Macular Degeneration: There is Hope
Author: Dr. Marc Grossman

Today, macular degeneration is the leading cause of irreversible blindness and by the year 2020, an estimated 7.5 million Americans will suffer significant vision loss due to macular degeneration. Although there is no effective treatment yet, natural remedies can go a long way in preventing the disease from progressing to the point of vision loss.

WHAT IS MACULAR DEGENERATION?
How do you know if you have the disease? Macular degeneration is the slow deterioration of the cells in the macula, a tiny yellowish area near the center of the retina where vision is most acute. This deterioration therefore affects your central vision, the very vision you use for reading, writing, driving, and identifying faces. When you have macular degeneration, straight lines become crooked, distinct shapes are blurry, lines become wavy, and there is a fog in the center of your vision. However your peripheral vision is not affected.

There are two types of macular degeneration. Ninety percent of people with macular degeneration have the dry type, in which small yellow spots called drusen form underneath the macula. The drusen slowly break down the cells in the macula, causing distorted vision. Dry macular degeneration can progress to the second, more severe type, called wet macular degeneration.

In the wet type of macular degeneration, new abnormal blood vessels begin to grow toward the macula, these new blood vessels may leak blood and fluid that further deteriorate the macula, causing rapid and severe vision loss.

CONVENTIONAL TREATMENT
At the present time, there is no effective treatment. Some causes of wet macular degeneration are treated with laser surgery, but the treatment itself may not effectively seal up a leaky blood vessel without at the same time permanently destroying retinal nerve fibers that pass through the area. According to the National Eye Institute, laser treatment can actually worsen vision and it is at least a year after surgery before any possible benefits may be realized.

As always, prevention is the best medicine. Since less than one per cent of those with macular degeneration have progressed to the point of legal blindness, most are in a position to benefit greatly from prevention.

PREVENTION AND TREATMENT
Although conventional eye doctors offer no effective treatment for macular degeneration at the present time, it can hopefully be prevented, and once diagnosed, can be treated with complementary treatments.

NUTRITIONAL INTERVENTION FOR MACULAR DEGENERATION
The two most important nutrients are lutein and zeaxanthin. What does lutein and zeaxanthin do for our eyes?

The macular pigment is actually composed of lutein and zeaxanthin, and functions as a color filter to protect the light- sensitive photoreceptor cells (the cones) from light originated free radical damage. Lutein and zeaxanthin have been identified as the only two caratenoid antioxidants specific to the lens and macular health. Lutein and zeaxanthin filter light and serve as potent free radical scavengers for the retina.

Lutein and zeaxanthin supplements are best taken separately from beta- carotene supplements because they compete for absorption. Also, they need fat to absorb well, so take them with food or a small amount of oil. The best time to take lutein is at night before you go to bed.

Other important nutrients for the treatment of macular degeneration include the following:
Zinc is found in high concentrations in the eye, especially the retina and its underlying tissues. Zinc helps bind the protective pigment layer of the retina to the underlying tissue.

Vinpocetine is an extract from periwinkle seeds, and helps increase retinal circulation. In one study, 100 predominantly atherosclerotic patients with eye disorders were given vinpocetine. Eighty-eight subjects responded with increased retinal circulation and improved visual acuity

Bilberry, nicknamed the vision herb, has accumulated 40 years of research confirming its benefits for the eyes. The constituents in bilberry responsible are called anthocyanosides. Bilberry improves the delivery of oxygen and blood to the eye, helps maintain the integrity of capillaries, helps stimulate the production of rhodopsin needed for night vision and contains antioxidants for healthy tissues and strengthening collagen.

Pycnogenol and/or grape seed extract: These contain a powerful antioxidant called proanthocyanidins that are many times stronger than vitamin E and vitamin C. It has a very powerful free radical scavenger ability. It strengthens capillaries, arteries and veins, improves circulation, reduces capillary fragility and reduces nerve damage in the eye. Richard Passwater, in his 1993 book “The Superantioxidant? mentions studies that have shown that pycnogenol improves visual acuity and the functioning of the retina, especially in cases of retinal damage caused by the microbleeding of the eye capillaries due to blood sugar imbalances.

Taurine is an important amino acid needed for the maintenance of vision and the regeneration of worn out tissues of the visual system. It is found in high concentrations in the retina, especially in the photoreceptor cells, where it protects cells from ultraviolet damage. Unfortunately the concentration of taruine decreases as we age. Furthermore, studies have shown that when taurine is removed from food, animals develop retinal degeneration, which is reversed upon the replacement of taurine.

