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Macular pigment is associated with glare-affected visual function and central visual field loss in glaucoma
  1. We Fong Siah1,
  2. Colm O’Brien1,2,
  3. James J Loughman3,4
  1. 1 Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland
  2. 2 School of Medicine, University College Dublin, Dublin, Ireland
  3. 3 School of Physics, Clinical and Optometric Sciences, College of Sciences and Health, Dublin Institute of Technology, Dublin, Ireland
  4. 4 Faculty of Health Sciences, African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa
  1. Correspondence to We Fong Siah, Mater Misericordiae University Hospital, Dublin 7, Ireland; wefong_siah{at}


Aim To evaluate the relationship between macular pigment optical density (MPOD) and glare disability in open-angle glaucoma.

Methods A cross-sectional analysis of baseline data (88 subjects; median age, 67 (range 36–84) years) collected during the Macular Pigment and Glaucoma Trial (ISRCTN registry number: 56985060). MPOD at 0.25°, 0.5° and 1° of retinal eccentricity was measured using customised heterochromatic flicker photometry. Mesopic contrast sensitivity with glare (mCSg), photostress recovery time (PRT) and self-reported glare symptoms were evaluated. Fourier-domain optical coherence tomography was used to analyse ganglion cell complex (GCC) and identify foveal involvement.

Results Low spatial frequency (f) mCSg was significantly correlated with MPOD at 0.25°(3 cycles per degree (cpd): r=0.25, p=0.04) and 0.5° (3 cpd: r=0.23, p=0.04) of retinal eccentricity. Those with foveal GCC loss exhibited lower MPOD, had worse low spatial fmCSg (1.5 cpd and 3 cpd, p=0.02 each) and prolonged PRT (p=0.02) in comparison with those without foveal involvement. The depth of central 10° field loss was related to MPOD at all eccentricities (p<0.01 for all). Those who reported glare symptoms had a significantly lower MPOD at all retinal eccentricities (0.25° and 1°: p=0.05 each; 0.5°: p=0.04), including those with foveal involvement (0.25°: p=0.05; 0.5°: p<0.01; 1°: p=0.01).

Conclusions Macular pigment level may be an important consideration among those experiencing disability glare in glaucoma, including those with foveal involvement.

Trial registration number ISRCTN56985060, Post-results.

  • glaucoma
  • macula
  • field of vision
  • psychophysics

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  • Contributors Research design: all authors. Data acquisition and/or research execution: WFS. Data analysis and/or interpretation and manuscript preparation: all authors.

  • Funding Howard Foundation.

  • Competing interests None declared.

  • Ethics approval Ethics approval was obtained from the local institutional review boards of the Mater Misericordiae University Hospital, Dublin and the Dublin Institute of Technology.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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