Trending Topic

23 mins

Trending Topic

Developed by Touch
Mark CompleteCompleted
BookmarkBookmarked
Luke G Qin, Michael T Pierce, Rachel C Robbins

The uvea is a vascular stratum that includes the iris, ciliary body and choroid. Uveitis is defined as inflammation of a part of the uvea or its entirety, but it is also used to describe inflammatory processes of any part of the eye, such as the vitreous or peripheral retina. The clinical taxonomy of uveitis […]

Macular Pigment Optical Density in Macular Health and Visual Function

Samanta Maci
Share
Facebook
X (formerly Twitter)
LinkedIn
Via Email
Mark CompleteCompleted
BookmarkBookmarked
Copy LinkLink Copied
Download as PDF
Published Online: Aug 5th 2012 European Ophthalmic Review, 2012;6(4):227-9 DOI: http://doi.org/10.17925/EOR.2012.06.04.227
Select a Section…
1

Abstract

Overview

Extensive research has described the biological and optical characteristics of the macular pigment (MP) and has confirmed its composition and dietary origin. Epidemiological and intervention trials support the protective role of MP in the retina as well as its positive effects on visual function in healthy individuals in addition to patients with age-related macular degeneration (AMD). The amount of MP in the macula can be assessed by measuring a surrogate optical indicator, macular pigment optical density (MPOD). New evidence from recently published clinical trials and a European consensus roundtable have confirmed that MPOD can be increased by increasing the ingestion of lutein and zeaxanthin and that MPOD increase benefits macular health and visual function. On balance, this recent evidence suggests a critical role of MP in eye health as well as the importance of assessing if adequate levels of the dietary macular carotenoids are regularly consumed in order to ensure proper availability for deposition into the macula.

Keywords

Lutein, zeaxanthin, macular pigment, MPOD, AMD, visual function

2

Article

In 1945, Wald reported that the macula lutea of humans and certain other primates contains a yellow pigment and suggested that this macular pigment (MP) was a carotenoid. By analysing the spectral sensitivity of the human foveal and peripheral photoreceptors, he estimated the light absorbed/transmitted by the macular pigment, and used the term macular pigment optical density (more recently associated with the acronym MPOD). At the same time he observed a great variation in the intensity of macula pigmentation among subjects – from foveas with no perceptible pigmentation to very intense coloured ones.1 Research conducted in recent decades has confirmed that the MP is composed by three distinct carotenoids lutein (L), zeaxanthin (Z) and meso-zeaxanthin (MZ).2,3 MP reaches highest concentration (per mm2 of tissue) at the centre of the fovea decreasing rapidly with distance from the epicentre. The concentrations of L, Z and MZ also vary with eccentricity – in the adult retina, while the three macular carotenoids are present in similar concentrations at foveal centre, as the eccentricity from the fovea increases, lutein becomes the predominant pigment with a decreasing amount of Z, and with MZ, approaching undetectable levels.3 The role of the MP in the human eye is well described and is based on the biological and optical characteristics of its main components.4–7 It acts as an antioxidant by quenching reactive oxygen species and as a filter for damaging high energy/short-wavelengths of visible light (blue light). These functions support the protective role of the MP in the retina, a tissue particularly susceptible to oxidative stress and the more recently explored beneficial effects on visual function.

