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Relationships between macular pigment optical density and lacquer crack related to high myopia

Purpose: Low macular carotenoid pigment rate (lutein and zeaxanthin) is a significant risk factor of macular degeneration. The aim of this paper is to investigate the relationship between macular pigment optical density (MPOD) and lacquer cracks (LC) in high myopia.

Methods: Prospective comparative observational study (NCT02205632) including high myopic patients with or without LC. Inclusion criteria were axial high myopia with or without LC. All patients underwent best-corrected visual acuity on logMAR chart, MPOD measurement, multicolor imaging, SD-OCT, autofluorescence and axial length measurement. MPOD was calculated using heterochromatic flicker photometry. Group 1 was defined as eyes without LC and group 2 as eyes with LC.

Results: Forty-five eyes in 32 patients with a mean age of 51.3 years were included in group 1 and 15 eyes in 13 patients aged 54.1 in group 2 (p=0.56). Mean spherical equivalent was -10.11 diopters in group 1 and -15.11 in group 2 (p=0.0004). Mean visual acuity was +0.08 in group 1 and +0.11 logMAR in group 2 (p=0.061). Axial length was 27.8 mm in group 1 and 29.2 in group 2 (p=0.0052). Central macular thickness was lower in group 1 (295 μm) than in group 2 (305μm) (p<0.0001) and choroidal macular thickness did not differ between the two groups (p=0.094). Mean MPOD in group 2 was 0.52 and 0.63 in group 1 (p=0.042).

Conclusion: A lower rate of MPOD was observed in cases of LC in high myopia. Dietary carotenoids could have a protective effect helping to reduce the risk of LC.

Keywords : pathologic myopia, lacquer cracks, lutein, zeaxanthin, macular pigment.