T. T. J. M. Berendschot

Macular pigment optical density measurements: evaluation of a device using heterochromatic flicker photometry

PurposeAccurate assessment of the amount of macular pigment (MPOD) is necessary to investigate the role of carotenoids and their assumed protective functions. High repeatability and reliability are important to monitor patients in studies investigating the influence of diet and supplements on MPOD. We evaluated the Macuscope (Macuvision Europe Ltd., Lapworth, Solihull, UK), a recently introduced device for measuring MPOD using the technique of heterochromatic flicker photometry (HFP). We determined agreement with another HFP device (QuantifEye; MPS 9000 series: Tinsley Precision Instruments Ltd., Croydon, Essex, UK) and a fundus reflectance method.MethodsThe right eyes of 23 healthy subjects (mean age 33.9±15.1 years) were measured. We determined agreement with QuantifEye and correlation with a fundus reflectance method. Repeatability of QuantifEye was assessed in 20 other healthy subjects (mean age 32.1±7.3 years). Repeatability was also compared with measurements by a fundus reflectance method in 10 subjects.ResultsWe found low agreement between test and retest measurements with Macuscope. The average difference and the limits of agreement were −0.041±0.32. We found high agreement between test and retest measurements of QuantifEye (−0.02±0.18) and the fundus reflectance method (−0.04±0.18). MPOD data obtained by Macuscope and QuantifEye showed poor agreement: −0.017±0.44. For Macuscope and the fundus reflectance method, the correlation coefficient was r=0.05 (P=0.83). A significant correlation of r=0.87 (P<0.001) was found between QuantifEye and the fundus reflectance method.ConclusionsBecause repeatability of Macuscope measurements was low (ie, wide limits of agreement) and MPOD values correlated poorly with the fundus reflectance method, and agreed poorly with QuantifEye, the tested Macuscope protocol seems less suitable for studying MPOD.

Macular pigment optical density relates to foveal thickness.

Purpose Macular pigment is composed of 2 dietary carotenoids, lutein and zeaxanthin, and is mainly present at the nerve fiber layers and ganglion cell layers of the retina, with peak concentrations in the fovea. It is thought to function as a blue-light filter and antioxidant, and therefore protect the retina from damaging influences that are thought to play a role in the pathogenesis of age-related macular degeneration. This study was performed to investigate the suggested positive relationship between foveal macular pigment optical density (MPOD) and foveal retinal thickness. Methods We determined MPOD and foveal thickness in the right eyes of 40 healthy Caucasian subjects (5 men, 35 women) recruited at the University of Maastricht, The Netherlands. Their mean age was 24.4±8.7 years. MPOD was determined by using a novel method of heterochromatic flicker photometry (HFP), where subjects have to detect flicker instead of conventionally minimizing a present flicker motion. Foveal thickness parameters were obtained using optical coherence tomography (OCT 3). Results We found a positively significant correlation between MPOD and central foveal thickness (r=0.359, p=0.027). In addition, we found a negatively significant correlation between foveal thickness and foveal width (r=–0.558, p<0.001). Conclusions Our data confirm the previously suggested positively significant correlation between MPOD and central foveal thickness. The observed negative relationship between foveal thickness and foveal width may be explained by eccentric scans on the OCT. (Eur J Ophthalmol 2009; 19: 836–41)

Five year results with the Artiflex Myopia phakic intraocular lens: long-term visual function, efficacy, safety and endothelial cell loss

