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1 From the Department of Psychology, University of Georgia, Athens, Georgia; and 2 Vision Science Laboratory, Arizona State University West, Phoenix, Arizona.
| Abstract |
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METHODS. Macular pigment optical density was measured psychophysically using a 1°, 460-nm test stimulus. Personal data were collected using a questionnaire.
RESULTS. 217 subjects (79 men, 138 women) were recruited from the Phoenix metropolitan area (age range = 1792 years). The average macular pigment density was 0.22 ± 0.13. There was a slight tendency for macular pigment density in this sample to decline with age (r = -0.14, P < 0.02). Average macular pigment density was significantly lower in women versus men (P < 0.05), lower in individuals with light-colored irises versus dark-colored irises (P < 0.009), and lower in heavy smokers compared to light (P < 0.0045) and never (P < 0.034) smokers.
CONCLUSIONS. Macular pigment density was lower than average levels obtained from the Northeast but similar to average values obtained in a recent study of adults recruited from Indianapolis. Consistent with past studies, MP density was 13% lower in women and 18% lower in individuals with light- versus dark-colored irises. The relation of smoking to macular pigment density was only significant for those current smokers who smoked more than 10 cigarettes per day (about a 25% reduction). The large number of individuals in this sample with low macular pigment density motivates the need for population-based assessment of the possibly poor nutritional state of the average Americans retina.
| Introduction |
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The other main functional hypothesis for MP is based on the possibility that the pigments improve visual resolution. The "acuity hypothesis" proposes that MP improves acuity by absorbing short-wave light, which is easily scattered and poorly focused.12 The acuity hypothesis is based on the problem that the optics of the eye create rather severe chromatic aberrations in the very spectral region that MP maximally absorbs (ca. 400490 nm).13 The possibility that MP improves visual performance is consistent with preliminary data showing that supplementing the MP carotenoid lutein (L) may improve visual function. For example, Zorge et al.14 recently reported that L supplements significantly improved visual function (e.g., acuity) in 20 patients with congenital retinal degenerations, such as retinitis pigmentosa. Similarly, Richer15 has shown that dietary supplementation of patients with AMD (n = 14) caused dramatic improvements in a number of visual function tests (e.g., 92% had significant improvements in contrast sensitivity). Richer supplemented using 5 ounces of spinach, which he suggested increased the patients MP density,16 leading to the improvements in visual function. Such studies have not addressed whether MP is improving the optics of the eye (the acuity hypothesis) and/or treating the underlying disease (the protection hypothesis). No direct empiric test of whether MP actually improves acuity is yet available.
Based on the available evidence, it is reasonable to conclude that MP does serve some function within the eye rather than simply being an imperfection in the eyes optics. Thus, the fact that MP density varies so dramatically between individuals is also meaningful. If this premise is correct, then information regarding "average" levels of MP density in the general population is needed. Although a number of large epidemiologic studies are available showing average levels of dietary carotenoid intake17 18 and blood levels of lutein and zeaxanthin,19 few large studies are available showing variation in retinal carotenoid levels within the normal population. The lack of a representative database is at least partially due to the advanced optics required to measure MP in the traditional manner (e.g., Maxwellian view optical systems). This has limited study of the MP carotenoids to smaller samples that may not be representative of the larger population. The recent availability of simplified optics for measuring MP in natural view20 has provided the means for larger studies on MP density to be conducted. In the present study, we report MP density in a large urban sample recruited from the Southwest region of the United States.
| Methods |
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Measurement of MP Optical Density
MP optical density was measured psychophysically using flicker
photometry (for a review of this procedure and the underlying
assumptions, see Snodderly and Hammond21
). Only the right
eye of each subject was measured. A circular test stimulus was
presented near the center of a 6°, 1.5 log Td, 470-nm circular
background. The size of the test stimulus was 1°. We also measured MP
density in some subjects (n = 171) with a 2° test and a
2° annular field to check within-session consistency (as described
more fully later). The wavelength composition of the test stimulus
alternated between a 460-nm measuring field (peak MP absorbance) and a
570-nm, 1.7 log Td reference field (minimal MP absorbance). The
measuring and reference fields were superposed and presented out of
phase at an alternation rate of 11 to 12 Hz in the foveal condition and
6 to 7 Hz in the parafoveal condition. Subjects adjusted the radiance
of the 460-nm measuring field to achieve minimal flicker with the 570
nm reference. This measurement was done in the fovea (where MP is the
most dense) and 4° in the parafovea (where light absorption by MP is
negligible).22
23
A tiny (5 minute) opaque fixation point
was located on the left edge of the background and subjects fixated
this point when making the parafoveal measurement. Subtracting the
foveal from the parafoveal log sensitivity measurement yields an
optical density measure of MP.
Light for the 10° background was produced by three LEDs (packed tightly in a triangular array) with peak energy at 470 nm and half-widths of approximately 20 nm. Light for the 570-nm reference field was produced by an LED with peak energy at 570 nm (half-width = 20 nm). Light for the 460 nm measuring field was produced by two LEDs with peak energy at 458 nm (half-width = 20 nm). Light from the LED sources was collimated with planoconvex lenses and was then passed through polycabonate diffusers (high-efficiency, holographic type; Physical Optics Co., Torrance, CA), which served essentially as back projection screens.
The size of the background and test stimulus was defined by circular apertures (constructed by computer-generated images exposed on high-density, photographic mylar film) placed after the collimating lenses. The background and test stimuli were then combined and reflected to the subject by a 2-inch beamsplitter whose front surface was located 16 inches from the subjects eye. The entire optical system was contained in a rectangular, black Plexiglas box. One side of the box contained a one-inch hole centered on the subjects optical axis through which the stimulus could be viewed. Head alignment was accomplished by the use of an adjustable head and chin rest assembly and, when properly aligned, the subject viewed the hole in the box as slightly larger and concentric with the background field.
