Lower Macular Pigment Optical Density in Foveal-Involved Glaucoma

• Published in: Ophthalmology (Rochester, Minn.) Vol. 122; no. 10; pp. 2029 - 2037
• Main Authors: Siah, We Fong, MRCPI, FRCOphth, Loughman, James, FAOI, PhD, O'Brien, Colm, FRCOphth, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2015
• Subjects: Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Densitometry; Double-Blind Method; Feeding Behavior; Female; Fourier Analysis; Fovea Centralis; Glaucoma, Open-Angle - diagnosis; Glaucoma, Open-Angle - metabolism; Humans; Intraocular Pressure - physiology; Lutein - metabolism; Macula Lutea - metabolism; Macula Lutea - pathology; Macular Pigment - metabolism; Male; Middle Aged; Ophthalmology; Optic Disk - pathology; Photometry - methods; Prospective Studies; Tomography, Optical Coherence; Tonometry, Ocular; Visual Acuity - physiology; Zeaxanthins - metabolism; NTG; POAG; OCT; Humphrey visual field; ETDRS; optical coherence tomography; Fourier domain; EMM5; normal-tension glaucoma; HFP; macular pigment optical density; analysis of variance; ANOVA; MD; AMD; logarithm of the minimum angle of resolution; MPOD; age-related macular degeneration; retinal nerve fiber layer; retinal ganglion cell; MP; RNFL; GCC; macular pigment; mean deviation; ganglion cell complex; logMAR; RGC; primary open-angle glaucoma; Early Treatment Diabetic Retinopathy Study; HVF; heterochromatic flicker photometry; Enhanced Macular Map 5; FD
• ISSN: 0161-6420; 1549-4713
• DOI: 10.1016/j.ophtha.2015.06.028

Purpose To evaluate the relationship between macular pigment optical density (MPOD) and structural parameters of the macula and optic nerve head in glaucomatous eyes. Design A cross-sectional analysis of the baseline data collected during the Macular Pigment and Glaucoma Trial (ISRCTN registry number: 56985060). Participants Eighty-eight subjects (48 male, 40 female) with a diagnosis of open-angle glaucoma and a median age of 67 years (interquartile range, 13; range, 36–84 years) were enrolled in this trial. Methods The MPOD at 0.25°, 0.5°, and 1° retinal eccentricity was measured using a customized heterochromatic flicker photometry technique. Glaucoma-related structural parameters were captured using RTVue Fourier-domain optical coherence tomography (FD-OCT). Statistical significance was set at P < 0.01, and P values ranging from 0.01 to 0.05 were considered borderline significant. Main Outcome Measures The MPOD and its relationship to the macula and optic nerve head topography in glaucomatous eyes. Results The MPOD peaked centrally at 0.25° of retinal eccentricity (mean ± standard deviation, 0.23±0.14) and decreased at more peripheral eccentricities. For the overall group, borderline significant correlations were observed between MPOD and a range of topographic measures, including inferior peripapillary retinal nerve fiber layer (RNFL) thickness, inferior ganglion cell complex (GCC) thickness, foveal inner retinal thickness, cup-to-disc area ratio, and optic disc rim area. Glaucomatous eyes with GCC loss involving the foveal zone on FD-OCT imaging (n = 52) had lower MPOD at 0.25°, 0.5°, and 1° of retinal eccentricity compared with those without foveal GCC involvement ( P < 0.001, for all). Those with foveal GCC loss also had greater glaucoma severity, and this was evident by lower GCC and RNFL thickness, greater cup-to-disc area ratio, and lower optic disc rim area ( P  < 0.001 for all). Conclusions Our observations indicate that MPOD is lower in glaucomatous eyes with foveal GCC involvement relative to those without foveal involvement. A longitudinal evaluation of MPOD and structural change among patients with glaucoma is required to elucidate the nature of any causal relationship that might exist between MPOD and foveal damage in glaucoma.