Age-Related Macular Degeneration

Age-Related Macular Degeneration

Age-related macular degeneration, often called AMD or ARMD, is the leading cause of vision loss and blindness among Americans who are age 65 and older. Because people in this group are an increasingly larger percentage of the general population, vision loss from macular degeneration is a growing problem.

AMD is degeneration of the macula, which is the part of the retina responsible for the sharp, central vision needed to read or drive. Because the macula primarily is affected in AMD, central vision loss may occur.

About 1.75 million U.S. residents currently have advanced age-related macular degeneration with associated vision loss, with that number expected to grow to almost 3 million by 2020.

 

 

Understanding Age-Related Macular Degeneration (AMD)

 

Age-related macular degeneration, often called AMD or ARMD, is the leading cause of vision loss and blindness among Americans who are age 65 and older. Because people in this group are an increasingly larger percentage of the general population, vision loss from macular degeneration is a growing problem.

 

AMD is degeneration of the macula, which is the part of the retina responsible for the sharp, central vision needed to read or drive. Because the macula primarily is affected in AMD, central vision loss may occur.

 

About 1.75 million U.S. residents currently have advanced age-related macular degeneration with associated vision loss, with that number expected to grow to almost 3 million by 2020.

 

Wet and Dry Forms of Macular Degeneration

 

Macular degeneration is diagnosed as either dry (non-neovascular) or wet (neovascular). Neovascular refers to growth of new blood vessels in an area, such as the macula, where they are not supposed to be.

 

Macular degeneration mainly affects central vision, causing “blind spots” directly ahead.

 

The dry form is more common than the wet form, with about 85 to 90 percent of AMD patients diagnosed with dry AMD. The wet form of the disease usually leads to more serious vision loss.

 

 

Dry macular degeneration (non-neovascular). Dry AMD is an early stage of the disease and may result from the aging and thinning of macular tissues, depositing of pigment in the macula or a combination of the two processes.

 

Dry macular degeneration is diagnosed when yellowish spots known as drusen begin to accumulate in and around the macula. It is believed these spots are deposits or debris from deteriorating tissue.

 

Gradual central vision loss may occur with dry macular degeneration but usually is not nearly as severe as wet AMD symptoms. However, dry AMD through a period of years slowly can progress to late-stage geographic atrophy (GA) — gradual degradation of retinal cells that also can cause severe vision loss.

 

No FDA-approved treatments are available for dry macular degeneration, although a few now are in clinical trials.

 

Blood Pressure Drugs Linked to Higher Risk for
Age-Related Macular Degeneration

 

Taking vasodilators and oral beta blockers for high blood pressure has been associated with a higher risk for developing age-related macular degeneration (AMD).

 

Very high blood pressure.
 High blood pressure must be controlled for good health, but the medications may increase risk of eye disease.

 

Analysis of data from the long-term Beaver Dam Eye Study of nearly 5,000 people found that taking vasodilators such as Apresoline and Loniten seems to bring a 72 percent greater risk of early-stage AMD. In fact, among those taking a vasodilator medication, 19.1 percent developed the eye disease.

 

And taking oral beta blockers such as Tenormin and Lopressor seems to increase the risk of neovascular AMD by 71 percent.

 

The researchers suggested that further clinical studies be conducted to replicate the results and to find out why taking these medications increase AMD risk, before changing anyone’s blood pressure medication.

 

A report of the analysis appeared online recently in the journal Ophthalmology.

 

Two large, five-year clinical trials — the Age-Related Eye Disease Study (AREDS; 2001) and a follow-up study called AREDS2 (2013) — have shown nutritional supplements containing antioxidant vitamins and multivitamins that also contain lutein and zeaxanthin can reduce the risk of dry AMD progressing to sight-threatening wet AMD.

 

Foods Containing Lutein and Zeaxanthin

 

The best natural food sources of lutein and zeaxanthin are green leafy vegetables and other green or yellow vegetables. Among these, cooked kale and cooked spinach top the list, according to the U.S. Department of Agriculture (USDA).

 

Non-vegetarian sources of lutein and zeaxanthin include egg yolks. But if you have high cholesterol, you’re much better off getting most of these yellow nutrients from fruits and vegetables.

 

Lutein and Zeaxanthin Foods
Food Serving mg
Kale (cooked) 1 cup 23.7
Spinach (cooked) 1 cup 20.4
Collards (cooked) 1 cup 14.6
Turnip greens (cooked) 1 cup 12.2
Spinach (raw) 1 cup 3.7
Green Peas (canned) 1 cup 2.2
Corn (canned) 1 cup 2.2
Broccoli (cooked) 1 cup 1.7
Romaine lettuce (raw) 1 cup 1.3
Carrots (cooked) 1 cup 1.1
Green beans (cooked) 1 cup 0.8
Eggs 2 (large) 0.3
 

Lutein and Zeaxanthin Supplements

 

Because of the apparent eye and cardiovascular benefits of lutein and zeaxanthin, many nutritional companies have added these carotenoids to their multiple vitamin formulas. Others have introduced special eye vitamins that are predominantly lutein and zeaxanthin supplements.