P rofessor P. Juhani Airaksinen passed away at the age of 68 on 24 October 2016, after a long and wearing disease. Juhani Airaksinen was born in 11December 1947 inHelsinki, as the first child of his chief anaesthesiologist father Jorma Airaksinen and his mother Hilkka. In school pictures, Juhani looks to be a joyful and jovial young man whose school reports were not able to predict his many successes in adulthood. As his best grades were in singing, his familiar and likable voice was already recognized early on. He liked to ski to school and enjoyed listening to jazz. The time spent with his grandfather was especially important to Juhani. Juhani’s considerable language skills were developed through regularmeetings with his childhood English teacher, and as a consequence of his study of medicine at the University of Marburg, Germany, from 1969 to 1975. His first two children, Tiina (1973) and Jukka (1975), were born inGermany in hismarriagewithTuulikki Hynninen. Juhani’s choice of medical specialty became crystal clear when he first saw the fundus of the eye with a three-mirror lens. Juhani’s ophthalmology residency (1977–82) and his thesis (1983) at the University of Oulu were mentored by Professor Henrik Forsius. His thesis – Detection of Early Glaucoma Changes After an Optic Disc Hemorrhage – led to a fellowship with Professor Stephen Drance at the University of British Columbia (1983–84). After Canada, together with Professor Anja Tuulonen, Juhani founded the GlaucomaResearchUnit at theUniversity of Oulu, which served for many years as a testing and reference site for first-generation ophthalmic imaging instruments. His daughters Hanna (1988) and Eveliina (1991) were born in common-law marriage with Anja Tuulonen. In addition to focusing on the detection and follow-upof early glaucomatous changes in the optic nerve and the retinal nerve fibre layer, as well as developing new photographic methods and techniques for imaging and analysis of the retinal nerve fibre layer, Juhani’s research interests dealt with the treatment for glaucomaand, particularly, surgical techniques in refractory glaucoma. Professor Airaksinen was internationally influential in the field of ophthalmic research. Among other things, he has been decorated with the Government of Canada Award in 1983, the KKK Lundsgaard Medal in 1985, the Alcon Research InstituteAward in1986and the HonorAward of theAmericanAcademy of Ophthalmology in 1995. He served as Chair of the ARVOGlaucoma Program Planning Committee (1994–95) and as a Member of the European Board of Ophthalmology’s Education Committee (1992–2000), a Member of the Board of the Finnish Medical Society Duodecim (1997–99) and Chair of the Ophthalmological Society of Finland (1992–93). He wasoneof the foundingmembers and the Honorary Member of the Finnish Glaucoma Society. In family circles as well as domestic and international forums, Juhani Airaksinen will be remembered as a charismatic and warm-hearted gentleman who had a unique ability to make people around him feel welcome and accepted.His companynever feltboring. We remember with gratitude his accomplishments in improving glaucomadiagnostic research.Asone friend touchingly phrased it, ‘The Northern Gods have a new colleague with a deep clear voice’.

[OP.5A.05] GLUCOSE METABOLISM STATUS IS ASSOCIATED WITH IMPAIRED RETINAL ARTERIOLAR VASODILATATION: THE MAASTRICHT STUDY

Objective: Type 2 diabetes (T2DM) is associated with a ∼2-fold increased risk of cardiovascular disease (CVD). This can be explained, in part, by the finding that large artery dysfunction already occurs before the onset of diabetes (‘ticking clock hypothesis’). Whether a similar phenomenon occurs for microvascular dysfunction is not known. We therefore tested the hypothesis that microvascular dysfunction (MVD) is already present in impaired glucose metabolism (IGM; prediabetes) and worsens further in T2DM by investigating the association between glucose metabolism and MVD using the retinal arteriolar dilator response to flicker light. Design and method: In a population-based cohort study with oversampling of T2DM (n = 2092), we determined flicker-light-induced retinal arteriolar %-dilatation (Dynamic Vessel Analyzer; Imedos, Germany) and glucose metabolism status (OGTT; classified as normal (NGM), IGM or T2DM). Differences were compared with multivariable regression adjusted for age, sex, waist, smoking, systolic-BP, lipid profile, retinopathy, eGFR, (micro)albuminuria, the use of lipid-modifying and/or blood-pressure-lowering medication, and prior CVD. Results: 1192 individuals had NGM (41% men, aged 58 ± 8 years (mean ± SD)), 323 IGM (54% men, aged 61 ± 7 years) and 577 T2DM (69% men, aged 63 ± 8 years). Arteriolar %-dilatation (mean ± SD) was 3.42 ± 2.84 in NGM, 3.01 ± 2.76 in IGM, and 2.34 ± 2.64 in T2DM. Adjusted analyses showed a lower %-dilatation in IGM (&bgr; = −0.20, [CI95% −0.56; 0.15]), which further decreased in T2DM (&bgr; = −0.61, [−0.97; −0.25]) vs NGM, p for trend = 0.001. In addition, higher HbA1c (&bgr; = −0.32, [−0.48; −0.16], p < 0.001) and fasting plasma glucose (FPG) (&bgr; = −0.16, [−0.24; −0.07], p < 0.001) were associated with lower arteriolar %-dilatation in fully adjusted models. Conclusions: Glucose metabolism status, HbA1c, and FPG are associated with reduced flicker-light-induced retinal arteriolar dilatation, independently of major cardiovascular risk factors. These findings support the concept that MVD precedes and thus may contribute to T2DM and T2DM-associated CVD.