Macular pigment optical density in wet age-related macular degeneration among Indians R Raman 1 , S Biswas 2 , K Vaitheeswaran 3 and T Sharma 1 Abstract Purpose To estimate the value of macular pigment optical density (MPOD) in adult south Indian population with wet age-related macular degeneration (AMD). Methods A total of 33 patients with wet AMD and 29 age-matched controls 450 years of age underwent MPOD measurement with the macular densitometer. The patients were also tested for their dietary intake of carotenoids, smoking history, and lifetime UV exposure. Results The mean MPOD values in the Indian population with wet AMD was 0.23 (95% CI: 0.18–0.29) vs control was 0.43 (95% CI: 0.37–0.49), Po0.0001, at 0.51 eccentricity. Ex-smokers had a lower MPOD than non- smokers (0.16 (0.09–0.23) vs 0.28 (0.22–0.34), P ¼ 0.026) and the lowest level of carotenoids intake had 48% lower MPOD than the highest level (0.14 (0.08–0.21) vs 0.33 (0.24–0.43), P ¼ 0.012). There was no significant age-related decline or gender variation in MPOD. Conclusion This study establishes the MPOD in adult Indian population with wet AMD, with a lack of macular pigment in association with wet AMD. Eye (2012) 26, 1052–1057; doi:10.1038/eye.2012.86; published online 25 May 2012 Keywords: macular pigment; age-related macular degeneration; carotenoids; lutein; zeaxanthin; ultraviolet Introduction Age-related macular degeneration (AMD) is one of the causes of irreversible blindness in people 450 years of age. 1,2 It has been estimated that 8 million people will be affected with AMD worldwide by the year 2020. 3 In India, the population Z60 years is expected to increase by 2.5-fold in 30 years (projected from 71 million in 2001 to 177.5 million in 2031). 4 INDEYE study have reported the prevalence of wet AMD in India to be 1.2%. 1 This prevalence is low as compared with the western populations. 5,6 Previous studies have shown that high intake of dietary carotenoids and high plasma levels of carotenoids are related to the reduced risk of AMD in many population. 7,8 The prevailing vegetarian dietary pattern among Indians may influence the macular carotenoids and thereby the prevalence of AMD. However, there is lack of data on macular carotenoids and AMD in the Indian population. The aim of the study is to elucidate the mean macular pigment optical density (MPOD) in subjects with wet AMD in south Indian population. Materials and methods Between the years 2003–2006, a genome-wide association study (GWAS) was done in southern India (unpublished data) for the estimation of genetic risk factors for wet AMD 9 in Indian ethnicity. It was a case–control study consisting of 230 individuals of south Indian ethnicity aged Z50 years, out of which 120 were unrelated cases and 110 was their age-matched controls. These subjects were recruited from the Vitreo-retinal out-patient clinic at the eye institute. The ancestral origin/ethnicity of the subjects was established through self-reporting or an open questionnaire. An informed consent was obtained from the subjects. Out of the subjects recruited in the GWAS, 33 cases and 29 controls were recruited for the present study. 1 Shri Bhagwan Mahavir Vitreoretinal Services, Chennai, India 2 Elite School of Optometry, Chennai, India 3 Department of Preventive Ophthalmology, Chennai, India Correspondence: R Raman, Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, 18, College Road, Chennai 600 006, Tamil Nadu, India Tel: þ 91 44 2827 1616; Fax: þ 91 44 2825 4180. E-mail: rajivpgraman@ gmail.com Received: 7 October 2011 Accepted in revised form: 29 March 2012 Published online: 25 May 2012 CLINICAL STUDY Eye (2012) 26, 1052–1057 & 2012 Macmillan Publishers Limited All rights reserved 0950-222X/12 www.nature.com/eye