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Originally published In Press as doi:10.1167/iovs.07-1181 on January 25, 2008
 (Investigative Ophthalmology and Visual Science. 2008;49:2077-2081.)
© 2008 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.07-1181
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Foveal Cone-Photoreceptor Integrity in Aging Macula Disorder

Martijn J. Kanis,1 Robert P. L. Wisse,1 Tos T. J. M. Berendschot,2 Jan van de Kraats,1 and Dirk van Norren1

1From the Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands; and the 2University Eye Clinic Maastricht, Maastricht, The Netherlands.

PURPOSE. To establish the relation between AMD stage and a quantitative measure for the integrity of foveal cone photoreceptors related to the optical Stiles-Crawford effect.

METHODS. Fifty-six AMD eyes and 57 control eyes were included in the final analysis. AMD was graded in accordance with the International Classification System into five mutually exclusive stages. Stages 0 to 1 were labeled no AMD, stages 2 to 3 were labeled early AMD, and stage 4 was labeled late AMD. Fundus reflectometry, together with a model-fit procedure, provided information on directional cone reflectance (Rd), a quantitative measure for the integrity of foveal cone photoreceptors. Optical densities of macular pigment (MPOD) and melanin (MOD) were also obtained. A general linear model analysis was used to compare Rd, MPOD, and MOD among the AMD stages.

RESULTS. Mean Rd was lower in early AMD (0.92%, P < 0.001) and late AMD (0.86%, P < 0.001) compared with mean Rd in the no-AMD stage (1.76%). Mean MPOD was not different in early AMD (0.53, P = 0.05), but it was lower in late AMD (0.19, P < 0.001) compared with mean MPOD in the no-AMD stage (0.42). Mean MOD was lower in early (1.09, P = 0.001) and late (1.01, P = 0.004) AMD compared with mean MOD in the no-AMD stage (1.23).

CONCLUSIONS. Foveal cones show signs of misalignment and/or outer segment deterioration in early AMD. Melanin rather than macular pigment may play a protective role against AMD, although loss of these ocular pigments can also be caused by AMD.






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