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Invest Ophthalmol Vis Sci. 2008 May;49(5):2077-81. doi: 10.1167/iovs.07-1181. Epub 2008 Jan 25.

Foveal cone-photoreceptor integrity in aging macula disorder.

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  • 1Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands.



To establish the relation between AMD stage and a quantitative measure for the integrity of foveal cone photoreceptors related to the optical Stiles-Crawford effect.


Fifty-six AMD eyes and 57 control eyes were included in the final analysis. AMD was graded in accordance with the International Classification System into five mutually exclusive stages. Stages 0 to 1 were labeled no AMD, stages 2 to 3 were labeled early AMD, and stage 4 was labeled late AMD. Fundus reflectometry, together with a model-fit procedure, provided information on directional cone reflectance (Rd), a quantitative measure for the integrity of foveal cone photoreceptors. Optical densities of macular pigment (MPOD) and melanin (MOD) were also obtained. A general linear model analysis was used to compare Rd, MPOD, and MOD among the AMD stages.


Mean Rd was lower in early AMD (0.92%, P < 0.001) and late AMD (0.86%, P < 0.001) compared with mean Rd in the no-AMD stage (1.76%). Mean MPOD was not different in early AMD (0.53, P = 0.05), but it was lower in late AMD (0.19, P < 0.001) compared with mean MPOD in the no-AMD stage (0.42). Mean MOD was lower in early (1.09, P = 0.001) and late (1.01, P = 0.004) AMD compared with mean MOD in the no-AMD stage (1.23).


Foveal cones show signs of misalignment and/or outer segment deterioration in early AMD. Melanin rather than macular pigment may play a protective role against AMD, although loss of these ocular pigments can also be caused by AMD.

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