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D Pauleikhoff

Publications and source records attributed to D Pauleikhoff.

At least 19 recordsLinked to original sources
PubMed2006

Comparison of two acrylic intraocular lenses with different haptic designs in patients with combined phacoemulsification and pars plana vitrectomy.

PURPOSE: The intra- and postoperative characteristics of two foldable single-piece intraocular lenses (IOL) with identical hydrophilic acrylic material, but different haptic designs (Akreos Adapt and Akreos Fit), were compared in combined phacoemulsification and pars plana vitrectomy (PPV). METHODS: This was a prospective, randomized study in patients with simultaneous cataract and vitreoretinal surgery. Group A (n=47 patients) included implantation of Akreos Fit IOL (two-point haptic) and group B (n=46 patients) implantation of Akreos Adapt IOL (four-point haptic). All intraoperative modifications of small-incision phacoemulsification and three-port PPV and IOL implantation and centration were documented. At 1 and 2 days and 6 months after surgery, best-corrected visual acuity (BCVA), slit-lamp appearance (including inflammation, IOL centration, capsulorhexis diameter, posterior capsule opacification (PCO), tonometry, and fundus findings were evaluated. RESULTS: The groups did not differ with respect to age, surgical indications and modifications, intraoperative IOL handling, and centration. At day 2, inflammation and capsulorhexis diameters were similar, but IOL decentration was slightly more frequent with Akreos-Fit IOLs. Six months after surgery, the rates of PCO, posterior synechiae, and BCVA were similar. Akreos-Fit had slightly smaller capsulorhexis diameters and slightly more capsular contraction and IOL decentration (P>0.05). CONCLUSIONS: Both of the Akreos IOL are feasible for combined phacoemulsification and PPV. Although similar in intraoperative handling, BCVA, and PCO, IOL centration was slightly better with Akreos-Adapt than with Akreos-Fit after combined surgery.

Aged↗
PubMed2006

Macular pigment optical density measurement in autofluorescence imaging: comparison of one- and two-wavelength methods.

BACKGROUND: Measurement of macular pigment (MP) can be performed by analysis of autofluorescence (AF) images. These can be obtained by standard 488-nm argon-imaging alone (one wavelength, 1-Lambda) or with additional digital subtraction of a second image at 514 nm (two wavelengths, 2-Lambda). The analyses are easy to perform, and we present a comparison of both methods and investigate their reliability and repeatability. METHODS: Inter-individual variability of MP optical density (MPOD) measurements was assessed in single eyes of 120 subjects with a modified Heidelberg retina angiograph (HRA). MPOD values obtained with one (488 nm) Lambda (MPOD(1Lambda)) were compared with those obtained with two (488 nm and 514 nm) Lambda (MPOD(2Lambda)). To test the repeatability of the two methods, 20 subjects were subjected to five repeated measurements. RESULTS: Among 120 individuals, mean MPOD(1Lambda) at 0.5 degrees eccentricity was 0.59 (range 0.06-1.32), mean MPOD(2Lambda) was 0.5 (range 0.01-1.21). Apart from this systematic difference, 1-Lambda and 2-Lambda measurements at 0.5 degrees agreed well across the range of MPOD values (beta=0.964, around the fovea, a systematic difference (0.11) was accompanied by declining agreement at higher MPOD values (beta=0.669, 95% CI 0.519-0.844; R=0.48). Among 20 subjects with five repeated measurements, the reliability ratio was 0.97 for 1-Lambda and 0.94 for 2-Lambda at 0.5 degrees and 0.93 and 0.94, respectively, at a distance of 2 degrees. CONCLUSIONS: Both methods showed a high repeatability with little influence of measurement error. They agree well at the fovea centre in terms of ranking individuals according to their MPOD, but provide increasingly deviating results at a distance of 2 degrees around the fovea, probably because the 1-Lambda method, in contrast to the 2-Lambda method, cannot compensate for disruptive influences and for heterogeneous distributions of the lipofuscin fluorophores. The 1-Lambda method can be performed by standard HRA and could therefore be used for screening in multicentre studies, but only approaches the actual amounts of MP. The 2-Lambda method remains the more precise method for MPOD measurement in autofluorescence imaging.

Adult↗
PubMed2006

Evolving European guidance on the medical management of neovascular age related macular degeneration.

