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Health Protocols

Macular Degeneration

What is Macular Degeneration?

Age-related macular degeneration (AMD) is a condition where the macula, the area of the eye responsible for the most distinct (central) vision, deteriorates and causes vision loss. AMD can be characterized as either atrophic (dry) or neovascular (wet). An eye doctor can recognize macular degeneration by the appearance of drusen (ie, cellular debris near the back of the eye) or hemorrhaging.

The exact cause of macular degeneration is not well understood, but chronic vascular disease could play an important role. Biomarkers predictive of cardiovascular risk (eg, elevated homocysteine and C-reactive protein levels) are also risk factors for AMD.

Natural interventions such as antioxidant vitamins, zinc, and carotenoids may help prevent degeneration and support healthy eyes.

What are the Risk Factors for Macular Degeneration?

  • Family history
  • Ethnicity—Caucasian-Americans are more likely than African-Americans
  • Vascular diseases (including cardiovascular disease)
  • Smoking
  • Phototoxicity (caused by exposure to blue and ultraviolet rays from sunlight)
  • Hypertension
  • Diet—including low intake of carotenoids and B vitamins, and high intake of saturated and trans fats

What are the Signs and Symptoms of Macular Degeneration?

  • Distorted central vision
  • Appearance of dark spots
  • Other visual distortions

What are Conventional Medical Treatments for Macular Degeneration?

  • Supplementation with antioxidant vitamins, carotenoids, and zinc
  • Intravitreous (injected into the vitreous humor in the eye) anti-vascular endothelial growth factor (anti-VEGF) inhibitors such as Macugen, Lucentis, and Avastin
  • Photodynamic therapy
  • Laser photocoagulation
  • Surgery (not usually recommended)
  • Visual aids such as implantable miniature telescopes

What are Emerging Therapies for Macular Degeneration?

  • Hormone replacement therapy

What Dietary and Lifestyle Changes Can Be Beneficial for Macular Degeneration?

  • Eat a healthy, well-balanced diet rich in omega-3 fatty acids (found in oily fish and flax seeds) and carotenoids (found in orange and yellow fruits and vegetables).
  • Quit smoking

What Natural Interventions May Be Beneficial for Macular Degeneration?

  • Vitamins A, C, and E, zinc, and copper. The Age-Related Eye Disease Study (AREDS), the largest and most important study of nutritional supplements in AMD, found this combination of nutrient improved AMD in most patients.
  • Carotenoids. Intake of carotenoids lutein, zeaxanthin, and meso-zeaxanthin is essential for eye health. Patients with AMD have sharply decreased levels.
  • Omega-3 fatty acids. Independent of supplementation with the AREDS nutrients, higher intakes of DHA and EPA were associated with a lower risk for progression to advanced AMD.
  • Bilberry. Anthocyanidins and cyanidin-3-glucoside (C3G) found in bilberry have been shown in preclinical studies to protect eye health.
  • Melatonin. The eye has multiple melatonin receptors. A clinical study showed AMD patients receiving melatonin did not experience further vision loss and had reduced pathologic macular changes.
  • Grape seed extract. Preclinical studies have shown grape seed extract may exert a protective effect against AMD and neurodegenerative disorders, as well as improve eye health.
  • L-carnosine. L-carnosine is important for protecting cells from free radical damage. Topically applied L-carnosine improved visual acuity, glare, and lens opacification in animals and humans with advanced cataracts.
  • Coenzyme Q10 (CoQ10). CoQ10 may protect eyes from free radical damage. Combined supplementation with CoQ10, acetyl-L-carnitine, and omega-3 fatty acids stabilized visual functions in patients affected by early AMD.
  • B vitamins. Elevated homocysteine levels and low B-vitamin levels are associated with an increased risk of AMD and vision loss in older adults. A large study found supplementing with folic acid, B6, and B12 significantly reduced the risk of AMD in adults with cardiovascular risk factors.
  • Other natural interventions that may benefit eye health include resveratrol, ginkgo biloba, selenium, lipoic acid, among others.
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