Macular pigment density in healthy subjects quantified with a modified confocal scanning laser ophthalmoscope

  • Henrike Wüstemeyer
  • Andreas Moessner
  • Cornelia Jahn
  • Sebastian Wolf
Clinical Investigation



In the industrialized world age-related macular degeneration (ARMD) is the leading cause for legal blindness beyond the age of 65 years. Recent studies indicate that the density of the macular pigment (MP) may play a central role in the development and progression of age-related maculopathy (ARM). We present results of measurements of macular pigment density (MPD) with a modified confocal scanning laser ophthalmoscope and compare macular pigment density values obtained from reflectance and autofluorescence images in healthy subjects.


A modified confocal scanning laser ophthalmoscope (Heidelberg Engineering, Heidelberg) was optimised for fundus reflectance and autofluorescence images at 488 nm and 514 nm. For autofluorescence imaging a band pass barrier filter with a short wavelength cut off at 530 nm was used. MPD maps were obtained, and MPD was evaluated within two degrees around the foveal center. In this study we included 109 healthy subjects aged from 18–75 years.


Average MPD ranged between 0.16 density units (D.U.) and 0.22 D.U. depending on the techniques used for the measurement. Using the reflectance method the mean MPD was 0.16±0.06 D.U., whereas a MPD of 0.22±0.07 D.U. resulted from autofluorescence images with the 530-nm barrier filter.


This study demonstrates the good feasibility of MPD measurements with a modified confocal SLO. In agreement with previous studies we found higher macular pigment density values calculated from autofluorescence images than from reflectance images. We could not find any differences in MPD related to age and gender. Prospective longitudinal studies to verify the influence of MPD on the development and progression of ARM are needed.