BACKGROUND: Until recently, only two options were available for the treatment of choroidal neovascularisation (CNV) associated with age related macular degeneration (AMD)-thermal laser photocoagulation and photodynamic therapy with verteporfin (PDT-V). However, new treatments for CNV are in development, and data from phase III clinical trials of some of these pharmacological interventions are now available. In light of these new data, expert guidance is required to enable retina specialists with expertise in the management of AMD to select and use the most appropriate therapies for the treatment of neovascular AMD. METHODS: Consensus from a round table of European retina specialists was obtained based on best available scientific data. Data rated at evidence levels 1 and 2 were evaluated for laser photocoagulation, PDT-V, pegaptanib sodium, and ranibizumab. Other treatments discussed are anecortave acetate, triamcinolone acetonide, bevacizumab, rostaporfin (SnET2), squalamine, and transpupillary thermotherapy. RESULTS: PDT-V is currently recommended for subfoveal lesions with predominantly classic CNV, or with occult with no classic CNV with evidence of recent disease progression and a lesion size <or=4 Macular Photocoagulation Study (MPS) disc areas (DA). The new classes of anti-angiogenic agents-namely, pegaptanib sodium and ranibizumab (the latter when peer reviewed phase III data become available) are recommended for subfoveal lesions with any proportion of classic CNV or occult with no classic CNV. For juxtafoveal classic CNV, PDT-V or anti-angiogenic therapy should be considered if the new vessels are so close to the fovea that laser photocoagulation would almost certainly extend under the centre of the foveal avascular zone. For all other well demarcated juxtafoveal lesions and for extrafoveal classic lesions, laser photocoagulation remains the standard treatment. Therapy should be undertaken within 1 week of the fluorescein angiogram on which the clinical decision to treat is based. At each follow up, fluorescein angiography should be performed and best corrected visual acuity measured as a minimum requirement. CONCLUSIONS: These recommendations provide evidence based guidance for the choice and use of non-surgical therapies for the management of neovascular AMD. Revisions of the recommendations may be required as new data become available.

Antibodies, Monoclonal↗
PubMed2005

[Association between classic cardiovascular risk factors and age-related maculopathy (ARM). Results of the baseline examination of the Münster Aging and Retina Study (MARS)].

BACKGROUND: Epidemiological studies have reported inconsistent associations between cardiovascular risk factors and the occurrence of age-related maculopathy (ARM). METHODS: In the baseline examination of the Muenster Aging and Retina Study (MARS), we assessed this potential relationship in 1060 subjects who underwent clinical and ophthalmologic examinations. The ARM status was graded according to international standardized classifications. RESULTS: There were 974 eye pairs available for analysis. Smoking, hypertension, hypercholesterolemia, and a history of myocardial infarction or stroke were found significantly more often in patients with ARM. There were no statistically significant multivariate associations between overweight, diabetes, or a history of myocardial infarction or stroke. CONCLUSIONS: Our results confirm previous epidemiological studies pointing to a potential role of atherosclerotic processes in the development of ARM.

Aged↗
PubMed2005

[The Position of the Retinological Society, the German Ophthalmological Society and the Professional Association of Ophthalmologists--comments on the current therapy for neovascular AMD].

BACKGROUND: Until recently, only two options were available for the treatment of choroidal neovascularization (CNV) due to age-related macular degeneration (AMD): laser photocoagulation and photodynamic therapy (PDT) with verteporfin. However, potential new treatments for CNV are under development, and data from phase III clinical trials are now available. Referring to these data, expert guidance is required to supply ophthalmologists with expertise in the management of AMD to select and use the most appropriate therapies in the treatment of neovascular AMD. METHODS: The therapeutic modalities discussed include thermal laser photocoagulation, PDT with verteporfin, triamcinolone acetonide and the possible combination with PDT, anecortave acetate, pegaptanib sodium and ranibizumab. After a short description of the treatment principles, a summary of the discussion of all relevant study results of the different treatment options with respect to the different subtypes of neovascular AMD is presented. These discussions resulted in an "up-to-date" recommendation of therapeutical strategies in neovascular AMD. RESULTS: For subfoveal lesions with predominantly classic CNV, or with occult with non-classic CNV and a lesion size < or = 4 macular photocoagulation study (MPS) disc areas (DA), PDT with verteporfin is recommended; for subfoveal lesions with minimally classic CNV, treatment with PDT or pegaptanib sodium is possible, even if there are some problems with the statistics in the studies with both treatment modalities. PDT with verteporfin should be considered for juxtafoveal lesions that are so close to the fovea that laser photocoagulation would almost certainly extend under the center of the foveal avascular zone, and for all other juxtafoveal lesions and for extrafoveal lesions laser photocoagulation is suggested. Therapy should be performed not later than one week after the initial fluorescein angiogram upon which the clinical decision for treatment is based. At each follow-up best-corrected visual acuity and a fundus examination should be performed as well as a fluorescein angiography every three months. CONCLUSIONS: These recommendations provide good clinical guidance for the choice and use of laser and pharmacotherapies for the management of CNV due to AMD. Revisions of the recommendations will be required as new data become available.

