Macular pigment and macular volume in eyes of patients with cystic fibrosis

Abstract

Background. Because patients with cystic fibrosis (CF) are living longer, chronic malabsorption of carotenoids associated with CF resulting in decreased macular pigment (MP) may affect macular long-term health in later-life pathology. This study compared the macular pigment optical density (MPOD) and corresponding central macular volume (MV) of adult CF subjects and age-matched normal controls subjects to determine whether chronic malabsorption associated with CF could adversely affect macular photoreceptor anatomy. Objective. Our aim was to compare MPOD with measurements of central MV in CF patients with age-matched controls. Design. In nine adult CF patients (ages: 29–46) without a history of carotenoid supplementation or known retinal or optic nerve disease MPOD and MV were measured by heterochromatic flicker photometry (HFP) and optical coherence tomography (OCT), respectively, and compared to results obtained from 14 age-matched controls. Results. MPOD was significantly reduced at 15’ and 30’ eccentricities in CF subjects compared to normal subjects (mean difference −0.21 at 15’, −0.25 at 30’, p < 0.005). No significant difference, in MV noted at any of the eccentricities tested between CF and normal subjects (CF: normal MV ratios ranged from 0.94 to 1.1 for all eccentricities with p > 0.1 at all eccentricities). Best corrected vision acuity and fundus examination were normal in all subjects. Conclusions. Unsupplemented CF patients have markedly lower levels of macular carotenoids (e.g., lutein and zeaxanthin), but well-maintained visual function and no significant reductions in central MV primarily composed of macular photoreceptors. Future studies are needed to determine whether the lifelong decrease in protective central retinal carotenoids predisposes CF patients to later-life retinal pathology.

Keywords::

• carotenoids
• cystic fibrosis
• macular pigment
• macular volume
• macular pigment optical density
• optical coherence tomography

Acknowledgments

Thanks to Jake S. Werner, PhD, of the Vision Science and Advanced Retinal Imaging Laboratory for sharing of expertise and instrumentation used and to the CF and control subjects participating in the study.

Declaration of interest

The authors report no declarations of interest. The authors alone are responsible for the content and writing of the paper.

Supported by grants from the National Center for Advanced Translational Sciences (NIH ULI TR000002), Research to Prevent Blindness and by the Cystic Fibrosis Foundation.