van Kuijk F. J. G. M., Pauleikhoff D., Pelosini L., Bird A. C.

Moorfields Eye Hospital, City Road, EC1V 2PD, London, UK

Macular pigment was first described as a yellow spot in the centre of the human eye, and was later identified as two xanthophyll carotenoids, lutein and zeaxanthin. Lutein and zeaxanthin not only accumulate in the macula, but are also concentrated in the photoreceptor outer segments of the peripheral retina. It has been established that lower plasma values of lutein and zeaxanthin correlate with lower levels of macular pigment in the eye, and this may constitute a risk factor for developing Age Related Macular Degeneration (ARMD). The mechanism by which lutein might influence ARMD is poorly understood. It would act as a blue light filter, thus reducing oxygen radical formation in the underlying photoreceptors. Most investigations on the role of macular pigment in ARMD are based on measurement of peak optical density in the center, using psychophysical methods. These studies do not take into account the large variation in distribution of macular pigment as observed by autofluorescent imaging. Using this imaging method we were able to establish four major distribution patterns of macular pigment in human retina. The most common pattern is primarily found in normal healthy individuals, while the three other patterns appear to be more commonly associated with ARMD. Based on these observations it is postulated that the distribution pattern of macular pigment may play a role in the development of ARMD. Future studies on the role of macular pigment in ARMD may require investigation of not only the peak optical density, but also the total amount of macular pigment present, which may vary widely based on lateral density and distribution.

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