Choroidal Neovascularization↗
PubMed2005

[Visual function and quality of life in patients with age-related maculopathy: results of the Münster Age and Retina Study (MARS)].

BACKGROUND: The aim of this study was to examine the association between increasing severity of age-related maculopathy (ARM) stages, visual function and quality of life. METHODS: Using the 25-item version of the National Eye Institute Visual Function Questionnaire (NEI VFQ) in the Münster age and retina study (MARS), 974 patients (normal fundus: n = 208; early ARM: n = 466; late ARM: n = 300) with bilateral gradable fundus photographs were asked about their visual function and quality of life. The NEI VFQ scales with regard to general health, general vision, near vision, distance vision and peripheral vision were assessed. According to the ARM stages, age- and gender-adjusted mean scores were calculated and tested for statistically significant differences. RESULTS: The perception of general health, general vision, near vision, distance vision and peripheral vision was getting worse with increasing severity of ARM stages. Comparing the maculopathy groups, significant differences in age- and gender-adjusted mean scores were found between patients with late ARM and healthy subjects and patients with late and early ARM. Furthermore, we observed for the dimension general vision a significant difference of the mean score between early ARM and healthy control group [mean score; early ARM: 68.7 (0.7) vs. control group: 72.2 (1.1); p = 0.005]. CONCLUSIONS: The results of the NEI VFQ reflect the clinical expectation of an inverse relation between increasing severity of ARM stages and visual function and quality of life.

Age Factors↗
PubMed2005

Classification of abnormal fundus autofluorescence patterns in the junctional zone of geographic atrophy in patients with age related macular degeneration.

AIM: To describe and classify patterns of abnormal fundus autofluorescence (FAF) in the junctional zone of geographic atrophy (GA) in patients with age related macular degeneration. METHODS: Digital FAF images were recorded in 164 eyes of 107 patients using a confocal scanning laser ophthalmoscope (cSLO; excitation 488 nm, detection above 500 nm) as part of a prospective multicentre natural history study (FAM Study). FAF images were obtained in accordance with a standardised protocol for digital image acquisition and generation of mean images after automated alignment. RESULTS: Image quality was sufficient for classification of FAF patterns in 149 eyes (90.9%) with lens opacities being the most common reason for insufficient image quality. Abnormal FAF outside GA in 149 eyes was classified into four patterns: focal (12.1%), banded (12.8%), patchy (2.0%), and diffuse (57.0%), whereby 12.1% had normal background FAF in the junctional zone. In 4% there was no predominant pattern. The diffuse pattern was subdivided into four groups including reticular (4.7%), branching (27.5%), fine granular (18.1%), and fine granular with peripheral punctate spots (6.7%). CONCLUSIONS: Different phenotypic patterns of abnormal FAF in the junctional zone of GA can be identified with cSLO FAF imaging. These distinct patterns may reflect heterogeneity at a cellular and molecular level in contrast with a non-specific ageing process. A refined phenotypic classification may be helpful to identify prognostic determinants for the spread of atrophy and visual loss, for identification of genetic risk factors as well as for the design of future interventional trials.

Aged↗
PubMed2004

[Münster age- and retina study (MARS). Association between risk factors for arteriosclerosis and age-related macular degeneration].

