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1. Association of macular pigment optical density with retinal layer thicknesses in eyes with and without manifest primary open-angle glaucoma

Author

Steven Bailey, Zhe Liu, Yao Liu, Robert B Wallace, Elizabeth Johnson, JoAnn E Manson, Ronald Gangnon, J A Mares, Barbara E K Klein, Charles Kooperberg, Julie Mares, Barbara V Howard, Shari Ludlam, Joan McGowan, Leslie Ford, Nancy Geller, Ross Prentice, Andrea LaCroix, Marcia L Stefanick, Cynthia A Thomson, Jennifer Robinson, Barbara Blodi, Lesley F Tinker, Ann Lundquist, Heather Stockman, Amitha Domalpally, Thomas Lawler, Catherine Thuruthumaly, Tyler Etheridge, Thasarat S Vajaranant, Billy R Hammond, Marine Nalbandyan, Corinne Engelman, Gloria Sarto, Erin LeBlanc, Karen Gehrs, Lesley Tinker, D Max Snodderly, Randy Hammond, Amy Millen, Bill Wooten, Jennifer Maykoski Portland, Chris Smith Madison, Kim Wood, Jennie Perry Raymond, Iowa City, Jean Walshire, Christine Sinkey, Courtney Blomme, Kristen Hall, Diane Pauk, Esther Mezhibovsky, Krista Christensen, Jacques Rossouw Bethesda, Garnet Anderson Seattle, Rebecca Jackson Columbus, Tucson Phoenix, Jean Wactawski Wende, Gainesville Jacksonville, Lewis Kuller Pittsburgh, Sally Shumaker Winston-Salem, Robert Brunner Reno, and Mark Espeland Winston-Salem

Subjects
Ophthalmology, RE1-994
Abstract

Objective To investigate associations between baseline macular pigment optical density (MPOD) and retinal layer thicknesses in eyes with and without manifest primary open-angle glaucoma (POAG) in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2).Methods and analysis MPOD was measured at CAREDS baseline (2001–2004) via heterochromatic flicker photometry (0.5° from foveal centre). Peripapillary retinal nerve fibre layer (RNFL), macular ganglion cell complex (GCC), ganglion cell layer (GCL), inner plexiform layer (IPL), and RNFL thicknesses were measured at CAREDS2 (2016–2019) via spectral-domain optical coherence tomography. Associations between MPOD and retinal thickness were assessed using multivariable linear regression.Results Among 742 eyes (379 participants), manifest POAG was identified in 50 eyes (32 participants). In eyes without manifest POAG, MPOD was positively associated with macular GCC, GCL and IPL thicknesses in the central subfield (P-trend ≤0.01), but not the inner or outer subfields. Among eyes with manifest POAG, MPOD was positively associated with macular GCC, GCL, IPL and RNFL in the central subfield (P-trend ≤0.03), but not the inner or outer subfields, and was positively associated with peripapillary RNFL thickness in the superior and temporal quadrants (P-trend≤0.006).Conclusion We observed a positive association between MPOD and central subfield GCC thickness 15 years later. MPOD was positively associated with peripapillary RNFL superior and temporal quadrant thicknesses among eyes with manifest POAG. Our results linking low MPOD to retinal layers that are structural indicators of early glaucoma provide further evidence that carotenoids may be protective against manifest POAG.

Published
2023
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2. Reticular Pseudodrusen Characteristics and Associations in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2), an Ancillary Study of the Women's Health Initiative

Author

Spencer C. Cleland, Amitha Domalpally, Zhe Liu, Jeong W. Pak, Barbara A. Blodi, Steven Bailey, Karen Gehrs, Robert Wallace, Lesley Tinker, Julie A. Mares, Julie Mares, Barbara Blodi, Yao Liu, Corinne Engelman, Ronald Gangnon, Gloria Sarto, Erin LeBlanc, Jennifer Robinson, D. Max Snodderly, Randy Hammond, Amy Millen, Elizabeth Johnson, Bill Wooten, Jennifer Maykoski, Ann Lundquist, Chris Smith, Kim Wood, Jennie Perry-Raymond, Heather Stockman, Jean Walshire, Christine Sinkey, Thomas Lawler, Courtney Blomme, Kristen Hall, Diane Pauk, Sherri Alexander, Esther Mezhibovsky, Krista Christensen, and Marine Nalbandyan

Subjects
medicine.medical_specialty, genetic structures, Fundus Oculi, Eye disease, Visual Acuity, Retinal Drusen, Multimodal Imaging, Article, Antioxidants, Macular Degeneration, Ophthalmology, medicine, Humans, Macula Lutea, Fluorescein Angiography, Aged, Multimodal imaging, Aged, 80 and over, business.industry, Women's Health Initiative, Age-Related Eye Disease Study, Macular degeneration, medicine.disease, Prognosis, Carotenoids, eye diseases, United States, Ophthalmoscopy, Reticular pseudodrusen, Cross-Sectional Studies, Infrared reflectance, Women's Health, Female, sense organs, business, Natural history study, Tomography, Optical Coherence
Abstract

Purpose To determine the prevalence and morphologic features of reticular pseudodrusen (RPD) and their association with participant demographics and age-related macular degeneration (AMD) status in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2) sample, an ancillary study of the Women’s Health Initiative Observational Study. Design Cross-sectional, multicenter, natural history study. Participants Nine hundred and twenty-seven eyes from 466 postmenopausal women 69 to 101 years of age. Methods Multimodal imaging, including spectral-domain (SD) OCT and infrared reflectance (IR), were used to identify RPD characteristics, including location (within or outside the 6-mm diameter circle centered at the macula), presence of peripapillary RPD, pattern of RPD, and RPD area. Age-related macular degeneration features from SD OCT, IR, and color photographs also were assessed and AMD severity was categorized. Main Outcome Measures Reticular pseudodrusen prevalence using SD OCT and IR imaging and AMD status. Results Reticular pseudodrusen were present in 130 eyes (14% of eyes, 16% of participants), with increasing prevalence with age: 7% in those younger than 78 years, 14% in those 78 to 83 years of age, and 30% in those older than 83 years. Using clinical classification of AMD with color photography, RPD were seen in 2.4% of eyes with no AMD or aging changes, 11.5% in early AMD, 25.1% in intermediate AMD, and 51.1% in late AMD. Mean RPD area was 17.4 mm2 (standard deviation, 14.7 mm2). Ribbon morphologic RPD (53%) was more common than dot morphologic RPD (36%). Reticular pseudodrusen mostly were located both within and outside the 6-mm circle with primarily superior retinal distribution. Reticular pseudodrusen were visualized with corresponding color fundus photography in only 38 eyes (4% of total eyes). Participants with and without RPD had a visual acuity±standard error of 77.9 ± 1.4 letters and 81.3 ± 0.4 letters, respectively (P = 0.02). Conclusions The prevalence of RPD in CAREDS2 increased with age and was associated with AMD severity. Reticular pseudodrusen were detected in eyes without other features of AMD and could represent an earlier disease state. Multimodal imaging with SD OCT and IR has significantly greater sensitivity for visualizing RPD than color fundus photography.

Published
2020

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