[Impact of eating habits on macular pathology assessed by macular pigment optical density measure]. / Impact des habitudes nutritionnelles sur la pathologie maculaire évalué par mesure de la densité optique du pigment maculaire.

INTRODUCTION: Low levels of lutein and zeaxanthin in blood or food are associated with an increased risk of age-related macular degeneration (AMD). These molecules, provided by food, form the macular pigment. PATIENTS AND METHODS: Patients included in this pilot study where categorized into four groups : (1) < 50 years with drusen, (2) > or = 50 years without drusen, (3) > or = 50 years with drusen, and (4) > or = 50 years with drusen and neovascularization. During consultation, macular pigment optical density was measured and information on pathology and eating habits were collected. RESULTS: Assessment of macular pigment optical density considering eating habits and groups showed that it was lower in group 1 patients when they ate less than five portions of fruits and vegetables per day and less than two portions of cabbage, broccoli, pepper, corn, or spinach a week. In groups 3 and 4, food supplement intake was related to an increase in optical density. Food supplements were consumed by 58.5 % of patients in group 4. CONCLUSION: Analysis of mean optical density measured by the MPS 9000 QuantifEYE considering eating habits confirmed the impact of food supplement intake on optical density, especially in patients > or = 50 years with drusen and with or without neovascularization.

[Alternative therapies for choroidal neovessels resulting from age-related macular degeneration]. / Thérapeutiques alternatives des néovaisseaux choroïdiens de la dégénérescence maculaire liée à l'âge.

Classic neovessels (CNVs) identified on fluorescein angiography may benefit from thermal laser photocoagulation when sparing the fovea. If they extend into it, photodynamic therapy may halt the natural progression to a central scotoma. Occult CNVs, when subfoveal, may benefit from photodynamic therapy when isolated (not associated with classic CNV or with a pigment epithelium detachment). A number of therapeutic approaches are being evaluated in order to diversify the therapeutic choices available for treatment of CNVs. Transpupillary thermotherapy, which causes a limited increase in retinal temperature, could produce a sclerosis of occult isolated CNV. This approach has shown interesting results in pilot studies but also carries a risk for iatrogenic effects. The American randomized clinical trial currently under way will provide an evaluation of this treatment. An antiangiogenic therapy currently in progress is studying anecortave acetate and another is investigating anti-VEGF compounds. Anecortave acetate, which demonstrated its angiostatic activity in experimental models as well as in a phase II study, is now in a worldwide randomized clinical trial. The anti-VEGF molecules (antibodies and oligonucleotides) have shown very interesting preliminary results and are being evaluated in a large number of patients. Finally, a preventive therapy consisting of oral supplementation with antioxidants (vitamins C, E, and A) and zinc is a major step forward, providing the possibility of a real and effective prevention of the complications of age-related maculopathy.