Text Size

Site Search powered by Ajax

Macular Degeneration

Macular Degeneration

Description

Macular degeneration is atrophy or deterioration of the macula, the central area of the retina. It may be an advanced stage of retina pigmentosa. Current estimates are that millions of Americans suffer from macular degeneration. With the aging population, this number is expected to increase dramatically, to 7.5 million by the year 2020.

Because it is predominantly age-related, it is often referred to as age-related macular degeneration, or ARM, or ARMD.

What is the macula?

Your eye is, basically, a camera. There is an opening (pupil/an aperture) at the front, which adjusts, with a lens, to bring objects into focus on the back of your eye (retina/film). The retina is made up of a delicate, light-sensitive tissue, rather like the film in a camera.

Incoming rays of light are focused at the center of the retina, termed the macula. The macula is very important to:

· what we see straight in front of us
· detailed activities such as reading and writing, and
· our ability to appreciate colors.

Sometimes the delicate cells of the macula become damaged and stop working. We do not know why this is, although it tends to happen as people get older. This is called Age-related Macular Degeneration (AMD).

Consequently, it usually involves both eyes, eventually. The visual cells simply cease to function, like the colors fading in an old photograph - this is known as 'dry' degeneration. The dry form accounts for 90% of cases and is caused by aging and thinning of the tissues of the macula. It develops slowly and usually causes mild vision loss. People often notice a dimming of vision when they read.

Wet macular degeneration is a much greater threat to vision loss even though it accounts for only 10% of cases. With the wet form of the disease, new blood vessels grow beneath the retina where they leak fluid and blood and can create a large blind spot in the center of your visual field. If this happens, there will be a marked disturbance of vision. The classic early sign of wet AMD is that straight lines appear crooked.


Causes

Although it's more common for people over 60, it is possible to develop symptoms in the 40's or 50's. This lends credence to the oxidative theory. A lack of dietary (and/or supplementary) antioxidants allows the macula to degenerate. Another common nutritional deficiency in the elderly, related to the eye, is zinc.

Macular degeneration often runs in families, so a genetic link is also being hunted.

Children and young people can also suffer from an inherited form of macular degeneration called macular dystrophy. Sometimes several members of a family will suffer from this, and if this is the case in your family it is very important that you have your eyes checked regularly.

Sometimes there is scarring of the macula caused by leaking blood vessels and this is called disciform maculopathy. This may occur, together with other retinopathy, most aggressively in diabetics.

Signs & Symptoms

In the early stages central vision may be blurred, or distorted. This may happen quickly, or develop over several months. You may be very sensitive to light, or actually see lights that are not there. This may cause some discomfort, occasionally but otherwise macular degeneration is not painful.

When advanced, patients will often notice a blank patch, or dark spot, in the center of their sight. This makes activities like reading, writing and recognizing small objects, or even faces, very difficult.

Symptoms can include:

· blurry or fuzzy vision
· straight lines, such as sentences on a page, telephone poles, and
· sides of buildings, appear wavy
· a dark or empty area appears in the center of vision

Fortunately, macular degeneration is not painful and cannot cause total blindness because only the central vision is involved. This means that almost everyone with macular degeneration will have enough side vision to get around and stay independent. However, age-related macular degeneration (AMD) is the leading cause of irreversible vision loss among older persons.

Nutritional Supplements

---------------------------------
General Supplements
---------------------------------

Anthrocyanadin (Bioflavonoids)
Beta-carotene
Copper
Lutein
Proanthocyanidins
Selenium
Taurine
Vitamin B6
Vitamin C
Vitamin E
Zinc

Please refer to the respective topic for specific nutrient amounts.

Note: All amounts are in addition to those supplements having a Recommended Dietary Allowance (RDA). Due to individual needs, one must always be aware of a possible undetermined effect when taking nutritional supplements. If any disturbances from the use of a particular supplement should occur, stop its use immediately and seek the care of a qualified health care professional.

Discussion:

It is claimed that vitamin and mineral supplements can stabilize dry macular degeneration. Controlled, scientific studies have not yet substantiated this, entirely; although a large National Eye Institute research study is in progress.

Because zinc is important for the health of the retina, some ophthalmologists think that supplements of zinc in the diet may slow down the process of macular degeneration. Zinc, being concentrated in the eye, is often highly recommended.

Studies have shown that some older people have low levels of zinc in their blood, either because of poor diet, or poor absorption, of zinc from food. It is possible that too much zinc may interfere with other trace minerals such as copper.