BACKGROUND: The association between arteriosclerosis and age-related macular degeneration (AMD) has only been examined in a few studies and the data is still very inconsistent. METHODS: A cross sectional study was initiated with 730 patients from the Münster age and retina study (MARS) which examines patients in the age range 60 to 80 years old who were referred by ophthalmologists from the Muenster area. Patients with narrow angle glaucoma were excluded. All patients underwent a standardized ophthalmoscopic examination und were classified into four groups: group 1 without AMD ( n=190), group 2 with unilateral or bilateral early forms of AMD ( n=340), group 3 with unilateral late forms of AMD ( n=139) and group 4 with bilateral late forms of AMD ( n=50). By means of these groups it was tested if there was a significant difference between the different risk factors for arteriosclerosis. RESULTS: The mean age was 72 years and 58% were women and the sex distribution within the different groups did not differ significantly (all trend tests with p>0.1). General risk factors for arteriosclerosis such as diabetes, body-mass-index and hypertension did not differ significantly (all trend tests with p>0.1). The number of smokers increased significantly with the severity of AMD ( p=0.02). Furthermore, various lipids were examined, adjusted for age and sex and showed significant decrease of HDL ( p=0.087) and significant increases of the HDL/LDL quotient ( p=0.0007) and the non-sober triglyceride values ( p=0.0058) correlated with the severity of AMD. CONCLUSIONS: There was a highly significant, direct association of indicators of dyslipidemia such as increasing HDL/LDL quotient and decreasing HDL with the severity of AMD. These results were underlined by increased triglyceride levels even if they were taken non-sober. The results must be interpreted with caution due to the explorative character of the evaluation.

Age Distribution↗
PubMed2004

[Retinal ICG-accumulation after ILM-staining during macular hole surgery?].

BACKGROUND: In earlier animal studies retinal accumulation of ICG after intravitreous application with subsequent transport to the optic nerve could be observed. In order to evaluate the possible retinal accumulation of ICG after ILM staining during macular hole surgery and to examine the potential changes in optic nerve function, a prospective study was initiated. METHODS: In 20 patients with macular holes grade 3, vitrectomy with ICG staining of the ILM (0.3 ml of a 1:10 diluted ICG solution under air), consecutive ILM peeling, and finally gas tamponade were performed. Preoperatively and 2, 4, 8, 12, and 24 weeks after vitrectomy, all patients underwent normal ophthalmological examination, native ICG picture, VEP examinations, and central visual field examination. RESULTS: Retinal ICG accumulation in the area of the macular hole, in the retinal axons at the temporal arcades, and around the optic disc could be observed in all 20 patients. This staining with ICG was progressively transformed towards the optic disc at the 4- and 8-week examinations. At the 12-week examination, ICG staining around the optic disc was still visible in all patients. The function of the optic nerve (VEP) demonstrated only minor changes during follow-up, and in the visual field examinations no peripheral changes could be observed. CONCLUSIONS: After ILM staining with ICG during macular hole surgery even with highly diluted ICG solutions an accumulation of ICG in the retinal ganglion axons was observed. This accumulation was visible shortly after surgery at the macular hole, temporal arcades, and the optic disc. The predominant staining of ICG at the optic disc during follow-up can be interpreted as transport of the accumulated ICG in the retinal axons and optic nerve. There seem to be no functional implications for optic nerve function and visual field examinations.

Female↗
PubMed2004

[Photodynamic therapy in AMD. Strategy for indication].

In recent years several prospective studies have dealt with the therapeutic possibilities of PDT. In consideration of lesion size and its composition, a subtly differentiated scheme of therapy has been developed. Based on essential studies, recommendations on the indication for photodynamic therapy are summarized. They are complemented by references to safety and efficacy of photodynamic therapy. Users of PDT are given a short summary of relevant studies with current recommendations, which might ease the daily procedure of indicating photodynamic therapy.

Choroidal Neovascularization↗
PubMed2003

Macular pigment: quantitative analysis on autofluorescence images.

