Macular Pigment in Aging and Disease

衰老和疾病中的黄斑色素

• 批准号: 9274977
• 负责人: BARBARA A BLODI
• 金额: $ 96.33万
• 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/9274977
• 关键词: 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; Follow-Up Studies; Food Supplements; Fundus; Guidelines; Incidence; Individual; Inflammation; Intake; Investigation; Knowledge; Lead; Light; Longitudinal Studies; Lutein; Measures; Nerve Degeneration; Neural Retina; Neurons; Nutritional; Optic Disk; Optical Coherence Tomography; Optics; Oxidative Stress; Participant; Photoreceptors; Pigments; Preventive measure; Prospective Studies; Prospective cohort; Recommendation; Recovery; Research; Retina; Retinal; Risk; Risk Marker; Role; Sampling; Serum; Speed; Supplementation; Techniques; Testing; Thick; Thinness; 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; lifestyle data; macula; meso-zeaxanthin; middle age; modifiable risk; mortality; neurosensory; nutrition related genetics; processing speed; prospective; protective effect; public health relevance; retinal nerve fiber layer; screening; secondary analysis; sound; 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（由申请人提供）：本提案的目的是评估黄斑色素（MP）水平，作为年龄相关性黄斑变性（AMD）发展的可修改风险标记，以及更广泛的神经视网膜和视觉功能丧失。先前的一些证据表明，由膳食类胡萝卜素叶黄素、玉米黄质和内消旋玉米黄质组成的 MP 会随着年龄的增长而下降，而保留 MP 可能有助于降低患眼病的风险。和/或视力丧失随着年龄的增长而变得更加普遍，这在之前的大型纵向研究中尚未得到评估，因此，MPOD 评估可能有助于筛查和识别。与年龄相关的视力丧失风险较高的中年人用于评估 MPOD 的设备已经适合临床使用，但需要证明 MPOD 与 AMD 和视力丧失的纵向关系的证据来提出适当的建议。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针对个体测试各种预防措施以降低风险，包括那些会增加黄斑色素的措施，可以提供解决纵向数据差距的证据。通过在类胡萝卜素与年龄相关的眼病研究 (CAREDS) 队列中进行前瞻性随访研究，以低成本获得了评估 AMD 的眼底照片，以及之前对 1,791 名女性进行的视力测量。 2001-2004 年，在妇女健康倡议中对这一群体进行年度随访，确保随访损失率低，记录死亡率和新发慢性疾病（包括常见的生活方式与年龄有关的眼病），并提供广泛的营养、遗传、遗传信息。十三年后的随访将提供第二组眼底照片，以记录 MPOD 与 AMD 发病率和/或进展的关系。其次，还将研究基线时的 MPOD 与测量的关系。结构和功能老化结构测量包括使用谱域光学相干断层扫描（SD-OCT）对视网膜厚度进行新测量，功能测量包括基线和随访之间的视力丧失。第三，将获得随访时 MPOD 水平的测量，以便对 MPOD 随着年龄的下降进行首次直接纵向估计，并提供一个机会来探讨平均与年龄相关的下降是否存在。在基线和随访期间，初始 MPOD 较高的女性以及叶黄素和玉米黄质摄入量较高的女性中，黄斑色素与衰老、年龄相关性视力丧失之间的关系较低。和 AMD，推进了解类胡萝卜素的作用所需的知识，从而随着年龄的增长保持视力并为临床指南提供信息。