Changes of macular pigment optical density in elderly eyes: a longitudinal analysis from the MARS study.

BACKGROUND: Macular pigment (MP) has been related to the occurrence of age related macular degeneration (AMD). We investigated prospectively in eyes of elderly individuals how magnitude and spatial distribution of MP had changed after 4 years.

METHODS: The study included 380 eyes from 237 participants of the Münster Ageing and Retina Study cohort which were free of advanced stages of AMD. MP optical density (MPOD) was measured in density units (D.U.) at eccentricities of 0.25°, 0.5°, 1.0° and 2.0° from the fovea using dual-wavelength autofluorescence; ring-like MP distributions were identified from MP density profiles. Changes were assessed with mixed linear models.

RESULTS: The study participants' mean age at baseline was 70.5 years. Early AMD was present in 150 study eyes (39.5 %) and a ring-like distribution of MPOD was found in 87 study eyes (22.9 %). After a median follow-up time of 3.96 years, the MPOD averaged over all eyes was slightly raised at the central fovea (from 0.658 to 0.670 D.U. (relative change +1.8 %), p = 0.08) and most markedly at 2.0° (from 0.157 to 0.172 D.U. (+9.5 %), p < 0.001). Multivariate analyses, adjusting for sex, body mass and carotenoid supplement intake, revealed that MPOD increments, at any distance from the fovea, were slightly less pronounced in older eyes. Serum concentrations of lutein at follow-up, presumably reflecting recent intake of antioxidant supplements, raised MPOD levels significantly at 1.0° and 2.0° (both p < 0.01) but not in the central fovea. Early AMD at baseline and ring-like MPOD distribution did not significantly impact on MPOD changes over time. A ring-like spatial distribution of MPOD persisted in over 80 % of the affected eyes.

CONCLUSIONS: Overall, the magnitude and spatial arrangement of MPOD was remarkably stable over time in elderly eyes. Significant MPOD rises in perifoveal regions probably indicate effects of lutein containing supplements. The persistence of ring-like MPOD distributions over time seems to suggest their determination by anatomical structures.