Macular Degeneration and the Macuscope™ AMD is a disease with genetic, behavioral, and environmental risk factors and is without cure. Many of these risk factors appear to be related to photochemical induced and oxidative damage in the retina/RPE. Low levels of lutein and zeaxanthin in the diet have been shown to be associated with an increased risk of AMD. These are two of the three carotenoids which comprise the macular protective pigment. The third carotenoid, meso-zeaxanthin, is not a part of our diet. It is created in the center of the macula from lutein, but may be deficient due to an inability to produce it. Studies using autopsy eyes, as well as studies of AMD subjects, point to an increased risk of AMD when a person's macular protective pigment level is low. There are reasons why these associations might be expected. The macular protective pigment is only accumulated in photoreceptor axons of the central macula. They screen the vulnerable tissue below from the damaging effects of high energy blue light. Lutein, zeaxanthin, and meso-zeaxanthin are also potent antioxidants, which may be their primary function in photoreceptor outer segments. How can macular protective pigment status be measured? A new instrument, the MacuScope™, has recently become commercially available. The MacuScope™ is a "heterochromatic flicker photometer," based on a design that has evolved and proven its worth as a powerful and well validated research instrument. Through a brief test, it provides the optical density (absorbance) of the patient's macular protective pigment, a quantity that is proportional to the pigment concentration. Those whose dietary intake of green leafy vegetables is poor or non-existent invariably score low, whereas those with a high intake, including vegetarians, are higher. Once it is determined that a person's macular protective pigment level is low, what can be done? Numerous clinical studies have been conducted in which subjects with low macular protective pigment levels were given carotenoid supplements and monitored using a research version of the MacuScope™. Almost invariably, the subjects responded with macular protective pigment increases of up to 40%, in as little as 6 months. The MacuScope™ is an improvement on the research instrument, and was designed to make the test easier and faster. The patient observes a small, pulsating visual stimulus, and is asked to respond when the pulsation stops or reaches a minimum, as the operator adjusts the rate of pulsation. This is done for a central target, through the pigment, and for a peripheral target, where the pigment is not found. From the difference between the two readings, the pigment density is calculated. AMD is a devastating disease, both socially and economically. Supplementation with all three carotenoids, monitored by the MacuScope™, could have a significant impact on the prevalence of AMD.
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