Macular Pigment in Aging and Disease

衰老和疾病中的黄斑色素

• 批准号: 9064807
• 负责人: BARBARA A BLODI
• 金额: $ 115.09万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-06-01 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9064807
• 关键词: Accounting; Address; Adopted; Age; Age related macular degeneration; Age-Years; Aging; Apoptosis; Beta Carotene; Blindness; Carotenoids; Chronic Disease; Clinical; Cohort Studies; Cross-Sectional Studies; Data; Development; Devices; Diet; Dietary Carotenoid; Disease; Eye; Eye diseases; Food Supplements; Fundus; Guidelines; Health; Incidence; Individual; Inflammation; Intake; Investigation; Knowledge; Lead; Life Style; Light; Longitudinal Studies; Lutein; Measures; Nerve Degeneration; Neural Retina; Nutritional; Optic Disk; Optical Coherence Tomography; Optics; Oxidative Stress; Participant; Photoreceptors; Pigments; Preventive measure; Recommendation; Recovery; Research; Retina; Retinal; Risk; Risk Marker; Role; Sampling; Serum; Speed; Staging; Supplementation; Techniques; Testing; Thick; Time; Vision; Visit; Visual Acuity; Woman; Women' s Health; age related; cohort; cost; density; design; follow-up; fovea centralis; genetic risk factor; health data; high risk; improved; macula; meso-zeaxanthin; middle age; modifiable risk; mortality; neurosensory; nutrition related genetics; processing speed; prospective; relating to nervous system; retinal nerve fiber layer; screening; sound; visual process; visual processing; zeaxanthin

 DESCRIPTION (provided by applicant): The purpose of this proposal is to evaluate macular pigment (MP) levels as a modifiable risk marker for the development of age-related macular degeneration (AMD), and more generalized loss of neural retina and vision function with age. Some previous evidence suggests that MP, comprised of the dietary carotenoids lutein, zeaxanthin and meso-zeaxanthin, declines with age, and that preserving MP might help reduce risk for developing eye diseases and/or vision loss which become more common as we age. This has not been previously evaluated in large longitudinal studies. MP optical density (MPOD) can be simply and non-invasively measured. Therefore, MPOD assessment might be useful in screening to identify individuals, in middle-age, who are at higher risk for age-related vision los. Devices to assess MPOD are already adapted for clinical use, but evidence addressing longitudinal relationships of MPOD to AMD and vision loss is needed to make recommendations about their appropriate use. If MPOD predicts AMD and/or age- or disease-related vision loss, then early assessment would permit the targeting of individuals for testing a variety of preventive measures to lower risk, including those which would increase macular pigment. Evidence to address the gap in longitudinal data can be obtained at low cost by conducting a prospective follow-up study in the Carotenoids in Age-Related Eye Disease Study (CAREDS) cohort. MPOD, fundus photographs to assess AMD, and visual acuity measures were previously obtained in 1,791 women in 2001-2004. Annual follow-up of this cohort, in the Women's Health Initiative, assures low loss to follow up, documents mortality and new chronic diseases (including common age-related eye diseases), and provides extensive nutritional, genetic, lifestyle, and health data. Follow-up visits thirteen years later will be conducted to provide a second set of fundus photographs to document the relationships of MPOD to AMD incidence and/or progression. Second, MPOD at baseline will also be studied in relation to measures of structural and functional aging at follow-up. Structural measures include new measures of the thickness of the retina, across several layers and regions, using spectral domain optical coherence tomography (SD-OCT). Functional measures include the loss of visual acuity between baseline and follow-up, and additional secondary measures obtained at follow-up. Third, measures of MPOD levels at follow-up will be obtained to permit the first direct longitudinal estimate of MPOD declines with age, and to provide an opportunity to explore whether average age-related declines are lower in women with higher initial MPOD, and in women with higher intakes of lutein and zeaxanthin, between baseline and follow-up. The proposed research will constitute the largest and longest extant investigation of relationships of macular pigment to aging, age-related vision loss, and AMD, thereby advancing knowledge needed to understand the role of carotenoids in preserving vision with age and informing clinical guidelines.

 描述（由适用提供）：该提案的目的是评估黄斑色素（MP）水平，作为与年龄相关的黄斑变性（AMD）发展的可修改风险标记，以及随着年龄的增长的神经视网膜和视力功能的更广泛性丧失。以前的一些证据表明，由饮食中的类胡萝卜素，玉米黄质和中玉蛋白的MP随着年龄的增长而下降，保留MP可能有助于降低患眼部疾病和/或视力丧失的风险，随着年龄的增长，这变得更加普遍。在大型纵向研究中，此前尚未对此进行评估。 MP光密度（MPOD）可以简单且非侵入性测量。因此，MPOD评估可能对筛查识别中年的个人有用，而这些个人面临与年龄相关的视力丧失风险更高的风险。评估MPOD的设备已经适用于临床使用，但是需要证明MPOD与AMD的纵向关系的证据，并且需要有关其适当使用的建议。如果MPOD预测AMD和/或与年龄或疾病相关的视力丧失，那么早期评估将允许个人靶向测试各种预防措施以降低风险，包括增加黄斑色素的风险。可以通过在与年龄相关的眼病研究（CAREDS）同类中进行类胡萝卜素的前瞻性随访研究来以低成本获得纵向数据中差距的证据。 MPOD，用于评估AMD的眼底照片，并在2001 - 2004年在1,791名女性中获得了视力测量。在妇女健康计划中，该队列的年度随访年度损失较低，记录死亡率和新的慢性疾病（包括常见的与年龄有关的眼部疾病），并提供广泛的营养，遗传，生活方式和健康数据。 13年后，将进行后续访问，以提供第二组的眼底照片，以记录MPOD与AMD事件和/或进展的关系。其次，基线时的MPOD还将与随访时结构和功能衰老的测量有关。结构措施包括使用光谱域光学相干断层扫描（SD-OCT）的新层和区域的视网膜厚度的新措施。功能度量包括基线和随访之间的视力丧失，以及随访时获得的其他二级措施。第三，将获得随访时MPOD水平的度量，以允许MPOD随着年龄的增长的第一个直接纵向估计，并提供一个机会，以探索较高初始MPOD的女性以及lute蛋白和Zeaxanthin摄入量较高的女性的平均年龄相关下降量是否较低。拟议的研究将构成黄斑色素与衰老，与年龄相关的视力丧失和AMD的关系最大，最长的扩展投资，从而促进知识，以了解胡萝卜素在保持视力和临床指南方面维护视力方面的作用。