Essential Fatty Acids (EFA’s) are just as essential to a healthy balance of body chemistry, and thus proper cell function, as good food, vitamins and minerals. They are an integral component of nerve cells, cell membranes and vital hormone like substances called prostaglandins, which help regulate numerous body functions, including normal immune response during inflammation. There are two basic types of EFA’s, omega-3 and omega-6. The best sources of omega 3 fatty acids are cold water fish- salmon, herring, mackerel as well as black currant seed oil, flax seeds and flax seed oil.

Omega-3 fatty acids are so essential to the retina, that when omega-3 levels begin to fall, the retina begins to recycle it within the eye. Omega-3 fats are essential for nerve conduction in the retina and to reduce cholesterol, thus helping to maintain retinal nutrition by keeping retinal blood vessels open.

Below are some other considerations:
Sunglasses should be worn when outside in bright sunlight. They should be 100 percent UVA and UVB blocking lenses with wrap around sides. Wear along with a 3 inch brim hat.

Aspirin: Aspirin thins the blood, so some doctors may recommend it for improving blood flow to the retina, but some studies have shown that aspirin actually can cause macular degeneration through retinal hemorrhages. Therefore, try to stay off aspirin.

Foods: The foods we recommend include kale, collard greens and spinach. Of these all have a high amount of lutein and zeaxanthin. Avoid refined sugars, caffeinated beverages, alcohol, margarine and red meat. Drink 8-10 glasses of water per day, but not with meals. Liquid can be taken 30 minutes before or 2 hours after a meal.

There are hundreds of research studies that show that what one eats can have a significant effect on health of the macula. Unfortunately, once a person has macular degeneration, a healthy diet is not enough to prevent this disease from worsening. The levels of nutrients found in foods and in typical multivitamins are not levels that significantly impact on the progression of the disease.

However, therapeutic doses of certain supplements have been shown not only to reduce the risk of macular degeneration, but also to improve vision in people who already have the disease. Since it can take up to nine months for retinal cells to rejuvenate, any nutritional program for macular degeneration should be taken for a minimum of nine months.

The following are some recommended therapeutic dosages for the above-mentioned nutrients (this can vary on an individual basis so contact a qualified health care practitioner if you have any questions)

Lutein - 6-30 mg
Zeaxanthin - 300 mcg
Zinc - 30 mg
Bilberrry - 180 mg
Pycnogenol or grape seed extract - 120 mg
Taurine - 1,000 mg
Essential fatty acids - 1,500 mg
Vinpocetine - 50 mg

In summary, proper nutritional supplementation and diet, as well important lifestyle changes, are fundamental in any preventive program or as an adjunct to any treatment given for macular degeneration. Macular degeneration is a difficult disease to control, and we need incorporate the best of what we have learned to date in nutritional support and supplementation. Sources:



The following provides a brief overview of some of the scientific
research done on nutrients and macular degeneration (see “Research Studies
at website: www.visionworksusa.com for more information)
eye and causes photo-oxidation in the macular region, which can cause
drusen. He concluded that lutein and zeaxanthin inhibit blue light
damage by absorbing blue light and inhibiting photo-oxidation.
Richer, J. Amer Optom Assoc; Jan 1999
Schepens Eye Research Institute , An Affiliate of Harvard Medical
School, “Improved Nutrition Could Prevent Vision Loss, Schepens Study
Finds,?February 1998.
Altern Med Rev 1998 Apr;3(2):128-36. Oftalmol Zh 1989;(8):463-5 Brain
Res Brain Res Rev 1991 May-Aug;16(2):151-69 J Neurosci Res
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Hammond, etal. Invest Ophthalvol Vis Sci 1997 Aug;38(9):1795-801
J T Landrum et al, "The Macular Pigment: A Possible Role in Protection
from Age-Related Macular Degeneration," Advances in Pharmacology, 1997,
Volume 38, Pages 537-556.
Landrum, et al. Exp Eye Res 1997 Jul;65(1):57-62
Seddon, et al. J. Amer Med Assoc; 1994.










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Marc Grossman, Optometrist and Licensed Acupuncturist, has been helping people preserve their vision in his private practice for over 20 years. He is the co-author of “Natural Eye Care?(Keats, April, 1999), and lectures internationally on natural eye care, nutrition and Chinese medicine. For more information on nutrition and eye disease, you can visit his website at http://www.visionworksusa.com, or call 888-735-8475.

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