Dietary Considerations

Good nutrition requires a diet with a healthy mixture of proteins, carbohydrates, fats, vitamins and minerals. The first step to overall good health is a balanced diet.

The xanthophylls (a class of carotenoid e.g. lutein and zeaxanthin) are concentrated in the macula of the eye. Dietary intake of lutein /zeaxanthin (xanthophylls) is strongly associated with a reduced risk of AMD, while other carotenoids do not offer significant protection. This protective effect (of lutein/zeaxanthin) was even more pronounced in smokers.

Two of the vegetables particularly high in these xanthophylls, spinach and collard greens, have reduced the risk of AMD. Participants eating ½ cup of these vegetables, 2 to 4 times a week, had a 46% reduction in AMD, while those eating 5 or more times had an incredible 86% reduction in incidence of AMD.

· Avoid rancid foods and all other sources of free radicals.
· Eat lots of blueberries, blackberries, and cherries.
· Eat lots of legumes (beans) and yellow vegetables.

Natural zinc-rich foods include: beans, pumpkin seeds, seafoods and whole grains.

Homeopathic Remedy

Equisetum (Horsetail)
Silicea tinct.

Treatment Schedule

Doses cited are to be administered on a 3X daily schedule, unless otherwise indicated. Dose usually continued for 2 weeks. Liquid preparations usually use 8-10 drops per dose. Solid preps are usually 3 pellets per dose. Children use 1/2 dose.

Legend

X = 1 to 10 dilution - weak (triturition)
C = 1 to 100 dilution - weak (potency)
M = 1 to 1 million dilution (very strong)
X or C underlined means it is most useful potency

Asterisk (*) = Primary remedy. Means most necessary remedy. There may be more than one remedy - if so, use all of them.


References

Boericke, D.E., 1988. Homeopathic Materia Medica.

Coulter, C.R., 1986. Portraits of Homeopathic Medicines.

Kent, J.T., 1989. Repertory of the Homeopathic Materia Medica.

Koehler, G., 1989. Handbook of Homeopathy.

Shingale, J.N., 1992. Bedside Prescriber.

Smith, Trevor, 1989. Homeopathic Medicine.

Ullman, Dana, 1991. The One Minute (or so) Healer.

Tissue Salts

Silicea

Herbal Approaches

----------
Herbs
-----------


Aloe vera
Bilberry
Chamomile
Ginkgo Biloba
Horsetail

Note: The misdirected use of an herb can produce severely adverse effects, especially in combination with prescription drugs. This Herbal information is for educational purposes and is not intended as a replacement for medical advice.

Aromatherapy - Essential Oils

Related Health Conditions

Aging
Cataract
Diabetes Mellitus
Eye disorders
Glaucoma
Infection

Abstracts

References

Allen-MJ Treating age-related macular degeneration [letter] Optom-Vis-Sci. 1994 Apr; 71(4): 293.

Bone RA & Landrum JT: Distribution of macular pigment components, zeaxanthin and lutein, in human retina. Methods Enzymol 213:360-6, 1992.

Bone RA et al., Distribution of lutein and zeaxanthin stereoisomers in the human retina. Exp Eye Res, 1997 Feb, 64:2, 211-8.

Bonte CA et al., Macular pattern dystrophy in patients with deafness and diabetes. Retina, 1997, 17:3, 216-21.

Browning DJ et al., The effect of patient characteristics on response to focal laser treatment for diabetic macular edema. Ophthalmology, 1997 Mar, 104:3, 466-72.

Darzins P et al., Sun exposure and age-related macular degeneration. An Australian case-control study. Ophthalmology, 1997 May, 104:5, 770-6.

Ederer F: Methodological problems in eye disease epidemiology. Epidemiol Rev, 1983, 5:, 51-66.

Ellis, J.M.: Diabetes New Therapies: Clinically Proven Usage of Vitamin B6. 1995.
Gaby, A. R. & Wright, J. V: Nutritional Factors in Degenerative Eye Disorders: Cataract and Macular Degeneration, Journal of The Advancement of Medicine, Spring, 1993;6(1):27- 40.

Goldberg J. et al., Factors associated with age-related macular degeneration. Am J Epidemiol 128:700-10, 1988.

Hammond BR Jr et al., Dietary modification of human macular pigment density. Invest Ophthalmol Vis Sci, 1997 Aug, 38:9, 1795-801.

Hankinson, S.E. et al., Nutrient intake and cataract extraction in women: a prospective study. BMJ 1992, 305: 335-339.

Heinerman, John. 1982. Herbal Dynamics. Root of Life, Inc.: Publ.

