The value of measurement of macular carotenoid pigment optical densities and distributions in age-related macular degeneration and other retinal disorders.

There is increasing recognition that the optical and antioxidant properties of the xanthophyll carotenoids lutein and zeaxanthin play an important role in maintaining the health and function of the human macula. In this review article, we assess the value of non-invasive quantification of macular pigment levels and distributions to identify individuals potentially at risk for visual disability or catastrophic vision loss from age-related macular degeneration, and we consider the strengths and weaknesses of the diverse measurement methods currently available.

Macular pigment optical density at four retinal loci during 120 days of lutein supplementation.

BACKGROUND: Increased consumption of lutein and zeaxanthin has been shown to increase macular pigment optical density (MPOD) in some individuals. Most interventions either obtained infrequent measures of MPOD or measured MPOD at a single retinal locus. PURPOSE: The aim of this study was to measure acute changes in MPOD at four retinal loci during lutein intervention. METHODS: For 120 days, three subjects consumed 30 mg of lutein and 2.7 mg of zeaxanthin supplement per day. MPOD was measured with heterochromatic flicker photometry at 20', 30', 60' and 120' eccentricity three or four times per week. High-performance liquid chromatography was used to measure serum carotenoid concentrations in blood samples collected at baseline and at 30-day intervals. RESULTS: At the two most central loci, MPOD significantly increased in all three subjects with a mean change of approximately 0.09 log units at 20' eccentricity and 0.08 log units at 30' eccentricity. MPOD significantly increased in two subjects at 60' eccentricity, and in one subject at 120' eccentricity. The increases in MPOD appeared to be linear and continued after treatment was ended. In all three subjects, log sensitivity at the reference locus decreased linearly. Serum lutein and serum zeaxanthin increased from baseline, reaching peak concentrations after 30 days of supplementation. CONCLUSION: The changes in MPOD suggest that carotenoid deposition occurs linearly and may be biased towards the central retina. Further, carotenoid deposition may occur outside the central fovea in interventions with pharmacological doses of carotenoid, resulting in underestimations of psychophysical measures of MPOD.

Macular pigment optical density and photophobia light threshold.

Light absorption by macular pigment may attenuate visual discomfort, or photophobia, for targets composed of short-wavelength light. Macular pigment optical density (MPOD) and photophobia light thresholds were measured psychophysically in 10 subjects. The energy necessary to induce photophobia for a short-wavelength target relative to a long-wavelength target was linearly related to MPOD, as well as estimates of peak MPOD and integrated macular pigment. In four subjects who consumed lutein supplements, increases in MPOD corresponded to increases in photophobia light thresholds. Light absorption by macular pigment appears to influence the amount of short-wavelength light necessary to elicit photophobia.

Spinach cultigen variation for tissue carotenoid concentrations influences human serum carotenoid levels and macular pigment optical density following a 12-week dietary intervention.

Increasing intakes of carotenoid-rich plant foods can increase serum carotenoid concentrations and macular pigment optical density (MPOD) in most, but not all, individuals. Research objectives for this study were to (1) characterize tissue lutein (L) and beta-carotene (BC) concentrations in carotenoid-rich spinach (Spinacia oleracea L.) cultigens and (2) determine serum carotenoid and MPOD responses in human subjects consuming spinach cultigens differing in tissue L and BC concentrations. Thirteen spinach cultigens were evaluated for carotenoid accumulations over two consecutive growing seasons. "Springer" (8.4 and 6.5 mg/100 g of fresh mass for L and BC, respectively) and "Spinner" (12.1 and 9.2 mg/100 g of fresh mass for L and BC, respectively) spinach cultigens were selected for a dietary intervention study and represented low- and high-L concentrations. The high-L ("Spinner") and low-L ("Springer" ) spinach treatment groups consisted of 10 subject volunteers ingesting five 50-g spinach servings/week during a 12-week intervention. Average serum L concentrations increased by 22% (P = 0.07) from baseline (0.233 micromol/L) to 12 weeks (0.297 micromol/L) for subjects consuming low-L spinach. Subjects consuming high-L spinach showed increases of 33% (P = 0.04) in serum L from baseline (0.202 micromol/L) to 12 weeks (0.300 micromol/L). Average MPOD did not change for the low-L treatment group; however, subjects in the high-L group demonstrated increases (P = 0.02) in MPOD at the 30' eccentricity between baseline (0.343) and 12 weeks (0.374). This study demonstrates that serum carotenoid and MPOD are determined by L concentrations present in the spinach matrix. Results emphasize the role of cultigen selection among vegetable crops in determining phytochemical effects on human health.

A 12-wk egg intervention increases serum zeaxanthin and macular pigment optical density in women.

Two carotenoids found in egg yolk, lutein and zeaxanthin, accumulate in the macular retina where they may reduce photostress. Increases in serum lutein and zeaxanthin were observed in previous egg interventions, but no study measured macular carotenoids. The objective of this project was to determine whether increased consumption of eggs would increase retinal lutein and zeaxanthin, or macular pigment. Twenty-four females, between 24 and 59 y, were assigned to a pill treatment (PILL) or 1 of 2 egg treatments for 12 wk. Individuals in the PILL treatment consumed 1 sugar-filled capsule/d. Individuals in the egg treatments consumed 6 eggs/wk, containing either 331 microg (EGG 1) or 964 microg (EGG 2) of lutein and zeaxanthin/yolk. Serum cholesterol, serum carotenoids, and macular pigment OD (MPOD) were measured at baseline and after 4, 8, and 12 wk of intervention. Serum cholesterol concentrations did not change in either egg treatment group, but total cholesterol (P = 0.04) and triglycerides (P = 0.02) increased in the PILL group. Serum zeaxanthin, but not serum lutein, increased in both the EGG 1 (P = 0.04) and EGG 2 (P = 0.01) groups. Likewise, MPOD increased in both the EGG 1 (P = 0.001) and EGG 2 (P = 0.049) groups. Although the aggregate concentration of carotenoid in 1 egg yolk may be modest relative to other sources, such as spinach, their bioavailability to the retina appears to be high. Increasing egg consumption to 6 eggs/wk may be an effective method to increase MPOD.

