietary intake of carotenoids showed a protective effect for AMD.
Conclusion
We found an inverse association between wet AMD and MPOD. Among the established risk factors of wet AMD, we found an inverse association of smoking, UV index, and obesity with MPOD, whereas a positive association was found between dietary intake of carotenoids and MPOD.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Beatty S, Murray IJ, Henson DB, Carden D, Koh H, Boulton ME . Macular pigment and risk for age-related macular degeneration in subjects from a Northern European population. Invest Ophthalmol Vis Sci 2001; 42: 439–446.
Bone RA, Landrum JT, Mayne ST, Gomez CM, Tibor SE, Twaroska EE . Macular pigment in donor eyes with and without AMD: a case-control study. Invest Ophthalmol Vis Sci 2001; 42: 235–240.
Obana A, Hiramitsu T, Gohto Y, Ohira A, Mizuno S, Hirano T et al. Macular carotenoid levels of normal subjects and age-related maculopathy patients in a Japanese population. Ophthalmology 2008; 115: 147–157.
Bernstein PS, Zhao DY, Wintch SW, Ermakov IV, McClane RW et al. Resonance Raman measurement of macular carotenoids in normal subjects and in age-related macular degeneration patients. Ophthalmology 2002; 109: 1780–1787.
Cuthbertson FM, Peirson SN, Wulff K, Foster RG, Downes SM . Blue light-filtering intraocular lenses: review of potential benefits and side effects. J Cataract Refract Surg 2009; 35: 1281–1297.
Mainster MA, Turner PL . Retinal examination and photography are safe...is anyone surprised? Ophthalmology 2010; 117: 197–198.
LaRowe TL, Mares JA, Snodderly DM, Klein ML, Wooten BR, Chappell R . CAREDS Macular pigment study group macular pigment density and age-related maculopathy in the Carotenoids in age-related eye disease study. An ancillary study of the women's health initiative. Ophthalmology 2008; 115: 876–883.
Nolan JM, Stack J, O' Donovan O, Loane E, Beatty S . Risk factors for age-related maculopathy are associated with a relative lack of macular pigment. Exp Eye Res 2007; 84: 61–74.
Berendschot TT, van Norren D . On the age dependency of the macular pigment optical density. Exp Eye Res 2005; 81: 602–609.
Hammond BR, Wooten BR, Snodderly DM . Cigarette smoking and retinal carotenoids: implications for age-related macular degeneration. Vision Res 1996; 36: 3003–3009.
Tomany SC, Cruickshanks KJ, Klein R, Klein BE, Knudtson MD . Sunlight exposure and the 10-Year incidence of age-related maculopathy. Arch Ophthalmol 2004; 122: 750–757.
Nolan J, O'Donovan O, Kavanagh H, Stack J, Harrison M, Muldoon A et al. Macular pigment and percentage of body fat. Invest Ophthalmol Vis Sci 2004; 45: 3940–3950.
Clemons TE, Milton RC, Klein R, Seddon JM, Ferris FL . 3rd. Age-Related Eye Disease Study Research Group. Risk factors for the incidence of advanced age-related macular degeneration in the Age- Related Eye Disease Study. Age Related Eye Disease Study report number 19. Ophthalmology 2005; 112: 533–539.
Mares JA, LaRowe TL, Snodderly DM, Moeller SM, Gruber MJ, Klein ML et al. CAREDS Macular Pigment Study Group and Investigators. Predictors of optical density of lutein and zeaxanthin in retinas of older women in the Carotenoids in Age-Related Eye Disease Study, an ancillary study of the Women’s Health Initiative. Am J Clin Nutr 2006; 84: 1107–1122.
Bird AC, Bressler NM, Bressler SB, Chisholm IH, Coscas G, Davis MD et al. An international classification and grading system for age-related maculopathy and age-related macular degeneration the international ARM epidemiological study group. Surv Ophthalmol 1995; 39: 367–374.
Leffondré K, Abrahamowicz M, Siemiatycki J, Rachet B . Modeling smoking history: a comparison of different approaches. Am J Epidemiol 2002; 156: 813–823.
Hebert JR, Gupta PC, Bhonsle RB, Murti PR, Mehta H, Verghese F et al. Development and testing of a quantitative food frequency questionnaire for use in Kerala, India. Public Health Nutr 1998; 1: 123–130.