 

There currently is no Recommended Dietary Allowance (RDA) or Recommended Daily Intake (RDI) for lutein or zeaxanthin, but some experts say you should ingest at least 6 milligrams (mg) of lutein per day for beneficial effects.

 

It remains unclear how much lutein and zeaxanthin is needed daily for adequate eye and vision protection. Also, it is unknown at this time whether supplements have the same effect as lutein and zeaxanthin obtained through food sources.

 

There are no known toxic side effects of taking too much lutein or zeaxanthin. In some cases, people who eat large amounts of carrots or yellow and green citrus fruits can develop a harmless yellowing of the skin called carotenemia. Though the appearance of the condition can be somewhat alarming and may be confused with jaundice, the yellow discoloration disappears by cutting back on consumption of these carotenoid-rich foods. (Carotenemia also can be associated with over-consumption of carotenoid-rich nutritional supplements.)

 

While the supplements are helpful for the prevention of wet AMD, neither the AREDS nor the AREDS2 study demonstrated any preventive benefit of nutritional supplements against the development of dry AMD in healthy eyes.

 

Currently, it appears the best way to protect your eyes from developing early (dry) macular degeneration is to eat a healthy diet, exercise and wear sunglasses that protect your eyes from the sun’s harmful UV rays and high-energy visible (HEV) radiation.

 

 

Popular Lutein and Zeaxanthin Supplements Include:

 

 

EyePromise Zeaxanthin + Lutein Eye Vitamin - Protect & Enhance Macular Health, Address Key Macular Degeneration Risk Factor
 

 

Alcon ICaps Multivitamin Eye Vitamin & Mineral Support, Coated Tablets , 100 tablets
 

 

MacularProtect Complete AREDS2 Vitamin & Mineral Supplement

 

 

MedOp MaxiVision Macula Formula - 60 Capsules

 

 

Twinlab OcuGuard Plus - 120 Capsules
 
PreserVision AREDS 2 Vitamin & Mineral Supplement 120 Count Soft Gels
 

PreserVision AREDS 2 Forumla is the#1 recommended brand by eye doctors for people with moderate-to-advanced Age Related Macular Degeneration (AMD),1  and has over 1,425 excellent reviews by consumers.

Manufactured y Bausch + Lomb which is the leader in eye vitamins,2  this advanced PreserVision Formula contains the exact same levels of all six nutrients based on the latest clinical evidence from the AREDS2 study.3 Completed in 2013, the Age Related Eye Disease Study 2 (AREDS2) was a five-year study conducted by the National Eye Institute (NEI) of the National Institutes of Health.4

 

1 Wolters-Kluwer Pharma Solutions, B+L Brand Management Report, 5/13/11
2 March 2009 Retinal AMD Tracker, Decision Analysts, Inc.
3 The Age Related Eye Disease Study 2 (AREDS2) Research Group. Lutein + Zeaxanthin and Omega-3 Fatty Acids for Age-Related Macular Degeneration [published online]. JAMA. 2013;309(19):doi:10.1001/jama.2013.4997
4 NEI Press Release: NIH Study Provides Clarity on Supplements for Protection Against Blinding Eye Disease, www.nei.nih.gov/news/pressreleases, accessed May 17, 2013

The source of lutein in many lutein supplements is marigold flowers, while for zeaxanthin it is often red peppers. If you choose a lutein and zeaxanthin supplement, make sure it’s a high quality product from a reputable dietary supplement company, such as the well-known products I’ve recommended here.

Remember that taking dietary supplements does not replace a healthy diet. Eating a well-balanced diet that includes plenty of fruits and vegetables usually is the best way to get the important eye nutrients you need.

Also, remember that individuals sometimes react differently to certain supplements, which can have unintended effects such as adverse reactions with medications. Consult with your physician or eye doctor before trying any vision supplements.

 

 

Other Suggestions to Protect and Enhance Eye Health:

 

Duco Women’s Shades Classic Oversized Polarized Sunglasses 100% UV Protection

Duco Women's Shades Classic Oversized Polarized Sunglasses 100% UV Protection 1220 Brown

 

 

Oakley Men’s Plaintiff Sunglasses 100% UV Protection Coating

Oakley Men's Plaintiff Sunglasses (Polished Gold Frame/Dark Grey Lens)

 

 

 

To avoid complications from macular degeneration, have your eyes examined regularly and report any vision changes. If you have experience with macular degeneration, please share your thoughts below.

 

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