Q: I was recently diagnosed with macular degeneration, what my ophthalmologist calls the “dry form”. I’m 64 years old and it has barely afffected my vision. My ophthalmologist recommended that I start a multivitamin for macular degeneration. Is there anything else I can do to preserve my eye sight?
A: There is quite a bit of information on nutrition and age-related macular degeneration (AMD). So much so nutrition has become the mainstay of therapy. We still need however more effective preventative and treatment strategies. One in ten folks over the age of 65 have some vision loss due to AMD, and nearly one in three over 75! Ninety percent of AMD is this non-exudative form also referred to as dry AMD, your diagnosis. This dry form is slower progressing than the wet. The wet form has specific medical treatments such as laser photocoagulation and medications. The dry form does not.
AMD is the progressive loss the photoreceptors, also called rods and cones. AMD affects the part of the retina where they are densest, the macula. Much of our visual acuity is dependent on this rich population of photoreceptors. Oxidative stress from free-radicals and damage from ultraviolet light combine in people who have a genetic predisposition to spell the early demise of these photoreceptors. This leads to vision loss and even to blindness. Although exactly how this occurs is not fully understood, enriching the diet with nutrients that specifically protect the retina from such damage is a good strategy. For instance, research shows that diets low in saturated fats and linoleic acid (common to many vegetable oils) and high in fish lower the risk of AMD.
Carotenoids, orange pigments found in colorful foods such as carrots are an important component of photoreceptors. The old notion of carrots being good for your night vision stems from this fact. The specific carotenoids lutein and zeaxanthin protect the eyes from damage. Studies support their use for both prevention and treatment of AMD. Food rich in these carotenoids include dark leafy greens, eggs, corn, grapes, oranges, squash, and zucchini. Definitely eat your vegetables.Studies showing benefit with supplementation with lutein used 10-15mg per day.
Zinc is a key mineral for eyes and its level may decline with age. Studies show benefit to patient with AMD with supplementation with zinc in the range of 45-80mg per day. Zinc can prevent copper absorption and lead to copper deficiency. Good eye supplement formulas with these healthy amounts of zinc will also add copper 1-4mg per day to prevent its deficiency.
Other important nutrients for AMD include taurine, B vitamins, selenium, fish oils, acetyl-L-carnitine, coenzyme Q10, and vitamin E. Vitamin E must be taken as “mixed tocopherols”, as taking the alpha form of vitamin E alone is likely to be ineffective. Each of these nutrients have been shown to slow the progression of AMD. Look for eye supplements that include these nutrients.
Other Plant-derived help include ginko biloba 80mg two times a day has been shown to improve vision in patients with AMD.Berries rich in anthocyanosides such as bilberries and blueberries are also believed to be of benefit but as yet have not been studied in AMD.
For those who have faster progressing forms of AMD, it is reasonable to measure levels of B6, B12, homocysteine, DHEA, and zinc with a routine laboratory. Specialty labs may also measure glutathione, taurine and coQ10. Correcting any of these deficiencies may help improve the treatment of AMD.
Also combinations of zinc and selenium have also been used intravenously (I.V.). In clinics who offer I.V. nutrient therapy, roughly a third of the patients have improved vision and another third experience a halting of progression. There are other unstudied observations that are very encouraging on the benefit of I.V. treatment with glutathione. Glutathione is a potent antioxidant and is notoriously difficult to absorb when taken orally.
Lastly protect your eyes with sunglasses that block U.V. rays. Be sure to keep your appointments with our ophthalmologist or retina specialist and report to your doctor any change in your vision.
Nexus January/February 2012