BACKGROUND: Macular pigment (MP) reduces oxidative damage in the central retina and can be quantified by flicker-photometric analysis (HFP) of MP optical density. These analyses demonstrate a very good correlation with central absorption by MP on autofluorescence (AF) images. With these techniques different types of MP-distribution have been described. In the present study a quantification analysis of MP in AF images was developed to verify these MP types and to compare MP distribution patterns between healthy individuals and those with age-related macular degeneration (AMD). METHODS: AF images (HRA) were analysed with respect to the area of central and paracentral absorption in 400 eyes with a computerised analysis program of MP optical density. The patients were between 41 and 90 years old (mean 67.2 years); 168 were male and 232 female, and 253 had early AMD and 147 showed no AMD characteristics. The central MP concentrations (peak) were measured, the amount of MP values within the first 8-pixel radius ("C"), the total amount of MP within a 120-pixel radius ("T") were calculated as the volume of the MP values over the regarded radius and the C/T ratio was registered. RESULTS: Four types of MP distribution (type 1, intense central and paracentral MP; type 2, less intense central and paracentral MP; type 3, only central MP; type 4, only paracentral MP) were identified. The differences in MP distribution were confirmed and clearly characterised by quantitative analyses of peak, total MP ("T"), central MP ("C") and C/T ratio: mean peak in type 1, 0.65; type 2, 0.42; type 3, 0.42; type 4, 0.29; mean total amount of MP in 120-pixel radius ("T") in type 1, 5829.0; type 2, 4412.5; type 3, 2709; type 4, 4302.8. MP types with lower levels of MP were significantly more often observed in the AMD group (AMD: type 1, 120=47.4%; types 2-4, 133=52.6%; healthy eyes: type 1, 112=76.2%; types 2-4, 35=23.8%) ( P<0.0001) CONCLUSIONS: Analysis of MP on AF images is a quantitative method for investigation of MP. With this method a wide variation in concentration and distribution of MP could be seen in the population. Four different types of MP distribution could be characterised and quantitatively distinguished. Reduced levels of MP seem to be associated with a higher risk of development of AMD as they were significantly more often observed in the AMD group. This strategy of quantitative MP analysis on AF images is easily practicable and may be used in further studies to investigate the role of MP as a potential risk factor for AMD.

Adult↗
PubMed2003

[Angiographic-histological correlation of late exudative age-related macular degeneration].

AIMS: To correlate the fluorescein angiographic (FAG) classification in age-related macular degeneration (AMD) with the histology of surgically excised choroidal neovascularization (CNV) membrane specimens. METHODS: 36 subretinal lesions surgically excised during macular translocation were investigated by light microscopy. Histologic results were correlated with fluorescein angiographic findings. RESULTS: Classic CNV lesions showed a subretinal fibrovascular membrane on histological examination. About 50% of the investigated classic CNV lesions had additional subpigment epithelial components, too. Occult CNV lesions showed a subpigment epithelial fibrovascular membrane on histological examination. A common histological component in lesions of exudative age-related macula degeneration was the appearance of diffuse deposits at the choroidal side of the retinal pigment epithelium. CONCLUSION: Different FAG characteristics in exudative AMD lesions were comparable with the histological results. In correspondence with FAG classification the CNV membranes were localized in different positions in relation to the RPE.

Aged↗
PubMed2002

Pigment epithelial detachment in the elderly. Clinical differentiation, natural course and pathogenetic implications.

BACKGROUND: A prospective analysis was performed to characterize the angiographic appearance, natural course and prognosis of serous pigment epithelial detachments (PEDs) in elderly patients. The aim was to differentiate PEDs according to their angiographic characteristics and to analyze the specific clinical, visual and morphologic course of the different PEDs. METHODS: Fluorescein and indocyanine green angiography were performed in 101 consecutive patients (53-87 years; 63 female, 38 male) with clinical signs of serous PED and drusen. RESULTS: Different types of serous PED were identified: polypoidal choroidal vasculopathy (PCV)-associated PED in 14 patients (13.9%), vascular PED in 72 (71.2%), and avascular PED in 15 (14.9%). All PEDs resulted initially in similar visual loss. Avascular PEDs were smaller than vascular PEDs, and the latter were smaller than PCV-PEDs. During follow-up these differences were always present, but all PEDs enlarged initially followed by regression. This course was associated in all PEDs with progressive visual loss, accompanied by the development of RPE atrophy in avascular PEDs or disciform scars or RPE tears in the two other types. CONCLUSION: Despite different associations, all PEDs have a similar clinical course with respect to visual loss and enlargement or regression. This is compatible with the proposed common pathogenetic background with a hydrophobic barrier in Bruch's membrane causing fluid resulting from RPE pumping activity to accumulate between the pigment epithelium and Bruch's membrane.

Aged↗
PubMed2002

[Pigment epithelium detachments in AMD (age-associated macular degeneration) and "polypoid choroidal vasculopathy". A fluorescein and indocyanine green angiography study].

