Macular Degeneration

Age-related macular degeneration (AMD) is a leading cause of visual loss in the elderly.

It affects the macula, which is the part of the eye’s retina that allows you to see fine detail. It blurs the central vision which is needed for "straight-ahead" activities such as reading, sewing, and driving. It is not painful.

There are two forms:

• Atrophic macular degeneration (dry form) occurs when the light-sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye. As dry AMD gets worse, you may see a blurred spot in the center of your vision.
• With exudative macular degeneration (wet form), which is much less common, abnormal blood vessels behind the retina start to grow under the macula. These new blood vessels tend to be very fragile and often leak blood and fluid. The blood and fluid raise the macula from its normal place at the back of the eye.

How Common Is Macular Degeneration?

• AMD is a leading cause of vision loss in Americans 60 years of age and older.
• 1.65 million Americans age 50 and older have advanced stages of AMD, and this number is expected to double by 2030.
• Worldwide, as many as 30 million people have AMD in various stages.

What Causes Macular Degeneration?

Many older people develop macular degeneration as part of the body's natural aging process. Exactly why it develops is not known.

What Are the Risk Factors for Macular Degeneration?

• The risk of macular degeneration increases with aging.
• Smoking.
• Obesity.
• Race. Caucasians are much more likely to lose vision from AMD than African Americans.
• Family history. People with a family history of AMD are at higher risk of getting the disease.
• Gender. Women appear to be at greater risk than men.
• Atherosclerosis (hardening of the arteries) increases risk of AMD.

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What Are the Symptoms of Macular Degeneration?

• Macular degeneration can cause different symptoms in different people.
• The condition may be hardly noticeable in its early stages.
• Sometimes only one eye loses vision while the other eye continues to see well for many years.
• When both eyes are affected, the loss of central vision may be noticed more quickly.
• Dry AMD
  • The most common symptom of dry AMD is slightly blurred vision. Blurring in central vision often gradually worsens over time.
  • There may be difficulty recognizing faces or a need for more light for reading and other tasks.
  • Dry AMD generally affects both eyes, but vision can be lost in one eye while the other eye seems unaffected.
  • One of the most common early signs of dry AMD is drusen. Drusen are yellow deposits under the retina. They often are found in people over age 60.
• Wet AMD
  • An early symptom of wet AMD is that straight lines appear wavy.
  • With wet AMD, loss of central vision can occur quickly. Wet AMD is more advanced and is more severe than the dry form.

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How Is Macular Degeneration Diagnosed?

Your ophthalmologist (Eye M.D.) can detect early stages of AMD during a medical eye examination that includes the following:

• a simple vision test in which you look at a chart that resembles graph paper (Amsler grid);
• viewing the macula with an ophthalmoscope;
• taking special photographs of the eye called fluorescein angiographs to find abnormal blood vessels under the retina.

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Conventional Treatment for Macular Degeneration

Certain types of "wet" macular degeneration can be treated with laser surgery, an outpatient procedure. Laser surgery and another form of treatment called photodynamic therapy use a focused beam of light to slow or stop leaking blood vessels that damage the macula. These procedures may preserve more sight overall, though they are not cures that restore vision to normal. Laser treatment is not effective for everyone and it does not restore vision that is already lost.

Treatment to help people adapt to lower vision levels, such as optical devices or refer you to a low-vision specialist or center. A wide range of support services and rehabilitation programs are also available to help people with macular degeneration maintain a satisfying lifestyle.

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Natural or Alternative Treatment for Macular Degeneration

Treatment Strategy

Use of dietary modifications, antioxidants and natural substances which help minimize free radical damage and increase circulation (nutrients and oxygen) to the macula.

Lifestyle

• Avoid heavy metals and other sources of free radical exposure.
• Wear UV protection for the eyes.

Dietary

• Consume a low-fat diet containing abundant amounts of colored fruits and vegetables (especially dark green vegetables). This diet is associated with a lowered risk for AMD. The protection may be the result of increased intake of antioxidant vitamins and minerals. However, various “non-essential” food components such as the yellow carotenes lutein, zeaxanthin, and lycopene and flavonoids (also found in colored fruits and vegetables) are proving to be even more significant in protecting against macular degeneration than traditional nutritional antioxidants.
• Consume plenty of dark green vegetables, especially spinach and collards. Lutein, which is found in these vegetables, is a major component of the macular pigment, and it appears to prevent macular damage resulting from exposure to the blue portion of the spectrum of visible light.
• Avoid fried foods, hydrogenated fats, trans fats, rancid food, and other sources of free radicals.
• Increase consumption of flavonoid-rich berries (blueberries, blackberries, cherries, etc.).
• Increase consumption of fish. One study found that people who ate fish had about half as much risk of developing macular degeneration.

Nutritional Supplements

• Antioxidants and zinc. In the major study Age Related Eye Disease, study participants were administered either (1) antioxidants (vitamin C, vitamin E, and beta carotene); (2) zinc and copper; (3) antioxidants plus zinc; or placebo.
  • There was a statistically significant reduction in the development of advanced AMD in the group treated with antioxidants plus zinc.
  • Both zinc alone and antioxidants plus zinc significantly reduced the odds of developing advanced AMD in people with early AMD.
  • Supplementation with zinc slows the rate of visual loss in patients with age related macular.
  • The physiological functions for zinc have been studied predominantly in retina and retinal pigment epithelium where zinc is believed to interact with taurine and vitamin A in vision.
• Taurine. Taurine deficiency resulted in retinal degeneration in animals. Taurine levels may decline with age.
• Other nutrients: Selenium; vitamin C, vitamin A. Each of these compounds plays a role in normal retinal function and may help protect ocular tissues through antioxidant activity or other mechanisms.
• Lutein and zeaxanthin. In the multicenter Eye Disease Case-Control study, they found a 57-percent decreased risk for AMD in individuals with the highest intake of lutein/zeaxanthin, compared to those who consumed the lowest level.
  • In an Italian study, 50 patients with AMD were given daily cocktails containing antioxidants and purified lutein or placebo for 18 months. The researchers demonstrated a two-fold increase in visual acuity in AMD patients compared to the placebo group.
• Intravenous nutrient therapy may be used in selected cases, or if oral treatment is ineffective: Intravenous administration of selenium and zinc, with or without other trace minerals, appears to improve visual function in some patients

Botanical (Herbal) Medicine

• Ginkgo biloba extract . In one study, administration of ginkgo improved long-distance visual acuity, compared with placebo, in patients with age-related macular degeneration. Ginkgo biloba extract is a good choice if the patient is also demonstrating signs of cerebrovascular insufficiency.
• Bilberry extract (Vaccinium myrtillis) is an excellent antioxidant with a strong affinity for the part of the retina that is damaged in macular degeneration. It helps to reinforce the collagen structures of the retina and preventing free radical damage.
• Grapeseed extract (Vitis vinifera) also has excellent antioxidant activity and positive effects on retinal blood flow and function. The Grape seed extract may be the most useful when there is significant sensitiviyt to light or poor night vision.

Homeopathy

A detailed homeopathic interview should be performed to determine the proper remedy for each individual.

Supplement Quality Is Important

Nutritional and botanical supplements used in these treatments are intended to have a physiological effect and clinical benefit, i.e., they are effective and your health improves.

The quality of nutritional supplements in the general marketplace is suspect. In order to get the maximum benefit to your health, be sure you purchase the highest quality nutritional supplements.

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What Should You Do Next?

The doctors at The Connecticut Center for Health are quite experienced in how to treat macular degeneration.

If you would like to learn more about natural medicine approaches to macular degeneration, contact one of our clinics for a free consultation or an appointment.