New Treatment Options for Macular Degeneration Give Hope to Patients
Allison Menezes, M.D.
Fellowship-trained Retina Specialist
Anita Shane, M.D.
Fellowship-trained Retina Specialist
Macular Degeneration affects central vision, making tasks such as reading difficult.
The retina is the thin, delicate lining of the inside back wall of the eye. The retina is responsible for the sensation of vision. Similar to the film of a camera, it captures focused images and sends the information via the optic nerve to the brain which processes the information. Without the retina, you would not see.
The center of the retina, the macula, is used for detailed work and reading. The surrounding portion of the retina is responsible for peripheral vision.
Macular degeneration, also known as age-related macular degeneration (AMD), is a deterioration of the macula that results in impaired central vision. AMD is the number one cause of blindness in those over age 55. Factors that increase the chance of having macular degeneration include age, fair complexion, female gender, smoking and heart disease. A large, well-designed study, AREDS (Age-Related Eye Disease Study,) has concluded that high levels of dietary supplements consisting of a combination of vitamin C, vitamin E, beta carotene and zinc at specific concentrations may lower the risk of developing advanced stages of macular degeneration by 25% for people at high risk. We recommend the vitamin combination that replaces the beta carotene with lutein.
Dry AMD is the most common type of macular degeneration. Visual deterioration is usually milder in this form. Wet AMD affects 10 percent of all individuals with macular degeneration and is more severe. In wet AMD, abnormal blood vessels leak fluid and blood into the retina, causing loss of vision.
Treatments for Macular Degeneration
Careful monitoring of vision and regular eye exams are important for those with both forms of AMD. Dietary modifications are also important to help reduce the risk of dry AMD from worsening.
A new class of drugs, known as anti-VEGF medications, have been shown to slow and even reverse the progression of the disease in some patients. This form of therapy is designed to inhibit the unwanted blood vessel growth caused by AMD, thereby reducing leakage and bleeding. Examples of new therapies that we now offer include: Avastin®, Lucentis® and Eylea®.
Dietary Supplements for Macular Degeneration
A large, well-designed study, AREDS (Age-Related Eye Disease Study,) has concluded that high levels of dietary supplements consisting of a combination of vitamin C, vitamin E, beta carotene and zinc at specific concentrations may lower the risk of developing advanced stages of macular degeneration by 25% for people at high risk. Determination for whether you are at high risk is made after a dilated examination of the retina and possibly a fluorescein angiogram. If you are a smoker, beta carotene supplement is not recommended because it may increase the risk of lung cancer. Smokers can use a similar vitamin supplement that substitutes lutein for beta carotene. People with a history of urinary tract infections are cautioned that zinc may increase the chances of developing such infections. Additionally, copper supplements need to be taken, as zinc will otherwise cause a copper deficiency. It is not known what the impact of taking antioxidants and zinc combination supplements for decades will be. These supplements have no effect on the progression of cataracts. If you are presently taking daily multivitamins, you may consider switching to Centrum as your daily multivitamin, as this supplement was also used by some patients in the large study without untoward effects. The dosages of nutrients used in these studies are as follows: 500 mg of vitamin C, 400 IU of vitamin E, 10 mg of lutein, 80 mg of zinc as zinc oxide and 2 mg of copper oxide as cupric oxide.
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