Low macular pigment optical density is associated with manifest primary open-angle glaucoma in older women

Abstract

BackgroundLower density of carotenoids lutein and zeaxanthin (L/Z) in the macula (i.e., macular pigment) has been linked to greater risk for age-related eye disease. ObjectiveWe evaluated whether macular pigment optical density (MPOD) was associated with primary open-angle glaucoma (POAG) among older women in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2). DesignMPOD was measured with customized heterochromatic flicker photometry (cHFP) in women who attended CAREDS2 study visits (2016-2019) and CAREDS1 (2001-2004). Manifest POAG at CAREDS2 was assessed using visual fields, disc photos, optical coherence tomography, and medical records. Age-adjusted linear and logistic regression models were used to investigate the cross-sectional association between POAG and MPOD at CAREDS2, and MPOD measured 15 years earlier at CAREDS1. ResultsAmong 426 CAREDS2 participants (mean age[range]: 80 years[69-98]), 26 eyes with manifest POAG from 26 participants were identified. Glaucomatous eyes had 25% lower MPOD compared to non-glaucomatous eyes (mean[SE]): 0.40[0.05] vs. 0.53[0.01] optical density units (ODU), respectively (p=.01). Compared to MPOD quartile 1, odds for POAG were lower for women in quartiles 2-4 (Ptrend=0.01) After excluding eyes with age-related macular degeneration, associations were similar but not statistically significant (Ptrend=0.16). Results were similar for MPOD measured at CAREDS1. ConclusionsOur results add to growing evidence that low MPOD may be a novel glaucoma risk factor and support further studies to assess the utility of dietary interventions for glaucoma prevention.