Age-Related Macular Degeneration

By Elizabeth Godley


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For anyone 50 years old or better, the thought of developing age-related macular degeneration, a disease of the eye’s retina that can lead to tunnel vision and eventual blindness, is frightening. But the good news is that this condition can be slowed down or completely stopped if it is treated early.

Age-related macular degeneration (AMD) is a condition that typically affects older adults. Approximately 25 per cent of those 65 years and more have signs of AMD.

The condition results in a loss of vision in the centre of the visual field (the macula) because of damage to the retina. The disease can make it difficult or impossible to read or recognize faces, although enough peripheral vision may remain to allow other activities of daily life, such as walking and shopping.

here are two forms of AMD, known as “dry” and “wet.” In the dry form, cellular debris called drusen accumulate behind the retina. In the wet form, which is more severe, blood vessels grow behind the retina. In both forms, the retina can become detached.
AMD can progress quickly and patients who are not closely monitored by a physician can lose their sight rapidly.
A genetic component means that there is a 50 per cent chance that someone with AMD inherited risk factors from their parents. One in five of these individuals will lose vision as they age. Early detection and treatment can prevent AMD, but most patients don’t see an eye doctor until they have some vision loss. By then, it is too late.

As Dr. Paul Chris, Executive Director of the Vision Institute of Canada, points out, research suggests that AMD may be treated and its progress halted with certain vitamins. Results of the Age-Related Eye Disease Study (AREDS), reported in the Archives of Ophthalmology (October 2001), indicated that high levels of antioxidants and zinc significantly reduced the risk of advanced age-related macular degeneration and its associated vision loss. The same nutrients had no significant affect on the development or progression of cataracts, another age-related eye condition.

The study, sponsored by the National Eye Institute in the U.S., found that people at high risk of developing advanced AMD lowered their risk by about 25 per cent when treated with a high-dose combination of vitamin C, vitamin E, beta-carotene and zinc.

“The vitamin formula does not prevent macular degeneration, but it can reduce its progress,” says Dr. Chris, an optometrist with a special interest in nutrition. He points out that people in their 60s do not absorb nutrients the way they did when they were younger. However, he says, the particular combination of vitamins, minerals and antioxidants recommended, “Almost changes from week to week.” One 2009 study recommended folic acid, B-6 and B-12, while another study supported a combination of vitamin C, beta-carotene, zinc and copper.
In 2006, a second AREDS study was launched to determine if a modified combination of vitamins, minerals and fish oil could further slow the progression of vision loss from AMD. This study, known as AREDS2, refined the findings of the original study by adding lutein and zeaxanthin (plant-derived yellow pigments that accumulate in the macula), as well as omega-3 fatty acids DHA and EPA (derived from fish oils) to the study formulation. Previous observational studies have suggested these nutrients may protect vision.

However, for those who believe they have symptoms, visit an eye specialist for an AMD test before running out to spend a bundle on vitamins and minerals, cautions Dr. David Maberley, an ophthalmologist with the University of B.C.’s Centre for Macular Research.
High doses of these substances can cause side-effects, particularly in smokers, who may be at increased risk for lung cancer. Men who consume high doses of these vitamins may also increase their risk of prostate problems.

Dr. Maberley also notes new genetic tests are available at a cost of several hundred dollars for close relatives of AMD patients who are concerned about their prospects.

For more information, visit www.macularisk.com

 

JANUARY 2011 SENIOR LIVING MAGAZINE VANCOUVER ISLAND

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