Stimuli were calibrated using a photocell (PIN-10, UDT Sensors, Inc., Hawthorne, CA). The LEDS were driven by a constant current power supply. Radiance variation was achieved by varying the frequency of a 1.5-msec pulse over a range of 300 to 300,000 Hz. Our calibration of the high-frequency pulse rate shows that the frequency delivery is nearly perfectly proportional to the radiance output. Thus, MP density values could be derived by simply calculating the log ratio of the frequencies of the 460-nm measuring field at the foveal and parafoveal eccentricities, respectively.
The apparatus used for the MP measurement delivered the stimulus in natural view, but used a stimulus configuration that was similar to configurations used in past studies, where the stimulus was presented in Maxwellian view.8 9 10 11 16 22 24 Recent data on 32 subjects (age range = 1660 years) has shown, however, that MP density measured in natural view and with slight differences in stimulus configuration (e.g., this study used a 4° rather than a 6° parafoveal reference) provides the same values as MP measured in Maxwellian view (range of MP values = 0.00.60).20 As an additional check, we measured the MP density of two highly experienced investigators using the Maxwellian systems in Boston8 11 16 and Phoenix20 and the natural view optical system used in the present study in Phoenix and a similar system in Indianapolis.25 The different systems yield the same values at the different sites (0.40 ± 0.05 and 0.64 ± 0.03).
Given the reliability of the MP measurement technique,22
we elected to limit subject assessment to only one experimental
session. Eight subjects, however, with no previous experience with
psychophysical tasks, were measured in 10 separate sessions spaced over
2 to 4 weeks to check the reliability of our current instrument. The
range of MP values across experimental sessions was 0.07 for the best
subject and 0.27 for the worst subject (average range = 0.166).
The values had strong central tendencies, however, and were reliable
(Cronbachs
= 0.97).
Because the spatial density distribution of MP is well known,22 26 subject accuracy can be checked by changing the spatial configuration of the stimulus and checking the resultant value against the known spatial density distribution of the pigments. To this end, we measured MP density using a 2° solid test field and a 2° annulus (see Table 1 ). Past work22 has suggested that MP density declines exponentially when it is measured at increasing distances from the center of the fovea. Consistent with this prediction, the average MP density at 2° (0.13) is what would be predicted based on the average MP density value at 1° (0.22). The edge hypothesis24 predicts that when MP density is measured using flicker photometry that the derived optical density value is largely determined at the edge of the flickering test stimulus rather than averaged across the entire test field. Although the average MP density obtained with the 2° annulus (0.10) was slightly lower than the value obtained with the solid 2° field (0.13), the correlation was high (n = 171, Y = 0.007 + 0.71X, r = 0.80). Consistent with past studies,22 these analyses suggest that the technique we used for measuring MP density provided reliable data.
Statistics
Results are expressed as mean ± SDs. P values for
inferential statistics were calculated using a one-tailed,
independent-groups Students t-test. Relationships were
analyzed using Pearson product moment correlational coefficients.
| Results |
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| Discussion |
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One limitation of the present study is that the reference for the MP measurement was obtained at a retinal eccentricity of 4°. Some preliminary data27 have suggested the possibility that MP might have a secondary spatial density peak at 4° in older individuals with high MP density (The Indianapolis population is not subject to this possible artifact because only subjects younger than 50 years were tested). This possibility is consistent with the age-related decline we found in MP density. Because the average MP density of individuals less than 50 years (n = 149, 0.229 ± 0.12) was only slightly lower (11%) than the average MP density of individuals more than 50 years (n = 68, 0.204 ± 0.148), any underestimation is probably small.
Similar to past studies,8 9 10 we found lower MP density in women compared to men (13%) and lower MP densityin subjects with light-colored irises compared to subjects with dark-colored irises (18%). We did not find a relationship between light smoking (>10 cigarettes per day) and MP density. Heavier smokers, however, did have significantly less MP density (approximately 25%) than either light smokers or never smokers. In contrast to earlier studies,8 9 10 all the relationships we found in this study were muted, probably because of the relatively low average MP levels within this population. No factor can deplete MP if an individual has no MP to deplete. Moreover, it is possible that depletion of MP is not linear and differs between subjects (similar to increases in MP in response to dietary supplementation).16 For example, equal exposure to a negative factor might lower MP density more in individuals with high MP levels compared to low MP levels.
For individuals with an average MP optical density of 0.22, 70% of the light at 460 nm is reaching the vulnerable outer segments of their macular cones. In contrast, we have measured individuals with MP density exceeding one log unit, which translates to only 2% to 3% of this damaging short-wave light reaching the cones. It is likely that this type of difference, considered over time, would produce meaningful differences in the aging of an individuals retina. This may be particularly meaningful in areas such as Arizona, where annual light levels are so high. Recent data11 comparing younger and older individuals suggests that to retard age-related loss of retinal sensitivity (measured as isolated sensitivity to short-wave light), MP density should be at least twice as high as the average in the present sample. Data from the US Department of Agriculture17 18 on dietary intake of fruits and vegetables indicate that the most frequently ingested fruits and vegetables in the United States contain little L and zeaxanthin. Future efforts should be directed toward increasing individuals intake of carotenoid-rich foods such as spinach.28
| Footnotes |
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Submitted for publication August 5, 1999; revised November 2 and November 30, 1999; accepted December 9, 1999.
Commercial relationships policy: N.
Corresponding author: Billy R. Hammond, Jr., Department of Psychology, Franklin College of Arts and Sciences, Psychology Building, University of Georgia, Athens, GA 30677. bhammond{at}egon.psy.uga.edu
| References |
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