Macular pigment distribution in Stargardt macular disease.

PURPOSE To investigate macular pigment optical density (MPOD) and distribution in patients with Stargardt disease. METHODS Prospective observational case series. The study included 13 eyes of 13 consecutive patients. A modified confocal scanning laser ophthalmoscope (SLO, Heidelberg, Germany) was used for MPOD measurement. It calculated the MPOD at 0.5° of the center of the fovea, and MPOD in the 0.5° and 2° areas. RESULTS Two different MPOD profile patterns were observed: group 1 was composed of patients with a flat profile, i.e., with very low MPOD in all locations, and group 2 presented a normal profile. In group 2, all eyes but one had good visual acuity (VA); in group 1, some displayed poor VA, but others had good VA. All patients in group 1 displayed a thinning of the macular area on OCT. CONCLUSIONS These results suggest that the flat MPOD profile, even if the visual acuity is good, could be associated with poor prognosis. The two different patterns of MPOD distribution described could reflect two different stages in the course of Stargardt disease. No strong correlations were found between MPOD profiles and visual acuity or macular thickness, but a straight trend was brought out that may indicate that the flat MPOD profile has a poor functional prognosis. Long follow-up is required to confirm this hypothesis.