Concordance of macular pigment measurements obtained using customized heterochromatic flicker photometry, dual-wavelength autofluorescence, and single-wavelength reflectance

Dennison, Jessica; Stack, Jim; Beatty, Stephen; Nolan, John M.

doi:10.1016/j.exer.2013.08.014

Cited by 54 publications

(72 citation statements)

References 72 publications

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“…Of note, the Spectralis device used in this study has been compared previously (by our group) with the Densitometer in normal healthy subjects. 23 In contrast to the current study, concordance in subjects free of retinal disease was good. 23 Possible reasons for the lack of agreement in the current study are discussed.…”

Section: Discussioncontrasting

confidence: 51%

“…This new technology uses confocal scanning laser ophthalmoscopy imaging with diode lasers to measure MP. 23,31 The 2WAF technique works on the principle of excitation of fluorophores (primarily lipofuscin) in the retina and provides a single-pass MP measurement. Fluorescence is an internal property of certain molecules (known as fluorophores) which makes them emit light when excited at certain wavelengths.…”

Section: Macular Pigment Measurementmentioning

confidence: 99%

“…A previous study from our group compared MP measurements using the Spectralis to measurements obtained using the Densitometer (which uses cHFP), and reported good concordance between the results obtained by the two devices at four different retinal eccentricities. 23 However, that previous study was performed in subjects free of retinal disease with a mean age of 49 6 13 years. 23 Therefore, to our knowledge until now, concordance between the Spectralis and the Densitometer has not been evaluated appropriately in the AMD population.…”

mentioning

confidence: 99%

“…23 However, that previous study was performed in subjects free of retinal disease with a mean age of 49 6 13 years. 23 Therefore, to our knowledge until now, concordance between the Spectralis and the Densitometer has not been evaluated appropriately in the AMD population. The current study was designed to investigate concordance between these two devices, and was done as part of the Central Retinal Enrichment Supplementation Trials (CREST), 24 a randomized double-blind clinical trial designed to investigate the impact of supplementation with the macular carotenoids (L, Z, and MZ) on visual function in healthy subjects with low MP and in subjects with early AMD (the study population used in the current investigation; CREST AMD [ISRCTN13894787]).…”

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confidence: 99%

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Concordance of Macular Pigment Measurement Using Customized Heterochromatic Flicker Photometry and Fundus Autofluorescence in Age-Related Macular Degeneration

Akuffo

Beatty

Stack

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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Citation: Akuffo KO, Beatty S, Stack J, et al. Concordance of macular pigment measurement using customized heterochromatic flicker photometry and fundus autofluorescence in agerelated macular degeneration. Invest Ophthalmol Vis Sci. 2015;56:8207-8214. DOI:10.1167/iovs.15-17822 PURPOSE. We compared macular pigment (MP) measurements using customized heterochromatic flicker photometry (Macular Metrics Densitometer) and dual-wavelength fundus autofluorescence (Heidelberg Spectralis HRA þ OCT MultiColor) in subjects with early agerelated macular degeneration (AMD).METHODS. Macular pigment was measured in 117 subjects with early AMD (age, 44-88 years) using the Densitometer and Spectralis, as part of the Central Retinal Enrichment Supplementation Trial (CREST; ISRCTN13894787). Baseline and 6-month study visits data were used for the analyses. Agreement was investigated at four different retinal eccentricities, graphically and using indices of agreement, including Pearson correlation coefficient (precision), accuracy coefficient, and concordance correlation coefficient (ccc).RESULTS. Agreement was poor between the Densitometer and Spectralis at all eccentricities, at baseline (e.g., at 0.258 eccentricity, accuracy ¼ 0.63, precision ¼ 0.35, ccc ¼ 0.22) and at 6 months (e.g., at 0.258 eccentricity, accuracy ¼ 0.52, precision ¼ 0.43, ccc ¼ 0.22). Agreement between the two devices was significantly greater for males at 0.58 and 1.08 of eccentricity. At all eccentricities, agreement was unaffected by cataract grade.CONCLUSIONS. In subjects with early AMD, MP measurements obtained using the Densitometer and Spectralis are not statistically comparable and should not be used interchangeably in either the clinical or research setting. Despite this lack of agreement, statistically significant increases in MP, following 6 months of supplementation with macular carotenoids, were detected with each device, confirming that these devices are capable of measuring change in MP within subjects over time. (http://www.controlled-trials.com number, ISRCTN13894787.)

