MACULAR TELANGIECTASIA Patterns of Distribution of Macular Pigment and Response to Supplementation

Purpose: By analyzing the patterns of macular pigment (MP) in type 2 idiopathic telangiectasia eyes, different stages in the changes reflecting the extent of disease can be observed. The purpose of this study was to determine whether the amount and the pattern of MP can be influenced by supplementation. Method: Eleven patients with type 2 idiopathic telangiectasia received 12 mg lutein and 0.6 mg zeaxanthin (Ocuvite Lutein AMD) daily for 9 months. For a period of 12 months, MP concentration was determined every 3 months by autofluorescence (2 excitation wavelengths: 488 and 514 nm). Results: When central accumulation of MP was similar to that in healthy subjects (with segment of reduced MP in the temporal fovea: MP Class I), supplementation enriched the MP at 0.5 degrees, 2 degrees, and 5 degrees to 6 degrees. In MP Class II (reduced concentration of MP centrally), accumulation could be detected at 2 degrees and 5 degrees to 6 degrees but not centrally. In MP Class III (oval-shaped effacement of MP centrally, surrounding oval-shaped ring of MP at 5 degrees-7 degrees eccentricity), supplementation promoted MP accumulation only at 5 degrees to 6 degrees. Conclusion: After oral supplementation with lutein/zeaxanthin, an increase in the MP was detected only in areas where the MP was present at baseline. Supplementation did not produce an increase in the area where the MP was absent. Degenerative processes causing an impairment in transport and storage of lutein and zeaxanthin may play a leading role in the pathogenesis of type 2 idiopathic telangiectasia. RETINA 30: 1282-1293, 2010