RS, an objective method of measuring MP levels in vivo, exhibits acceptable reproducibility and test-retest variability. The results demonstrated good correlation between RS and HFP measurements of MP, thus authenticating RS against a validated psychophysical technique of measuring MP. However, investigators should use only one of these instruments for the duration of any given study because of differences in the scientific rationale, and the factors that influence RS and HFP measurements of MP.
Aim: Macular pigment (MP) is composed of two hydroxycarotenoids contained within the photoreceptors and the axons of the central neurosensory retina, with peak concentrations in the Henle layer. A full thickness macular hole (FTMH) is characterised by absence of all retinal layers in an area centred at the former centre of the fovea. The authors report the results of a study designed to investigate MP levels in patients following successful FTMH surgery, using Raman spectroscopy, and to correlate these findings with functional and topographic outcomes. Methods: The following details were recorded for 12 eyes of 12 patients following successful closure of a FTMH: best corrected visual acuity; macula threshold test, fixation, fundus photography, and macular pigment levels using Raman spectroscopy. High resolution imaging of the retina using optical coherence tomography (OCT) was performed in nine of the 12 study eyes. Results: Mean (SD) best corrected visual acuity was 0.6 (0.4) and improved significantly from preoperative levels. On macula threshold testing of the operated eye, a central scotoma was detectable in one eye only (8.3%). MP levels were demonstrable in 10 of the 12 study eyes following successful FTMH surgery. MP levels were higher in three study eyes, and lower in seven study eyes, when compared with the fellow eye. Of the three pairs of eyes where MP levels were greater in the study eye, macular pathology was present in two fellow eyes. Conclusions: The presence of MP was confirmed in the neurosensory retina of an anatomically closed FTMH in 10 of 12 study eyes, although the levels were lower than the fellow normal macula in nine of 10 cases. This suggests a good degree of physiological recovery of photoreceptors and their axons following successful FTMH surgery.A t the macula, there exists a yellow pigment, known as macular pigment (MP), which is composed of two hydroxycarotenoids, lutein (L) and zeaxanthin (Z). 1 Evidence is accumulating that this pigment is important for maintenance of macular health through its absorptive and/or its antioxidant properties. A full thickness macular hole (FTMH) is characterised by absence of all layers of the neurosensory retina at the anatomical fovea, and is an important cause of unilateral visual impairment in the elderly. The vast majority of FTMHs are idiopathic in nature, and typically evolve over a period of weeks to months through a series of stages, described eloquently by Gass. Successful FTMH surgery achieves anatomical closure, and foveal reapposition, with consequential visual improvement. It also suggests physiological and functional recovery of the photoreceptors. However, re-accumulation of MP following successful FTMH surgery has not, to date, been investigated. The ability of the photoreceptors to capture and stabilise L and Z following successful FTMH surgery would indicate a good degree of physiological recovery and may reflect functional outcome. PATIENTS AND METHODSThis study comprised 12 eyes of 12 patients with successful closure of idiopat...
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