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Evidence of lower macular pigment optical density in chronic open angle glaucoma
  1. Estera Igras1,
  2. James Loughman2,3,
  3. Matthew Ratzlaff1,
  4. Rónán O'Caoimh4,
  5. Colm O'Brien1,5
  1. 1Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland
  2. 2Optometry Department, School of Physics, College of Sciences and Health, Dublin Institute of Technology, Dublin, Ireland
  3. 3Faculty of Health Sciences, African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa
  4. 4James Connolly Memorial Hospital, Ophthalmology Department, Dublin, Ireland
  5. 5Department of Ophthalmology, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
  1. Correspondence to Dr James Loughman, Optometry Department, School of Physics, College of Sciences and Health, Dublin Institute of Technology, Dublin 8, Ireland; james.loughman{at}


Background/aims Macular pigment (MP) plays an important role in visual function and in the protection of the retina from oxidative damage. It is not known whether glaucoma, a progressive neurodegenerative disease of the optic nerve, is associated with alterations in MP. This study was designed to investigate the relationship, if any, between the optical density of MP optical density (MPOD) and glaucoma.

Methods 40 subjects (23 males, 17 females) with open angle glaucoma (mean age 69 ±11), and 54 normal controls (23 males, 31 females) without ocular disease (mean age 66 ±11), visual acuity (VA) >6/18, were recruited, and underwent a comprehensive eye examination including biomicroscopy, fundoscopy, Goldmann tonometry and visual field assessment, using the 24-2 SITA-fast algorithm on the Humphrey visual field analyser (II-i Series). MPOD, at 0.5° of retinal eccentricity was determined, for all subjects, using heterochromatic flicker photometry.

Results Median (IQR) MPOD for subjects with glaucoma was 0.23 (0.42) compared to 0.36 (0.44) for controls. The difference in MPOD between the glaucoma cases and controls was statistically significant (z=−2.158, p=0.031). There was no significant correlation (p>0.05) between MPOD and disease severity.

Conclusions These findings suggest that MPOD is lower in patients with glaucoma. Further investigation is needed to determine the significance of MP in glaucoma, its relationship to glare symptoms in glaucoma and to assess what role therapeutic strategies aimed at increasing MP levels could have in the management of glaucoma.

  • Glaucoma
  • Macula
  • Vision

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