title: Blue-light reflectance imaging of macular pigment in infants and children.
abstract: OBJECTIVE
  While the role of the macular pigment carotenoids in the prevention of age-related macular degeneration has been extensively studied in adults, comparatively little is known about the physiology and function of lutein and zeaxanthin in the developing eye. We therefore developed a protocol using a digital video fundus camera (RetCam) to measure macular pigment optical density (MPOD) and distributions in premature infants and in children.
  
  
  METHODS
  We used blue light reflectance to image the macular pigment in premature babies at the time of retinopathy of prematurity (ROP) screening and in children aged under 7 years who were undergoing examinations under anesthesia for other reasons. We correlated the MPOD with skin carotenoid levels measured by resonance Raman spectroscopy, serum carotenoids measured by HPLC, and dietary carotenoid intake.
  
  
  RESULTS
  We enrolled 51 infants and children ranging from preterm to age 7 years. MPOD correlated significantly with age (r = 0.36; P = 0.0142), with serum lutein + zeaxanthin (r = 0.44; P = 0.0049) and with skin carotenoid levels (r = 0.42; P = 0.0106), but not with dietary lutein + zeaxanthin intake (r = 0.13; P = 0.50). All premature infants had undetectable macular pigment, and most had unusually low serum and skin carotenoid concentrations.
  
  
  CONCLUSIONS
  Our most remarkable finding is the undetectable MPOD in premature infants. This may be due in part to foveal immaturity, but the very low levels of serum and skin carotenoids suggest that these infants are carotenoid insufficient as a consequence of low dietary intake and/or severe oxidative stress. The potential value of carotenoid supplementation in the prevention of ROP and other disorders of prematurity should be a fruitful direction for further investigation.
authors: Department of Ophthalmology and Visual Sciences, Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT 84132, USA. paul.bernstein@hsc.utah.edu
authors: Paul S
authors: PS
authors: Bernstein
authors: Mohsen
authors: M
authors: Sharifzadeh
authors: Aihua
authors: A
authors: Liu
authors: Igor
authors: I
authors: Ermakov
authors: Kelly
authors: K
authors: Nelson
authors: Xiaoming
authors: X
authors: Sheng
authors: Cynthia
authors: C
authors: Panish
authors: Bonnie
authors: B
authors: Carlstrom
authors: Robert O
authors: RO
authors: Hoffman
authors: Werner
authors: W
authors: Gellermann
mesh_terms: D002338:Carotenoids / Q000097:blood / Q000378:metabolism; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005584:Fovea Centralis / Q000254:growth & development / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D007231:Infant, Newborn; D008027:Light; D014975:Lutein / Q000097:blood / Q000378:metabolism*; D008297:Male; D008954:Models, Biological; D010781:Photography; D012178:Retinopathy of Prematurity / Q000473:pathology*; D012867:Skin / Q000378:metabolism; D013059:Spectrum Analysis, Raman; D024341:Xanthophylls / Q000097:blood / Q000378:metabolism*; D065146:Zeaxanthins
chemical_list: D024341:Xanthophylls; D065146:Zeaxanthins; D002338:Carotenoids; D014975:Lutein
keywords: carotenoid; imaging; lutein; macular pigment; zeaxanthin
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