AIMS: A prospective analysis to differentiate the angiographic appearance of pigment epithelial detachments (PED) in age-related macular degeneration (AMD) was performed. The aim was to verify if characteristics of polypoidal choroidal vasculopathy (PCV) can be observed in elderly patients with Central European background. PATIENTS AND METHODS: Fluorescein and indocyanine green angiography was performed in 101 consecutive patients (53-87 years, 63 females, 38 males) with clinical signs of PED and drusen. RESULTS: Different types of PED could be differentiated: PCV-associated PED in 14 patients (13.9%), vascularized PED in 72 patients (71.2%), and nonvascularized PED in 15 patients (14.9%). CONCLUSIONS: The clinical diagnosis of PED in AMD can be differentiated by angiography into PCV-associated PED, vascularized PED, and nonvascularized PED. This differentiation is important because PCV-associated PED may have a pathogenetic and genetic background other than age-related changes in Bruch's membrane. These patients also may share a natural course and treatment options different from PED in AMD.

Aged↗
PubMed2002

A portable instrument for measuring macular pigment with central fixation.

PURPOSE: To evaluate the reliability and validity of a portable instrument for measuring macular pigment optical density. METHODS: The instrument is small, uses light emitting diodes as light sources and the principles of heterochromatic flicker photometry of comparing foveal and extra-foveal minimum flicker matches. It uses central fixation for the extra-foveal matches, which subjects found easier than eccentric fixation. Subjects with healthy eyes used the instrument to measure their pigment density in a number of eye clinics. RESULTS: The mean pigment density in 124 eyes in 124 individuals was 0.41 +/- 0.16 (mean +/- SD), there was no significant change with age but the density was less in females, those with light irides, smokers, subjects on diets low in precursor carotenoids and in those exposed to several hours of daylight every day or who used sun beds. CONCLUSIONS: The portable instrument gave valid and reliable data that confirmed published values for macular pigment. It was convenient to use in the clinic and has potential as a screening tool.

Adolescent↗
PubMed2001

[Pathogenesis of central serous chorioretinopathy: angiographic and electrophysiological studies].

BACKGROUND: By the combination of fluorescein and indocyanine green angiography and multifocal electroretinography (mERG) we examined the correlation of angiographic and electrophysiological findings in acute central serous choroiditis (CSC) to find out if this leads to further information about the course of the disease. MATERIAL AND METHODS: Patients with unilateral, acute CSC (n = 49) were examined by the use of fluorescein and indocyanine green angiography and mERG. The examinations were repeated after 6 and 12 weeks. RESULTS: Of the patients 47 (96%) showed hypofluorescent areas in the early pictures of the ICG angiography which changed to hyperfluorescence in the late phase pictures in 39 patients (80%). Of the asymptomatic paired eyes, 31 (63%) showed abnormalities in the ICG pictures. The amplitudes in mERG were reduced in the study eyes as well as in the paired eyes and only recovered slowly. Angiographic healing was seen in 44 (90%) patients during the follow-up time, while the reduction of mERG amplitudes recovered more slowly and did not reach normal levels. CSC is a bilateral disease of the central choroid with acute decompensation of the retinal pigment epithelium in one eye. This leads angiographically to a local hypofluorescence with subsequent hyperfluorescence caused by barrier breakdown. The functional recovery follows the morphological healing only slowly. The mERG seems to be an adequate measurement method.

Acute Disease↗
PubMed2001

[Macular pigment and age-related macular degeneration].

The present concepts of the pathogenesis of AMD include cumulative light damage by oxidative processes in the macular photoreceptors as environmental co-factor for the development of AMD. The direct causative connection of this hypothesis has still to be established but wide circumstantial evidence from epidemiological and basic scientific investigations are strongly supportive. Macular pigment consisting of lutein and zeaxanthin through there ability to filter light and by direct antioxidative properties, has been proposed as the most effective protective factor in the central retina ("natural sun glasses") and could be important to reduce light induced oxidative retinal damage. The observation, that with age and especially in eyes with AMD lower concentrations of macular pigment could be found, can be interpreted that low macular pigment concentrations may be associated with higher risk for AMD. Through dietary intake and eventually with supplementation the concentration of macular pigment can be increased, and analysis of the correlation between macular pigment and AMD may be important to characterise a possible influenceable AMD risk factor.

Aged↗