Macular pigment: New clinical methods of detection and the role of carotenoids in age-related macular degeneration

Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in people over the age of 65. The Age-Related Eye Disease Study (AREDS) suggests antioxidants may delay the advance of age-related macular degeneration. The macular pigments zeaxanthin and lutein may serve as antioxidants as well as blue filter to protect the retina. In this review, the general characteristics of macular pigment are described. The nutritional value of zeaxanthin/lutein and methods to assess macular pigment are discussed. Several emerging instruments to assess macular pigment, including heterochromatic flickering photometer, motion detection photometer, fundus reflectance spectroscope, Raman spectrometer, and autofluorescence spectrometry, are introduced and reviewed. Optometrists should be aware that they may play a role to assess and monitor the risk of AMD. There is an opportunity to incorporate measurement of macular pigment in optometric practice.