Emerging Options: Hormone Therapy DHEA
Research has shown that the hormone dehydroepiandrosterone (DHEA) is abnormally low in patients with AMD (Bucolo 2005). DHEA has been shown to protect the eyes against oxidative damage (Tamer 2007). Because the macula requires hormones to function, an emerging theory hypothesizes that low blood sex hormone levels cause the retinal macula to accumulate cholesterol in an attempt to produce its own hormones (Dzugan 2002). The accumulation of cholesterol in macula may lead to the production of pathologic drusen and subsequent macular degeneration. An inverse association of female hormone with neovascular AMD was observed with current and former use of hormone replacement therapy among Caucasian and Latino women (Edwards 2010). Restoring optimal hormone balance with bioidentical hormones may be an effective new treatment for both men and women. Clinical studies are underway to test this hypothesis and possible hormonal treatment options.
Melatonin. Melatonin is a hormone and strong antioxidant that scavenges free radicals. Several studies have shown that many areas of the eye have melatonin receptors (Rastmanesh 2011; Lundmark 2006). In a clinical study, 100 patients with dry or wet AMD received 3 mg of melatonin at bedtime. The treatment prevented further vision loss. After six months, visual acuity had not diminished and the majority of patients had reduced pathologic macular changes upon examination (Yi 2005).