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The association between macular pigment optical density and visual function outcomes: a systematic review and meta-analysis

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To conduct a systematic review and meta-analysis on data related to macular pigment optical density (MPOD) and visual function in adults with healthy eyes.


MEDLINE®, Cochrane, and Commonwealth of Agriculture Bureau abstracts databases were searched for English-language publications between 1946 and August 2018. Included studies examined correlation of MPOD and visual function in adults with healthy eyes at all timepoints and all designs, except for case–control, case reports, and reviews. Visual function outcomes of interest included photostress recovery, contrast sensitivity, visual acuity, glare sensitivity/disability, and dark adaptation. Random effects model meta-analyses combined study-level correlation (r).


Twenty-two publications were included. In meta-analysis MPOD was found to be significantly correlated with contrast sensitivity at 30′ (two studies, summary r: 0.37; 95% CI 0.15, 0.56), and at 1° eccentricity with a spatial frequency of 7, 11, and 21 cpd (three studies, summary r: 0.31; 95% CI 0.06, 0.52), with photostress recovery at a 1° eccentricity with a moderate background, 10 cpd, and 16% contrast (two studies, summary r: −0.17; 95% CI −0.31, −0.02), and at 30′ (four studies, summary r: −0.57; 95% CI −0.78, −0.24), and with glare disability at 30′ eccentricity with a log scale at 460 nm (three studies, summary r = 0.47; 95% CI 0.32; 0.59). There were insufficient data for meta-analysis for other visual functions.


Our review identifies a link between MPOD and visual function with significant correlations with photostress recovery, glare disability, and contrast sensitivity.

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Fig. 1: Study flow diagram.

Change history

  • 12 October 2020

    The original HTML version of this Article was updated shortly after publication to change the copyright line (the Authors opted to change the licence type from standard to Open Access).


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We wish to thank James M. Stringham, Ph.D., at Duke University and John M. Nolan, Ph.D., at the Waterford Institute of Technology for their scientific guidance.


This work was supported by the International Life Sciences Institute North America Bioactive Committee. ILSI North America is a public, nonprofit science organization that provides a forum to advance understanding of scientific issues related to the nutritional quality and safety of the food supply. ILSI North America receives support primarily from its industry membership.

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Correspondence to Elizabeth J. Johnson.

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EJJ’s current position is at Ocean Spray Corp but maintains an appointment at Friedman School at Tufts University at which the work was performed.

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Johnson, E.J., Avendano, E.E., Mohn, E.S. et al. The association between macular pigment optical density and visual function outcomes: a systematic review and meta-analysis. Eye 35, 1620–1628 (2021).

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