Macular Pigment Optical Density and the Diet
Studies conducted in monkeys raised on a xanthophyll-free diet from birth have shown that the macular pigment is of dietary origin and that L and Z supplementation can replenish the macular pigment. Moreover, those results indicate that, while the accumulation of L and Z in serum and retina stems from the ingestion of these two xanthophylls with the diet, MZ originates exclusively from the conversion of L in the macula. MZ is not present in serum.8,9 Additional observations conducted in thesexanthophyll-free animals indicate the presence of drusen in the igment epithelium.8 A recent publication addressed the effect of acute blue-light exposure in xanthophyll-free animals lacking the macular pigment in comparison to control animals fed stock diet containing xanthophylls.10 The presence of the macular pigment rendered control animals less susceptible to blue light-induced damage in both the fovea and parafovea although more damage was observed in the parafoveal area than in the fovea. The xanthophyll-free animals, who exhibited no MP, experienced similar damage in both the foveal and parafoveal areas resulting from blue-light exposure as well as more damage than control animals. Supplementation of the xanthophyll-free animals with L or Z increased macular pigment density and decreased foveal susceptibility to blue-light induced damage to control levels. In the author’s words, “L and Z when provided in the diet and deposited as macular pigment, provided foveal protection from acute blue-light photochemical damage. It seems probable that these nutrients would also protect the macula against chronic blue-light-induced damage”.

To view the full article in PDF or eBook formats, please click on the icons above.

2

References

  1. Wald G, Human vision and the spectrum, Science,
    1945;101(2635):653–8.

  2. Bone RA, Landrum JT, Tarsis SL, Preliminary identification
    of the human macular pigment, Vision Res,
    1985;25(11):1531–5.

  3. Bone RA, Landrum JT, Friedes LM, et al., Distribution of
    lutein and zeaxanthin stereoisomers in the human retina,
    Exp Eye Res, 1997;64(2):211–8.

  4. Krinsky NI, Landrum JT, Bone RA, Biologic mechanisms of
    the protective role of lutein and zeaxanthin in the eye,
    Annu Rev Nutr, 2003;23:171–201.

  5. Khachik F, Bernstein PS, Garland DL, Identification of lutein
    and zeaxanthin oxidation products in human and monkey
    retinas, Invest Ophthalmol Vis Sci, 1997;38(9):1802–11.

  6. Stahl W, Macular carotenoids: lutein and zeaxanthin,
    Augustin A (ed): Nutrition and the Eye, Dev Ophthalmol Basel,
    Karger, 2005;38:70–88.

  7. Bernstein PS, Delori FC, Richer S, et al., The value of
    measurement of macular carotenoid pigment optical
    densities and distributions in age-related macular
    degeneration and other retinal disorders, Vision Research,
    2010;50:716–28.

  8. Malinow MR, Feeney-Burns L, Peterson LH, et al., Dietrelated
    macular anomalies in monkeys. Invest Ophthalmol Vis
    Sci, 1980;19(8):857–63.

  9. Neuringer M, Sandstrom MM, Johnson EJ, Snodderly DM,
    Nutritional manipulation of primate retinas: effects of lutein
    or zeaxanthin supplements on serum and macular pigment
    in xanthophyll-free rhesus monkeys, Invest Ophthalmol Vis Sci,
    2004;45(9):3234–43.

  10. Barker FM, Snodderly D, Johnson EJ, et al., Nutritional
    manipulation of primate retinas, V: effects of lutein,
    zeaxanthin, and n-3 fatty acids on retinal sensitivity to
    blue-light-induced damage, Invest Ophthalmol Vis Sci, 2011
    Jun;52(7):3934–42.

  11. Seddon JM, Ajani UA, Sperduto RD, et al., Dietary
    carotenoids, vitamins A, C, and E, and advanced age-related
    macular degeneration. Eye Disease Case-Control Study
    Group, Jama, 1994;272(18):1413 –20.

  12. Delcourt C, Carriere I, Delage M, et al., Plasma lutein and
    zeaxanthin and other carotenoids as modifiable risk factors
    for age-related maculopathy and cataract: the POLA Study,
    Invest Ophthalmol Vis Sci, 2006;47(6):2329–35.

  13. 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(1):235–40.

  14. Age-Related Disease Study Group, The relationship of
    dietary carotenoid and vitamin A, E, and C intake with
    age-related macular degeneration in a case-control study:
    AREDS Report No. 22, Archives of Ophthalmology,
    2007;125(9):1225–32.