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Section: Discussioncontrasting

confidence: 51%

Section: Macular Pigment Measurementmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Concordance of Macular Pigment Measurement Using Customized Heterochromatic Flicker Photometry and Fundus Autofluorescence in Age-Related Macular Degeneration

Akuffo

Beatty

Stack

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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“…The basic mechanism and handling of this instrument is described elsewhere. 17,18 The pupil was dilated to at least 7 mm diameter using a topical mydriatic agent. After taking autofluorescent images, a macular pigment optical density map was constructed with the prototype software.…”

Section: Observation Of the Distribution Of Macular Pigmentmentioning

confidence: 99%

Evidence of Carotenoid in Surgically Removed Lamellar Hole-Associated Epiretinal Proliferation

Obana

Sasano

Okazaki

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To determine the constituents and origin of the yellow pigment in surgically removed lamellar hole-associated epiretinal proliferation (LHEP) in patients with lamellar macular hole (LMH).METHODS. This prospective case series comprised nine eyes with LMH in patients aged 41 to 83 years. The presence of LHEP was confirmed by preoperative optical coherence tomography; the distribution of macular pigment was observed by two-wavelength fundus autofluorescence technique before and after surgery. The subjects underwent a 25-gauge vitrectomy, and the surgically removed epiretinal membranous tissue was fixed with formalin. The specimens were examined using resonance Raman microscopy, and paraffin sections were stained with antiglial fibrillary acidic protein.RESULTS. Seven cases presented with LHEP, and the presence of yellow pigment was confirmed using an operating microscope. Carotenoid-specific Raman signals with three major Raman peaks could be identified in the specimens with LHEP. These specimens were positive for glial fibrillary acidic protein staining. Using the fundus autofluorescence technique, a central defect in the distribution of the macular pigment was noted in the exact area of the lamellar hole. This type of defect was no longer visible after surgical repair of the lamellar hole.CONCLUSIONS. The constituents of the yellow pigment in the removed LHEP were carotenoids that typically originate from the macular xanthophyll pigments at the fovea. Since LHEP is reported to be composed of Müller cells, we hypothesize that xanthophyll carotenoids at the fovea are contained in the Müller cells.

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Questioning Macular Pigment Measurement Methods and Genetic Risk of Age-Related Macular Degeneration

2018

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To the Editor The article titled "Effect of Dietary Supplementation With Lutein, Zeaxanthin, and ω-3 on Macular Pigment: A Randomized Clinical Trial," by Korobelnik et al 1 has drawn conclusions that may not follow readily from the data. In specific, the finding that macular pigment (MP) does not increase in response to supplemental lutein among firstgeneration offspring of patients with neovascular age-related macular degeneration (AMD) might not be correct.In this study, 2 techniques were used to measure MP. 1 The first technique, the use of a MPD-Visucam (Carl Zeiss Meditec), has been independently discredited by multiple investigators on multiple occasions. 2,3 The investigators also used the Heidelberg Retina Angiograph to measure MP, an instrument which, to our knowledge, has not been validated and for which there are no published concordance data with readings taken with validated instruments. To measure MP with this device, the image must cover an expanse of retina that includes an anatomic site where MP is known to be optically present and an anatomic site where MP is known to be optically absent (a reference point). Measurements of MP are then calculated from the difference of the readings recorded centrally and those recorded at the reference point, in much the same way that one measures the height of a mountain against sea level and not from a point that is someway up a mountain path. Unfortunately, the reported method lacks a valid reference point; rather, it uses 6°, where MP is optically plentiful. Furthermore, MP is known to increase at 6°of eccentricity in response to supplementation, and so in this case the rising mountain peak was measured against a likewise rising mountain path, masking actual increases in MP. 4 Moreover, if 50% genetic risk for AMD precluded macular response to supplemental lutein (ie, the average genetic risk of the study cohort), surely those with 100% genetic risk (ie, patients with AMD) would also not respond to supplemental lutein? Yet we know from more than 20 peer-reviewed publications, 5 each using validated technology to measure MP, that maculae with AMD do exhibit increases in MP in response to supplemental lutein. Finally, the study did not have a profile-matched control group (ie, participants without a family history of AMD). This limitation would impede a clinically meaningful comment on the macular response to supplemental lutein in the cohort of interest.In summary, we would question the interpretation of the results of their study. We would welcome hearing how the authors would interpret their results in light of these comments.

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Concordance of macular pigment measurements obtained using customized heterochromatic flicker photometry, dual-wavelength autofluorescence, and single-wavelength reflectance

Cited by 54 publications

References 72 publications

Concordance of Macular Pigment Measurement Using Customized Heterochromatic Flicker Photometry and Fundus Autofluorescence in Age-Related Macular Degeneration

Concordance of Macular Pigment Measurement Using Customized Heterochromatic Flicker Photometry and Fundus Autofluorescence in Age-Related Macular Degeneration

Evidence of Carotenoid in Surgically Removed Lamellar Hole-Associated Epiretinal Proliferation

Questioning Macular Pigment Measurement Methods and Genetic Risk of Age-Related Macular Degeneration

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