McCarty CA, Lee SE, Livingston PM, Bissinella M, Taylor HR . Ocular exposure to UV-B in sunlight: the Melbourne visual impairment project model. Bull World Health Organ 1996; 74: 353–360.
Snodderly DM, Mares JA, Wooten BR, Oxton L, Gruber M, Ficek T . CAREDS Macular Pigment Study Group Macular pigment measurement by Heterochromatic flicker photometry in older subjects: the carotenoids and age-related eye disease study. Invest Ophthalmol Vis Sci 2004; 45: 531–538.
Bressler NM . ‘Early detection and treatment of neovascular age related macular degeneration’. J Am Board Fam Pract 15 (2) 142–152.
Anonymous. Antioxidant status and neovascular age-related macular degeneration. Eye Disease Case-Control Study Group. Arch Ophthalmol 1993; 111: 104–109.
Seddon JM, Ajani UA, Sperduto RD, Hiller R, Blair N, Burton TC et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration Eye Disease Case-Control Study Group. JAMA 1994; 272: 1413–1420.
Cho E, Hankinson SE, Rosner B, Willett WC, Colditz GA . Prospective study of lutein/zeaxanthin intake and risk of age-related macular degeneration. Am J Clin Nutr 2008; 87: 1837–1843.
Jahn C, Wüstemeyer H, Brinkmann C, Trautmann S, Mössner A, Wolf S . Macular pigment density in age-related Maculopathy. Graefe’s Arch Clin Exp Ophthalmol 2005; 243: 222–227.
Wooten BR, Hammond BR . Spectral absorbance and spatial distribution of macular pigment using heterochromatic flicker photometry. Optom Vis Sci 2005; 82: 378–386.
Chang Y, Lee FL, Chen SJ, Chen SF . Optical measurement of human retinal macular pigment and its spatial distribution with age. Med Phys 2002; 29: 2621–2628.
Hammond BR, Curran-Celentano J, Judd S, Fuld K, Krinsky NI, Wooten BR et al. Sex differences in macular pigment optical density: relation to plasma carotenoid concentrations and dietary patterns. Vis Res 1996; 36: 2001–2012.
Broekmans WM, Berendschot TT, Klöpping-Ketelaars IA, de Vries AJ, Goldbohm RA, Tijburg LB et al. Macular pigment density in relation to serum and adipose tissue concentrations of lutein and serum concentrations of zeaxanthin. Am J Clin Nutr 2002; 76: 595–603.
Curran-Celentano J, Hammond BR, Ciulla TA, Cooper DA, Pratt LM, Danis RB . Relation between dietary intake, serum concentrations, and retinal concentrations of lutein and zeaxanthin in adults in a Midwest population. Am J Clin Nutr 2001; 74: 796–802.
Bone RA, Landrum JT, Cao Y, Howard AN, Alvarez-Calderon F . Macular pigment response to a supplement containing mesozeaxanthin, lutein and zeaxanthin. Nutr Metab 2007; 4: 1–8.
Hammond BR, Johnson EJ, Russell RM, Krinsky NI, Yeum KJ, Edwards RB . Dietary modification of human macular pigment density. Invest Ophthal Vis Sci 1997; 38: 1795–1801.
Nolan JM, Stack J, O'connell E, Beatty S . The relationships between macular pigment optical density and its constituent carotenoids in diet and serum. Invest Ophthal Vis Sci 2007; 48: 571–582.
Berendschot TT, Goldbohm RA, Klöpping WA, van de Kraats J, van Norel J, van Norren D . Influence of lutein supplementation on macular pigment, assessed with two objective techniques. Invest Ophthalmol Vis Sci 2000; 41: 3322–3326.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Raman, R., Biswas, S., Gupta, A. et al. Association of macular pigment optical density with risk factors for wet age-related macular degeneration in the Indian population. Eye 26, 950–957 (2012). https://doi.org/10.1038/eye.2012.69
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/eye.2012.69
Keywords
This article is cited by
-
Is there any association between the frequency of wet age-related macular degeneration recurrences and the seasons of the year?
International Ophthalmology (2023)
-
The use of heterochromatic flicker photometry to determine macular pigment optical density in a healthy Australian population
Graefe's Archive for Clinical and Experimental Ophthalmology (2014)
-
Influence of seasonal sunlight intensity and iris color on the anti-VEGF therapy for neovascular age-related macular degeneration
Eye (2013)