Johnson-LE: The emerging role of vitamins as antioxidants. Arch-Fam-Med. 1994 Sep; 3(9): 809-20.

Kaminski-MS et al: Evaluation of dietary antioxidant levels and supplementation with ICAPS-Plus and Ocuvite. J-Am-Optom-Assoc. 1993 Dec; 64(12): 862-70.

Katz ML, Parker KR, Handelman GJ, et al: Effects of antioxidant nutrient deficiency on the retina and retinal pigment epithelium of albino rats: a light and electron microscopic study. Exp Eye Res 34:339-69, 1982.

Khachik F et al., Identification of lutein and zeaxanthin oxidation products in human and monkey retinas. Invest Ophthalmol Vis Sci, 1997 Aug, 38:9, 1802-11.

Klauss, V. & Adala, H.S. Traditional herbal eye medicine in Kenya. World Health Forum. 1994, 15: 138-143.

Klein R et al., The five-year incidence and progression of age-related maculopathy: the Beaver Dam Eye Study [see comments]. Ophthalmology, 1997 Jan, 104:1, 7-21.

Kristinsson JK et al., Retinal vessel dilatation and elongation precedes diabetic macular oedema. Br J Ophthalmol, 1997 Apr, 81:4, 274-8.

Lebuisson, D.A. et al: Treatment of senile macular degeneration with Ginkgo biloba extract. A preliminary double-blind, drug versus placebo study. Presse Med. 1986, 15: 1,556-1,558.

Mares-Perlman-JA et al: Dietary fat and age-related maculopathy. Arch-Ophthalmol. 1995 Jun; 113(6): 743-8.

Mares-Perlman-JA et al: Association of zinc and antioxidant nutrients with age-related maculopathy. Arch-Ophthalmol. 1996 Aug; 114(8): 991-7.

Mayne-ST: Beta-carotene, carotenoids, and disease prevention in humans. FASEB-J. 1996 May; 10(7): 690-701.

Midena E et al., Macular function impairment in eyes with early age-related macular degeneration. Invest Ophthalmol Vis Sci, 1997 Feb, 38:2, 469-77.

Morley JE et al., Nutrition in the elderly [clinical conference]. Ann Intern Med, 1988 Dec 1, 109:11, 890-904.

Newsome, D.A. et al. Oral zinc in macular degeneration. Arch Ophthmol., 1988; 106: 192-198.

Oshinskie-LJ: Age-related macular degeneration. Optometry-Clinics. 1996; 5(1): 25-53. (102 ref)

Richer-SP: Is there a prevention and treatment strategy for macular degeneration? J-Am-Optom-Assoc. 1993 Dec; 64(12): 838-50.

Richer S: Multicenter ophthalmic and nutritional age-related macular degeneration study--part 1: design, subjects and procedures. J Am Optom Assoc, 1996 Jan, 67:1, 12-29.

Sarma-U et al: Nutrition and the epidemiology of cataract and age-related maculopathy. Eur-J-Clin-Nutr. 1994 Jan; 48(1): 1-8.

Scharrer, A. & Ober, M.: Anthocyanosides in the treatment of retinopathies. Klin. Monat. Aug. 1981, 178: 386-389.

Schlach, W. Carotenoids in the retina - a review of their possible role in preventing or limiting damage caused by light and oxygen. Free Radicals & Aging. 1992:281-297.

Seddon JM et al., Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group [see comments] [published erratum appears in JAMA 1995 Feb 22;273(8):622]. JAMA, 1994 Nov 9, 272:18, 1413-20.

Snoddely, M. Evidence for protection against age-related macular degeneration by carotenoids and antioxidant vitamins. Am. J. Clin. Nutr. 1995,62: 1,448S-1,461S.

Taylor-A et al: Oxidation and aging: impact on vision. Toxicol-Ind-Health. 1993 Jan-Apr; 9(1-2): 349-71.

Tsubota, K. & Nakamori, K.: Dry Eyes and Video Display Terminals. New England Journal of Medicine, February 25, 1993;328(8):584.

van-der-Hagen-AM et al: Free radicals and antioxidant supplementation: a review of their roles in age-related macular degeneration. J-Am-Optom-Assoc. 1993 Dec; 64(12): 871-8.

West S. et al., Are antioxidants, or supplements, protective of age-related macular degeneration? Arch Ophthalmol 112:222-7, 1994.

Young RW: Solar radiation and age-related macular degeneration. Surv Ophthalmol 32:252-69, 1988.