New clues to cause of mac­u­lar de­gen­er­a­tion

Nu­tri­tional stud­ies point to new pre­ven­tion and treat­ment strate­gies

The Covington News - - Health & Wellness -

Age- Re­lated Mac­u­lar De­gen­er­a­tion is a lead­ing cause of vi­sion loss in the United States, but dis­cov­er­ies about the roles played by nu­tri­tion, ge­netic fac­tors and im­mune re­sponse are pro­vid­ing clues to new pre­ven­tion and treat­ment mea­sures.

AMD can de­stroy the de­tailed, cen­tral vi­sion we need to read, drive, rec­og­nize faces, and en­joy daily life.

March is AMD Aware­ness Month, and Pre­mier Oph­thal­mol­ogy en­cour­ages Ge­or­gians to know their risks for AMD. “ We have a greater un­der­stand­ing of AMD than ever be­fore,” says Dr. Jef­feries. “ We are see­ing ex­cit­ing clin­i­cal and re­search ad­vances, but catch­ing AMD early still of­fers the best chance of pre­serv­ing vi­sion. Peo­ple need to know their risks so that they can save their sight.”

As part of the EyeS­mart cam­paign, the Amer­i­can Academy of Oph­thal­mol­ogy and Eye­Care Amer­ica, a pub­lic ser­vice pro­gram of the Foun­da­tion of the Academy, rec­om­mend that adults with no signs or risk fac­tors for eye dis­ease get a base­line eye dis­ease screen­ing at age 40— the time when early signs of dis­ease and changes in vi­sion may start to oc­cur. Based on the re­sults of the ini­tial screen­ing, an oph­thal­mol­o­gist will pre­scribe the nec­es­sary in­ter­vals for fol­low- up ex­ams.

For in­di­vid­u­als at any age with symp­toms of or at risk for eye dis­ease, such as those with a fam­ily his­tory of eye dis­ease, the Academy rec­om­mends that in­di­vid­u­als see their oph­thal­mol­o­gist to de­ter­mine how fre­quently their eyes should be ex­am­ined. One of the best ways to re­duce AMD risk is to quit smok­ing, as smok­ers have twice the risk of non­smok­ers.

New clues

Cer­tain nu­tri­ent sup­ple­ments are now known to be pro­tec­tive: the first AgeRe­lated Eye Dis­ease Study ( AREDS 1) of 4,000 peo­ple with AMD found that the pro­gres­sion to ad­vanced dis­ease among peo­ple at high risk de­clined by 25 per­cent when the sub­jects were given a high- dose com­bi­na­tion of an­tiox­i­dants and zinc. Eye MDs rec­om­mend this sup­ple­ment for­mula to their AMD pa­tients when ap­pro­pri­ate.

Th­ese nu­tri­ents may strengthen the abil­ity of a layer of cells in the eye’s retina to with­stand ox­ida­tive stress, a prob­a­ble fac­tor in AMD de­vel­op­ment. In the sec­ond AREDS study now un­der­way, re­searchers are as­sess­ing lutein, zeax­an­thin, and omega- 3 fatty acids, as­so­ci­ated in some large stud­ies with re­duced risk of de­vel­op­ing AMD.

Both AREDS projects were spon­sored by the Na­tional In­sti­tutes of Health. Eat­ing fruits and deeply col­ored veg­eta­bles such as red pep­pers and spinach — food sources of an­tiox­i­dants — pro­vides many health ben­e­fits, and one is likely to be pro­tec­tion against AMD.

About AMD

The dis­ease takes two forms, termed “ dry” and “ wet.” In the early “ dry” stage, drusen, yel­low de­posits, de­velop un­der the retina, but most peo­ple do not have a change in vi­sion. Pa­tients with more and larger drusen, and more pig­ment changes in the cen­tral retina, or mac­ula, are con­sid­ered to have in­ter­me­di­ate AMD and are at higher risk for both ad­vanced “ dry” and “ wet” AMD.

The ma­jor­ity of those with in­ter­me­di­ate AMD do not progress to the ad­vanced stage but should be care­fully fol­lowed by an Eye MD to in­sure timely treat­ment if needed.

Ad­vanced AMD can oc­cur in the “ dry” or the “ wet” form. Once the “ dry” form reaches the ad­vanced stage, with blind spots in the cen­tral vis­ual field, no med­i­cal or sur­gi­cal treat­ment is avail­able, al­though pa­tients can be pro­vided with lowvi­sion tech­nolo­gies, in­clud­ing im­proved light­ing and mag­ni­fi­ca­tion, to main­tain their qual­ity of life.

In the “ wet” form, ab­nor­mal new blood ves­sels de­velop un­der the retina that bleed or leak fluid and form scars, caus­ing cen­tral vi­sion loss. Only about 10 per­cent of the 10 to 15 mil­lion Amer­i­cans with AMD have the “ wet” form, but un­til two years ago it was re­spon­si­ble for most of the se­vere vi­sion loss.

New, highly ef­fec­tive treat­ments such as the in­jectable med­i­ca­tions ranibizumab and be­va­cizumab are dra­mat­i­cally re­duc­ing dam­age from “ wet” AMD: vi­sion sta­bi­lizes in over 90 per­cent of pa­tients and ac­tu­ally im­proves in more than 30 per­cent.

For more in­for­ma­tion about AMD and other eye dis­eases, visit www. geteyesmart. org.

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