Bartlett Hannah, Howells Olivia, Eperjesi Frank
Ophthalmic Research Group, School of Life & Health Sciences, Aston University, Birmingham, United Kingdom.
Clin Exp Optom. 2010 Sep;93(5):300-8. doi: 10.1111/j.1444-0938.2010.00499.x. Epub 2010 Jul 14.
This review compares the results of studies that have investigated the impact of lutein and zeaxanthin supplementation on macular pigment optical density (MPOD) with those that have investigated the reliability of techniques used to measure macular pigment optical density. The review will focus on studies that have used heterochromatic flicker photometry for measurement of macular pigment optical density, as this is the only technique that is currently available commercially to clinicians. We identified articles that reported on supplementation with lutein and/or zeaxanthin and/or meso-zeaxanthin on macular pigment optical density measurement techniques published in peer-reviewed journals, through a multi-staged, systematic approach. Twenty-four studies have investigated the repeatability of MPOD measurements using heterochromatic flicker photometry. Of these, 10 studies provided a coefficient of repeatability or data from which the coefficient could be calculated, with a range in values of 0.06 to 0.58. The lowest coefficient of repeatability assessed on naïve subjects alone was 0.08. These values tell us that, at best, changes greater than 0.08 can be considered clinically significant and at worst, only changes greater than 0.58 can be considered clinically significant. Six studies assessed the effect of supplementation with up to 20 mg/day lutein on macular pigment optical density measured using heterochromatic flicker photometry and the mean increase in macular pigment optical density ranged from 0.025 to 0.09. It seems reasonable to conclude that the chance of eliciting an increase in macular pigment optical density during six months of daily supplementation with between 10 and 20 mg lutein that is of sufficient magnitude to be detected by using heterochromatic flicker photometry on an individual basis is small. Commercially available heterochromatic flicker photometers for macular pigment optical density assessment in the clinical environment appear to demonstrate particularly poor coefficient of repeatability values. Clinicians should exercise caution when considering the purchase of these instruments for potential monitoring of macular pigment optical density in response to supplementation in individual patients.
本综述比较了研究叶黄素和玉米黄质补充剂对黄斑色素光密度（MPOD）影响的研究结果，以及研究用于测量黄斑色素光密度技术可靠性的研究结果。本综述将重点关注使用异色闪烁光度法测量黄斑色素光密度的研究，因为这是目前临床医生唯一可在市场上获得的技术。我们通过多阶段、系统的方法，在同行评审期刊上识别了关于叶黄素和/或玉米黄质和/或内消旋玉米黄质补充剂对黄斑色素光密度测量技术影响的文章。有24项研究使用异色闪烁光度法研究了MPOD测量的可重复性。其中，10项研究提供了可重复性系数或可据此计算该系数的数据，其值范围为0.06至0.58。仅对未经训练的受试者评估的最低可重复性系数为0.08。这些值告诉我们，充其量，大于0.08的变化可被视为具有临床意义，而最糟糕的是，只有大于0.58的变化可被视为具有临床意义。六项研究评估了每天补充高达20毫克叶黄素对使用异色闪烁光度法测量的黄斑色素光密度的影响，黄斑色素光密度的平均增加范围为0.025至0.09。似乎可以合理地得出结论，在每天补充10至20毫克叶黄素的六个月期间，引发黄斑色素光密度增加且增加幅度足以通过个体使用异色闪烁光度法检测到的可能性很小。临床环境中用于评估黄斑色素光密度的市售异色闪烁光度计似乎显示出特别差的可重复性系数值。临床医生在考虑购买这些仪器以潜在监测个体患者补充剂后黄斑色素光密度时应谨慎行事。
