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Macular Pigment: Individual Variation and Protective factor from AMD?
Trieschmann M., Spital G., Jesse I., Lommatzsch A., Pauleikhoff D.,
St. Franziskus-Hospital, Augenabteilung (Münster)
Purpose: Macular Pigment (MP) reduces oxidative damage in the central retina by absorption of blue light and direct antioxidative properties. Histological studies showed a wide individual variation in the peak concentration and lateral distribution of MP. This can be confirmed in flickerphotometric analysis of MP optical density. These analyses also demonstrate a very good correlation with central absorption by MP on autofluorescent (AF) images. With these techniques variation in MP concentration and distribution can be shown and an association between early AMD and lower concentrations of MP was suggested.
Patients and Methods: AF images (HRA) were analysed in respect of the peak, radius and area of central absorption in 386 eyes Of these eyes 112 were normal eyes (12-82 years, mean 49.6y) and 174 eyes with early AMD (drusen, RPE-proliferation or atrophy, 50-89y, mean 71.1y).
Results: Four types of MP distribution (type 1 intense central and paracentral MP, type 2 less intense central and paracentral MP, type 3 only central MP, type 4 only paracentral MP) were identified and confirmed by observing peak, radius and area of central and paracentral MP (decreasing concentrations of MP type1>type2>type3>type4). Wide variation between individuals was seen in normal eyes (Type 1 67 (59,8%), Type 2 34 (30,4%), Type 3 7 (6,3%), Type 4 4 (3,6%) as well as in eyes with early AMD (Type 1 74 (42,5%), Type 2 81 (46,5%), Type 3 5 (2,9%) Typ 4 14 (8,1%)). No age correlation in the MP type distribution was found in normal eyes (p=.5). The AMD groups contained significantly more often eyes with low MP concentrations (p<.001). Low MP concentrations were especially associated with RPE-proliferation (type 4 16,7%) and atrophic spots (type 4 21,4%) (p<.01).
Conclusions: MP concentrations vary widely in the population with respect to peak concentration and distribution. A Lower MP Concentration seems to be associated with early AMD and especially RPE-proliferation and focal atrophy. The pathogenetic significance and clinical implications of these findings have yet to be identified.