  15. Nolan JM, Stack J, O’Donovan O, et al., Risk factors for
    age-related maculopathy are associated with a relative
    lack of macular pigment, Experimental Eye Research,
    2007;84(1):61–74.

  16. Stringham JM, Hammond BR Jr, The glare hypothesis of
    macular pigment function, Optometry and Vision Science, 2007.
    84(9):859–64.

  17. Stringham JM, Garcia PV, Smith PA, et al., Macular pigment
    and visual performance in glare: benefits for photostress
    recovery, disability glare, and visual discomfort, Invest,
    Ophthalmol, Vis, Sci, 2011;52(10):7406–15.

  18. Richer S, Stiles W, Statkute L, et al., Double-masked,
    placebo-controlled, randomized trial of lutein and
    antioxidant supplementation in the intervention of atrophic
    age-related macular degeneration: the Veterans LAST study
    (Lutein Antioxidant Supplementation Trial) Optometry,
    2004;75(4):216–30.

  19. Stringham JM, Hammond BR, Macular pigment and visual
    performance under glare conditions, Opthometry and Vision
    Science, 2008;85(2):82–8.

  20. Jentsch S, Schweitzer D, Hammer M, Dawczynski J, Optische
    Makulapigmentdichte (MPOD) als protektive Faktor bei der
    trockenen altersbedingten Makuladegeneration (AMD) –
    Ergebnisse der LUTEGA-Studie, Presented at: DOG
    Congress 2011, (abstract #839).

  21. Jentsch S, Schweitzer D, Hammer M, et al., The
    lutega-study: lutein and omega-3-fatty acids and their
    relevance for macular pigment in patients with age-related
    macular degeneration (AMD), Presented at: ARVO 2011
    (abstract #624).

  22. Richer S, Stiles W, Graham-Hoffman K, et al., Randomized,
    double-blind, placebo-controlled study of zeaxanthin and
    visual function in patients with atrophic age-related macular
    degeneration, the zeaxanthin and visual function study (ZVF)
    FDA IND #78, 973, Optometry, 2011;82;667–80.

  23. Piermarocchi S, Saviano S, Parisi V, et al., For the Carmis
    study group, carotenoids in age-related maculopathy italian
    study (CARMIS): two-year results of a randomized study,
    Eur J Ophthalmol, 2011;22(2):216 –225.

  24. Parisi V, Tedeschi M, Gallinaro G, et al., Carotenoids and
    antioxidants in age-related maculopathy italian study:
    multifocal electroretinogram modifications after 1 year,
    Ophthalmology, 2008;115(2):324–33 e2.

  25. Dawczynski J, Optische Makulapigmentdichte und
    Altersabhängige Makuladegeneration, CME supplement in:
    Ophthalmologische Nachrichten, 2012 Aug, issue 8.

  26. European Consensus Roundtable, MPOD in macular health
    and visual function, Frankfurt, Germany, March 14, 2012.

  27. United States Department of Agriculture, What we eat in
    America, NHANES 2009–2010. Available at: www.ars.usda.
    gov/Services/docs.htm?docid=18349 (accessed 28
    September 2012).

  28. O’Neill ME, Carroll Y, Corridan B, et al., A european
    carotenoid database to assess carotenoid intakes and
    its use in a five-country comparative study, Br J Nutr,
    2001;85(4):499–507.

3

Article Information

Disclosure

Samanta Maci is an employee of Kemin.

Correspondence

Samanta Maci, Kemin Human Nutrition and Health, Campo Grande 35- 8ºD, 1700-087 Lisboa, Portugal. E: samanta.maci@kemin.com

Support

The publication of this article was supported by Kemin.

Received

2012-09-06T00:00:00

4

Further Resources

Share
Facebook
X (formerly Twitter)
LinkedIn
Via Email
Mark CompleteCompleted
BookmarkBookmarked
Copy LinkLink Copied
Download as PDF
Close Popup