Retinal Pigment Epithelium Reflectance Image Macular Pigment Inner Limit Membrane Autofluorescence Image 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Beatty S, Boulton M, Henson D, Koh HH, Murray IJ (1999) Macular pigment and age-related macular degeneration. Br J Ophthalmol:867–877Google Scholar
  2. 2.
    Beatty S, Murray IJ, Henson DB, Carden D, Koh H, Boulton ME (2001) Macular pigment and risk for age-related macular degeneration in subjects from a Northern European population. Invest Ophthalmol Vis Sci 42:439–46PubMedGoogle Scholar
  3. 3.
    Berendschot TT, Goldbohm RA, Klopping WA, van de Kraats J, van Norel J, van Norren D (2000) Influence of lutein supplementation on macular pigment, assessed with two objective techniques. Invest Ophthalmol Vis Sci 41:3322–3326PubMedGoogle Scholar
  4. 4.
    Berendschot TT, Willemse-Assink JJM, Bastiaanse M, de Joung PTVM, van Norren D (2002) Macular pigment and melanin in age-related maculopathy in a general population. Invest Ophthalmol Vis Sci 43:1928–1932PubMedGoogle Scholar
  5. 5.
    Bernstein PS, Yoshida MD, Katz NB, McClane RW, Gellermann W (1998) Raman detection of macular carotenoid pigments in intact human retina. Invest Ophthalmol Vis Sci 39:2003–2011PubMedGoogle Scholar
  6. 6.
    Bird AC, Bressler NM, Bressler SB, Chisholm IH, Coscas G, Davis MD, de Jong PTVM, Klaver CCW, Klein BEK, Klein R, Mitchell P, Sarks JP, Sarks SH, Soubrane G, Taylor HR, Vingerling JR (1995) An international classification and grading system for age-related maculopathy and age-related macular degeneration. Surv Ophthalmol 39:367–374PubMedGoogle Scholar
  7. 7.
    Bone RA, Landrum JT, Fernandez L, Tarsis SL (1988) Analysis of the macular pigment by HPLC: retinal distribut age study. Invest Ophthalmol Vis Sci 29:843–849PubMedGoogle Scholar
  8. 8.
    Bone RA, Landrum JT, Hime GW, Cains A, Zamor J (1993) Stereochemistry of the human macular carotenoids. Invest Ophthalmol Vis Sci 34:2033–2040PubMedGoogle Scholar
  9. 9.
    Bressler NM, Bressler SB (1995) Preventative ophthalmology age-related macular degeneration. Ophthalmology 102:1206–1211PubMedGoogle Scholar
  10. 10.
    Bressler NM, Bressler SB, West SK, Fine SL, Taylor HR (1989) The grading and prevalence of macular degeneration in Chesapeake Bay watermen. Arch Ophthalmol 107:847–852PubMedGoogle Scholar
  11. 11.
    Delcourt C, Cristol JP, Tessier F, Leger CL, Descomps B, Papoz L (1999) Age-related macular degeneration and antioxidant status in the POLA study. POLA Study Group. Pathologies Oculaires Liees a l'Age Arch Ophthalmol 117:1384–90Google Scholar
  12. 12.
    Delori FC (1993) Macular pigment density measured by reflectometry and fluorometry. In: Noninvasive assessment of the Visual System. OSA Technical Digest, pp 240–243Google Scholar
  13. 13.
    Delori FC, Goger DG, Hammond BR, Snodderly DM, Burns SA (2001) Macular pigment density measured by autofluorescence spectrometry: comparison with reflectometry and heterochromatic flicker photometry. J Opts Socm Am 18:1212–1230Google Scholar
  14. 14.
    Hammond BR, Jr., Caruso-Avery M (2000) Macular pigment optical density in a Southwestern sample. Invest Ophthalmol Vis Sci 41:1492–1497PubMedGoogle Scholar
  15. 15.
    Holz FG, Pauleikhoff D (1996) Age-related macular degeneration. 2. Therapeutic approaches. Ophthalmologe 93:483–506PubMedGoogle Scholar
  16. 16.
    Kirchhof B (1997) Surgical aspects of AMD, adjuvant techniques to restore visual function after macular surgery: pigment epithelial transplantation. Opthalmologica BelgicaGoogle Scholar
  17. 17.
    Klein R, Klein BEK, Jensen SC (1997) The relation of cardiovascular disease and its risk factors to the 5-year incidence of age-related maculopathy The beaver dam eye study. Ophthalmology 104:1804–1812PubMedGoogle Scholar
  18. 18.
    Landrum JT, Bone RA (2001) Lutein, zeaxanthin, and the macular pigment. Arch Biochem Biophys 385:28–40PubMedGoogle Scholar
  19. 19.
    Landrum JT, Bone RA, Kilburn MD (1997) The macular pigment: a possible role in protection from age macular degeneration. Adv Pharmacol 38:537–556PubMedGoogle Scholar
  20. 20.
    McCarty CA, Mukesh BN, Fu CL (2001) Risk factors for age-related maculopathy. Arch Ophthalmol 119:1455–1462PubMedGoogle Scholar
  21. 21.
    Schmidt-Erfurth U, Miller JW, Sickenberg M, Laqua H, Barbazetto I, Gragoudas ES, Zografos L, Piguet B, Pournaras CJ, Donati G, Lane AM, Birngruber R, van den Berg H, Strong HA, Manjuris U, Gray T, Fsadni M, Bressler NM (1999) Photodynamic therapy with verteporfin for choroidal neovascularization caused by age-related macular degeneration: results of retreatments in a phase 1 and 2 study. Arch Ophthalmol 117:1177–1187PubMedGoogle Scholar
  22. 22.
    Snodderly DM (1995) Evidence for protection against age-related macular degeneration by carotenoids and antioxidant vitamins. Am J Clin Nutr 62 [Suppl 6]:1448S–1461SGoogle Scholar
  23. 23.
    Snodderly DM, Brown PK, Delori FC, Auran JD (1984) The macular pigment. I. Absorbance spectra, localization and discrimination from other yellow pigments in primate retinas. Invest Ophthalmol Vis Sci 25:660–673PubMedGoogle Scholar
  24. 24.
    Snodderly DM, Handelman GJ, Adler AJ (1991) Distribution of individual macular pigment carotenoids in central retina of macaque and squirrel monkeys. Invest Ophthalmol Vis Sci 32:268–279PubMedGoogle Scholar
  25. 25.
    The Eye Disease Case Control Study Group (1992) Risk factors for neovascular age-related macular degeneration. Arch Ophthalmol 110:1701–1708PubMedGoogle Scholar
  26. 26.
    Wooten BR, Hammond BRJ, Land RI, Snodderly DM (1999) A practical method for measuring macular pigment optical. Invest Ophthalmol Vis Sci 40:2481–2489PubMedGoogle Scholar
  27. 27.
    Wüstemeyer H, Jahn C, Nestler A, Barth T, Wolf S (2002) A new instrument for the quantification of macular pigment density: first results in patients with AMD and healthy subjects. Graefes Arch Clin Exp Ophthalmol 240:666–671PubMedGoogle Scholar
  28. 28.
    Young RW (1987) Pathophysiology of age-related macular degeneration. Surv Ophthalmol 31:291PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Henrike Wüstemeyer
    • 1
  • Andreas Moessner
    • 1
  • Cornelia Jahn
    • 1
  • Sebastian Wolf
    • 1
  1. 1.Klinik und Poliklinik für AugenheilkundeUniversität LeipzigLeipzigGermany

Personalised recommendations