Macular Pigment Optical Density. The ability to measure lutein and zeaxanthin levels in the macula is of great importance to enhance research, to provide a methodology to assess eye health and offer responsive, appropriate clinical care. Traditional laboratory methods used to measure lutein and zeaxanthin, namely high-performance liquid chromatography (HPLC), cannot be used on living eyes, so a surrogate optical indicator of xanthophyll levels in the eye is often employed: macular pigment optical density (MPOD). MPOD is a measurement of the attenuation of blue light by macular pigment and is linearly related to the amount of lutein and zeaxanthin in the macula.
- Over two dozen studies have been published demonstrating an increase in macular carotenoids following lutein/zeaxanthin supplementation of 2-30 mg per day or a high carotenoid diet1-26.
- The body of evidence from eight epidemiological studies provides support from an observational perspective that consumption of lutein and zeaxanthin from food is associated with reduced risk for AMD27-33.
- The anatomical location of macular carotenoids is ideal for them to act as an optical filter. Consistent with this, improvements in visual function and comfort parameters have been associated with lutein and zeaxanthin supplementation and subsequent increases in MPOD in close to a dozen published studies34-38,17,39,14,40-43.
- A growing body of evidence suggests a relationship between levels of macular pigment and risk of age-related eye diseases, although a direct link has not been established. Risk factors for AMD including tobacco use, light iris color, age, obesity, and gender are associated with low levels of MPOD. Additionally, five studies have shown that in eyes that have been afflicted with AMD (examined post-mortem) or eyes that have been deemed to have a higher risk for AMD (due to AMD in the fellow eye) tend to have lower MPOD than healthy eyes or eyes that are deemed to be at lower risk to AMD44-47,4.
Based up these findings there is considerable interest in incorporating methods to measure the amount of lutein and zeaxanthin in the macula to enhance research and clinical care to identify individuals at risk for visual loss from AMD.
Expert Review of the Value of MPOD Measurement
An article in an upcoming issue of Vision Research reviews the findings from a panel of experts with extensive experience in carotenoid physiology and/or macular pigment measurement48. This panel reached a consensus on the value of noninvasive macular pigment measurement as a screening tool for AMD risk based on a review of the literature and their clinical experience. The following conclusions were reached:48
- "The current body of knowledge regarding macular lutein and zeaxanthin and their roles in protection against age-related eye diseases support the hypothesis that AMD is in part a manifestation of an ocular deficiency of these molecules and that higher macular levels may protect against AMD."
- "Macular pigment measurement has the potential to become a commonly tested biomarker to measure risk for eye disease and visual function."
- Approximately, 43% of the U.S. population have what the panel considers to be "low MPOD" -- a central MPOD below 0.2 d.u.49
- "More clinical studies are necessary to more accurately define the range of MPOD values and distributions that might correlate with disease risk; however, the body of evidence that supports a link between a lack of macular pigment and AMD risk is growing."
- "Expansion of the scientific data and improvements in methodology and equipment necessary to measure MPOD levels in a diverse population will hopefully bring about a paradigm shift in way we recognize, diagnose, and treat those at risk for AMD and other age-related eye diseases."
Macular pigment measurement would enable individuals with low levels of MPOD, and possibly greater risk for eye disease, to take actions to improve their eye health such as increasing their intake of lutein and zeaxanthin through diet and/or supplementation, maintaining a healthy weight, and not smoking. 48
Review additional MPOD consensus panel conclusions in Vision Research.
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Diane E. Alexander, Ph.D. is a Technical Service Manger at Kemin Health, LC. She received her Ph.D. in Molecular Microbiology and Microbial Pathogenesis from the Washington University School of Medicine.