Rockville, Md. – New research out of the University of Wisconsin-Madison, identified an inverse reaction between macular pigment levels and open-angle glaucoma in a 15-year follow-up cohort of older women participating in National Eye Institute (NEI) R01-funded Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2) (2016 - 2019). The research is being presented at 2021 Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO), which is being hosted virtually.

Glaucoma clinician-scientist Yao Liu, MD, MS and the CAREDS2 research team’s study was the first to identify an inverse association between Macular pigment optical density (MPOD) and manifest primary open-angle glaucoma (POAG) in a longitudinal cohort of 630 older women.

MPOD was measured at both CAREDS baseline (2001 - 2004) and CAREDS2 (2016 -2019) using customized heterochromatic flicker photometry. The manifest POAG status at CAREDS2 was the adjudicated by two glaucoma specialists masked to MPOD in 1258 eyes (630 participants) based on abstracted medical records, intraocular pressure, visual fields, stereo disc photos, and peripapillary retinal nerve fiber layer optical coherence tomography. Associations between MPOD and manifest POAG were investigated utilizing age-adjusted logistic regression models in the full sample and also a subgroup analysis of the ‘worst’ eye in each participant based on severity of glaucomatous visual field loss. Additional sensitivity analyses among the subset of eyes with stable MPOD showed similar findings over 15 years.

Liu notes that further studies are warranted to confirm whether low macular pigment levels may be a novel modifiable glaucoma risk factor and support the development of low-cost, dietary interventions for glaucoma prevention, such as dietary intake of carotenoids, including lutein and zeaxanthin.

“As a glaucoma clinician-scientist, I have seen far too many patients lose their vision despite, and as a result of, aggressive treatments to lower intraocular pressure,” says Liu. “There is an urgent need to identify new, modifiable risk factors other than intraocular pressure to prevent vision loss from glaucoma. Our [CAREDS2] research team is fully dedicated to improving vision outcomes for age-related eye disease, including glaucoma, the leading cause of irreversible blindness worldwide, and to the large-scale translation of vision research to benefit our communities.”

Abstract title: Low macular pigment levels are associated with manifest primary open-angle glaucoma in the carotenoids in age-related eye disease study

Presentation start/end time: Tuesday, May 4, 2021 10:15am – 12noon ET

Presentation number: 3527667


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The Association for Research in Vision and Ophthalmology (ARVO) is the largest eye and vision research organization in the world. Members include approximately 10,000 eye and vision researchers from over 75 countries. ARVO advances research worldwide into understanding the visual system and preventing, treating and curing its disorders. Learn more at

Meeting Link: 2021 Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO)