Macular Pigment Imaging in AREDS2 Participants: An Ancillary Study of AREDS2 Subjects Enrolled at the Moran Eye Center

Abstract

PURPOSE. Age-Related Eye Disease Study 2 (AREDS2) is a randomized, placebo-controlled study designed to determine whether supplementation with 10 mg of lutein and 2 mg of zeaxanthin per day can slow the rate of progression of agerelated macular degeneration (AMD). Although some biomarkers of response to carotenoid supplementation such as serum concentrations are part of the AREDS2 protocol, measurement of carotenoid concentrations in the eye and other tissues is not. In this approved ancillary study, macular pigment optical density (MPOD), macular pigment distributions, and skin carotenoid levels at enrollment and at each annual visit were measured to assess baseline carotenoid status and to monitor response to assigned interventions.METHODS. All subjects enrolled at the Moran Eye Center had MPOD and macular pigment spatial distributions measured by dual-wavelength autofluorescence imaging and total skin carotenoids measured by resonance Raman spectroscopy.RESULTS. Baseline MPOD in enrolled subjects was unusually high relative to an age-matched control group that did not consume carotenoid supplements regularly, consistent with the high rate of habitual lutein and zeaxanthin consumption in Utah AREDS2 subjects prior to enrollment. MPOD did not correlate with serum or skin carotenoid measurements.CONCLUSIONS. Useful information is provided through this ancillary study on the ocular carotenoid status of AREDS2 participants in the target tissue of lutein and zeaxanthin supplementation: The macula. When treatment assignments are unmasked at the conclusion of the study, unique tissuebased insights will be provided on the progression of AMD in response to long-term, high-dose carotenoid supplementation versus diet alone. (ClinicalTrials.gov number, NCT00345176.) (Invest Ophthalmol Vis Sci. 2012;53:6178-6186)

The Age-Related Eye Disease 2 Study: Micronutrients in the Treatment of Macular Degeneration

“…For example, a baseline study from Utah observed that its subjects had surprisingly high MPOD levels at the baseline visit of the study, probably because of an inadequate 30-d supplementfree washout period. This finding was consistent with the observation that 70% of Utah subjects had been taking lutein and zeaxanthin supplements regularly for many years before enrollment (142). Follow-up MPOD measurements of these subjects recorded at scheduled visits every 6 mo during the study period did not provide any convincing evidence of an effect of supplementation.…”

“…No macular pigment optical density (MPOD) measurements were included in the AREDS2 protocol, because the image-based instrumentation had not been sufficiently standardized at that time. Moreover, the psychophysical methods were thought to require too much time and subject training during the very busy study visits, but an ancillary study conducted at the Utah site had the equipment and experience to measure macular pigment with dual-wavelength autofluorescence imaging (142).…”

Reflection-based imaging of macular pigment distributions in infants and children

“…This behavior is different from about five distinguishable MP distribution patterns observable in healthy adults 13,15 and AMD patients. 23 In all nine prematurely born infants, MP was found to be absent. In all these cases, a distinguished macular region could not be detected, as seen from a representative B-chip image in Fig.…”

“…The behavior is similar to the respective correlation in adult eyes. 13,15,23 While at any particular age, the peak MPOD levels can differ by about one order of magnitude between subjects, there is on average a steady linear increase of MPOD levels over the first 6 years of life, as shown in Fig. 11.…”

Novel description of macular pigment optical density spatial distribution using cHFP

“…Four discrete MP distributions have been described by Trieschman et al [5] while Bernstein et al [6] categorized five distinct MP distribution subgroups.…”