Diet and serum carotenoid concentrations affect macular pigment optical density in adults 45 years and older.

The dietary carotenoids lutein (L) and zeaxanthin (Z) are the principal components of macular pigment (MP). Protection of the central retina by MP is suggested, but data are limited. Dietary practices and serum carotenoid concentrations were investigated in 98 adults, 45-73 y old, in relation to MP. Macular pigment optical density (MPOD) was measured at 4 loci: 10 min (10', 30 min (30'), 60 min (60'), and 120 min (120') retinal eccentricity. Serum L + Z concentrations in fasting subjects were correlated with MPOD: 10' (r = 0.29, P = 0.008), 30' (r = 0.342, P = 0.0006), and 60' (r = 0.73, P = 0.001) eccentricity. Dietary L + Z was positively correlated with MPOD: 10' (r = 0.24, P = 0.02), 30' (r = 0.237, P = 0.02), 60' (r = 0.27, P = 0.009), and 120' (r = 0.25, P = 0.02) eccentricity. The lowest fruit and vegetable consumers had lower MPOD at 30' (P = 0.01), 60' (P = 0.03), and 120' (P = 0.006) eccentricity compared with the highest consumers. Based on age quartiles (45-49 y), (50-55 y), (56-61 y), and (62-74 y), the youngest and oldest had higher MPOD than those 56-61 y at 60' (P < 0.05). Compared with those with a BMI (kg/m(2)) >/= 27, those with a BMI < 27 had higher serum concentrations of beta-carotene (P = 0.002), and higher MPOD at 60' (P = 0.04) and 120' (P = 0.01). These findings suggest that carotenoid-rich diets and serum carotenoids positively contribute to MP status.

Spatial properties of photophobia.

PURPOSE: To determine the spatial properties of stimuli that elicit photophobia (PP) in normal subjects: Does PP exhibit spatial summation? Are different parafoveal quadrants (superior, inferior, temporal, and nasal) of the retina differentially sensitive in PP? What is the relationship between PP sensitivity and retinal eccentricity? What is the relationship between the spatial properties of PP and the spatial distribution of macular pigment (MP)? METHODS: A Maxwellian-view optical system with a xenon light source was used to present the stimuli. Four normal subjects viewed stimuli of various sizes, retinal locations, and one of two chromatic contents: xenon-white and a broadband orange. The intensity of the test stimulus was increased between trials until the PP threshold was reached. The squinting response corresponding to PP was assessed by electromyography and used as an objective criterion of PP. Three parameters were examined: stimulus size, parafoveal retinal locus (superior, inferior, temporal, and nasal), and retinal eccentricity (extending into the perifovea). Spatial profiles of MP were measured psychophysically using heterochromatic flicker photometry (HFP). RESULTS: Spatial summation for PP was found essentially to adhere to Piper's law (radiance proportional to square root of stimulus area). The PP response was greater to centrally than peripherally viewed targets. In this regard, MP acted as a spatially integrated filter in the attenuation of PP. CONCLUSIONS: The degree of spatial summation found for PP indicates that an increase of 1.0 log unit in field area results in an approximately 0.57-log-unit decrease in the radiance required to elicit PP. PP appears to serve the function of retinal photoprotection.

Action spectrum for photophobia.

Thresholds for photophobia (light-induced discomfort) were determined at wavelengths from 440 to 640 nm for three subjects. Photophobia was assessed by means of electromyography, which was used to measure subjects' level of squinting. After correction for absorption by macular pigment and the ocular media, subjects' functions displayed a trend of increasing sensitivity with decreasing wavelength. We propose that the corrected function is indicative of increased sensitivity to potential retinal damage by short-wavelength light. It is therefore suggested that photophobia serves a function of biological protection. Results also suggest that photophobia is significantly mitigated by macular pigment in the short wavelengths.

Light exposure and macular pigment optical density.

PURPOSE: Biochemical research has demonstrated that lutein and zeaxanthin, the two macular carotenoids, are bleachable pigments. Further, evidence suggests that exposure to UV light can degrade plasma carotenoid levels in vivo. The present study investigated the effects of exposure to normal levels of light on the levels of lutein and zeaxanthin in the retina. METHODS: The optical density of macular pigment (MPOD) was measured in two male subjects under four different light-adaptation conditions for 20 days. Heterochromatic flicker photometry was used to measure MPOD at 0.5 degrees eccentricity. RESULTS: The four conditions of light adaptation did not significantly affect MPOD. As in previous studies, however, a significant day-to-day difference was observed for both subjects. CONCLUSIONS: The results suggest that lutein and zeaxanthin levels in the eye are unaffected by light and oxidation throughout the day. This justifies current research methods in which MPOD measures are made regardless of the time of day. However, significant between-day variance indicates that multiple MPOD measures may be necessary to evaluate lutein and zeaxanthin levels in the retina accurately.