New insights into the role of the macular carotenoids in age-related macular degeneration. Resonance Raman studies

The human macula uniquely concentrates extraordinarily high levels of two xanthophyll carotenoids, lutein and zeaxanthin. The function, metabolism, and physiology of these yellow pigments are incompletely understood, but they are likely to prevent age-related damage to the foveal region by virtue of their ability to act as free-radical quenching antioxidants and to absorb phototoxic blue light with high efficiency. A wealth of circumstantial evidence suggests that high macular levels of these two carotenoids may protect against age-related macular degeneration (AMD), but definitive prospective clinical studies still remain to be conducted. It is imperative to gain a greater knowledge of the basic biochemical and physiological mechanisms underlying the specific uptake and metabolism of lutein and zeaxanthin in the macula and to develop improved methods of quantifying macular carotenoid levels noninvasively in order to facilitate the rational design of successful interventions against the leading cause of irreversible blindness in the elderly in the developed world. The development of resonance Raman spectroscopic methods for the objective measurement of macular carotenoid levels in living humans with and without AMD will be reviewed.