Macular Pigment Density and Age-Related Maculopathy in the Carotenoids in Age-Related Eye Disease Study: An Ancillary Study of the Women's Health Initiative
Received 22 January 2007; received in revised form 7 June 2007; accepted 8 June 2007. published online 14 September 2007.
Purpose
To examine the association between intermediate age-related macular degeneration (AMD) and the optical density of macular pigment (MPOD), which is composed of lutein and zeaxanthin from the diet.
Design
Cross-sectional cohort study.
Participants
We included 1698 of 2005 women ages 54 to 86 years and participating in the Carotenoids in Age-Related Eye Disease Study, an ancillary study of the Women's Health Initiative.
Methods
The MPOD was measured noninvasively by heterochromatic flicker photometry. Fundus photographs were taken to document prevalent AMD.
Main Outcome Measures
Intermediate AMD (n = 305) and two subtypes—large drusen (n = 233) and pigmentary abnormalities (n = 157).
Results
After adjusting for covariates, the odds ratio (OR) and 95% confidence interval (CI) for AMD among women in quintile (Q) 5 (n = 339) versus 1 (n = 340) for MPOD was 1.4 (0.9, 2.1). However, after excluding women with possible unstable diets and recent supplement use due to chronic disease history, associations reversed (OR Q2–5 vs. 1, 0.8; 95% CI, 0.5–1.2), but remained nonsignificant. Associations also differed between middle-aged (54–69 years) and older (≥70 years) women (P-interaction = 0.09), but less so, after excluding women who were likely to have unstable diets: adjusted ORs (95% CI) were 0.5 (0.3–1.0; P = 0.08) for intermediate AMD among middle-aged women (n = 516) with MPOD in Q2 to Q5 versus 1 and 1.0 (0.5–2.0; P = 0.90) for older women (n = 422).
Conclusions
The MPOD is not cross-sectionally associated with AMD. The inconsistency of relationships across age groups and in subgroups of women who are likely to have more stable diets suggests that cross-sectional associations may be biased and highlights the need to study these relationships prospectively.
Available online: September 14, 2007.
1Department of Family Medicine, University of Wisconsin–Madison, Madison, Wisconsin.
2Department of Ophthalmology & Visual Sciences, University of Wisconsin–Madison, Madison, Wisconsin.
3Department of Human Ecology/Nutritional Sciences and Institute for Neuroscience and Center for Perceptual Systems, University of Texas, Austin, Texas.
4Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon.
5Department of Psychology, Brown University, Providence, Rhode Island.
6Department of Biostatistics and Medical Informatics, University of Wisconsin–Madison, Madison, Wisconsin.
Correspondence to Julie A. Mares, PhD, Professor, University of Wisconsin, Department of Ophthalmology and Visual Sciences, 610 North Walnut Street, 1063 WARF Building, Madison, WI 53726-2336.
Manuscript no. 2007-85.
Supported by the National Heart, Lung, and Blood Institute, Bethesda, Maryland (grant nos. EY 13018, DK07665); Research to Prevent Blindness, New York, New York; and Retina Research Foundation, Houston, Texas.
The authors have no commercial or proprietary interest in the products or companies mentioned in the article.
ABSTRACT