PurposeTo identify patterns summarizing the retinal vascular network in the elderly and to investigate the relationship of these vascular patterns with cardiovascular history.MethodsWe conducted a population-based study, the Montrachet study (Maculopathy Optic Nerve nuTRition neurovAsCular and HEarT diseases), in participants older than 75 years. The history of cardiovascular disease and a score-based estimation of their 10-year risk of cardiovascular mortality (Heart SCORE) were collected. Retinal vascular network analysis was performed by means of Singapore “I” Vessel Assessment (SIVA) software. Principal component analysis was used to condense the information contained in the high number of variables provided and to identify independent retinal vascular patterns.ResultsOverall, 1069 photographs (1069 participants) were reviewed with SIVA software. The mean age was 80.0 ± 3.8 years. We extracted three vascular patterns summarizing 41.3% of the vascular information. The most clinically relevant pattern, Sparse vascular network, accounted for 17.4% of the total variance. It corresponded to a lower density in the vascular network and higher variability in vessel width. Diabetic participants with hypoglycemic treatment had a sparser vascular network pattern than subjects without such treatment (odds ratio, [OR], 1.68; 95% CI, 1.04–2.72; P = 0.04). Participants with no history of cardiovascular disease who had a sparser vascular network were associated with a higher Heart SCORE (OR, 1.76; 95% CI, 1.08–2.25; P = 0.02).ConclusionsThree vascular patterns were identified. The Sparse vascular network pattern was associated with having a higher risk profile for cardiovascular mortality risk at 10 years.

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Citation: Alassane S, Binquet C, Cottet V, et al. Relationships of macular pigment optical density with plasma lutein, zeaxanthin, and diet in an elderly population: the Montrachet study. Invest Ophthalmol Vis Sci. 2016;57:116057: -116757: . DOI:10.1167 PURPOSE. To investigate the association of macular pigment optical density (MPOD) with plasma lutein, zeaxanthin, and diet in an elderly population. METHODS.We conducted a population-based study, the Montrachet (Maculopathy Optic Nerve, nuTRition neurovAsCular, and HEarT disease) study, in subjects older than 75 years. The MPOD was measured by means of the two-wavelength autofluorescence technique. Plasma lutein and zeaxanthin were measured in fasting blood samples using HPLC. Food frequency consumption was assessed with self-reported food frequency questionnaires. RESULTS.Overall, 433 healthy participants (62.1% females) were included. Mean age was 82.0 6 3.6 years. Mean MPOD at 0.58 eccentricity was 0.57 6 0.25 density units (DU) and was higher in women than in men (0.59 6 0.25 vs. 0.53 6 0.25, P ¼ 0.017). The MPOD was lower in alcohol consumers than in non-alcohol consumers (0.55 6 0.25 vs. 0.61 6 0.25, P ¼ 0.016). Median plasma lutein and zeaxanthin levels were 281.4 lg/L and 20.0 lg/L, respectively, and were higher in women (P ¼ 0.010 and P ¼ 0.003, respectively). The MPOD was positively correlated with plasma lutein and zeaxanthin (r ¼ 0.10, P ¼ 0.030 and r ¼ 0.11, P ¼ 0.027, respectively). A higher consumption of squash was associated with higher plasma lutein and zeaxanthin. Adjusting for confounders and diet revealed that MPOD was weakly associated with plasma lutein in nonsmokers (b ¼ 0.11, P ¼ 0.021).CONCLUSIONS. This study suggests that plasma lutein is associated with MPOD after taking into account potential confounding factors in an elderly population.Keywords: macular pigment optical density, lutein, zeaxanthin, diet, elderly, population-based study I ncreased life expectancy is a major characteristic of modern populations. 1 However, aging has long been recognized as a risk factor for life-threatening cardiovascular and neurologic diseases; for example, and diseases impacting quality of life such as osteoporosis, dementia, and eye diseases. 2 Age-related eye diseases are a burden for the economy and a major cause of moderate to severe visual impairment and blindness. 3 Agerelated macular degeneration (AMD) has a high prevalence, up to 36% after 85 years of age for early AMD, 4 and could affect 196 million people by 2020 and 288 million by 2040.5 Several risk factors have already been identified, both genetic and environmental. 6 Oxidative stress is involved in the pathogenesis of AMD related to the retina's high consumption of nutrients and oxygen and its exposure to light. To counteract the deleterious effects of free radicals to the retina, macular pigment (MP) made up of three main carotenoids, lutein (L), zeaxanthin (Z), and meso-zeaxanthin, constitutes a barrier to blue-light damage and has antioxidant properties.7 Many epidemiological and i...