macular degeneration

Dry AMD

Aging changes at the back of the eye (AMD) involve the part of the eye responsible for central vision. This part of the eye is called the macula and is the central part of the retina. This condition can take two major forms termed dry and wet. The dry form of the condition is much more common than the wet form and generally causes less serious vision decline. This type of AMD is also likely to progress much more slowly than wet AMD. On average if we take 100 people with AMD around 80 to 90 will have the dry form of the condition. The other 10 to 20 will have the wet form. Milder forms of dry AMD can often be present without noticeable vision decline.

Recent studies indicate that it may be possible to reduce the risk of dry AMD from progressing to a more severe stage by modifying lifestyle and diet. The first sign of dry AMD is often the development of tiny yellow grain like deposits under the retina. These often start being small in size and gradually, often over many years, grow larger in size and increase in number. These deposits are called drusen. It is now recognised that people with just a few small drusen will have a very low chance of developing more advanced AMD over a five year period (around 1.3%) compared to a much higher risk of developing more advanced AMD in those who have already developed some larger drusen bodies.

Later signs of dry AMD may include gradual loss of specialised cells called retinal pigment epithelial cells (RPE). These cells act as the nutritional support system for the retina. Patchy loss of these cells is fairly common even early on in the AMD process but with time the patchy areas of RPE cell loss may coalesce and form larger islands of cell loss - a finding termed geographic atrophy. This stage of dry AMD is often associated with poor vision and is one of the types of AMD termed advanced.
Smoking

There is much evidence that smoking increases the risk of severe vision loss from AMD and from many other conditions. Stopping could therefore be of great benefit to you both for AMD and for your general health. In addition those patients who are non smokers for at least five years are also able to safely take the high dose vitamins discussed later. 

Vitamin supplements


The ARED study showed that AMD could be "slowed down" by using high dose vitamins containing Beta Carotene (a type of vitamin A), Vitamins C & E, Zinc & Copper. These were used at very high doses and were successful in slowing down AMD progression by around 25% after five years of use. This mixture of Vitamins A,C,E & Zinc/copper is now known as the AREDS formula. This type of formulation is recommended when there is already significant dry AMD present and only in non smokers. For smokers an alternative formulation (without the Vitamin A as this may increase the risk of lung cancer in smokers) can be considered. Recent updates on the ARED study have also indicated the likely positive effect of Lutein and Omega 3. There are now formulations available over the counter that contain Lutein in addition to the standard AREDS formula. At present most GPs are not obliged to prescribe these supplements on the NHS. This situation is currently under review in the Calderdale & Huddersfield area. The links given below may help you source these supplements for yourself.

http://www.ocuvite-store.co.uk/acatalog/index.html

http://www.viteyes.co.uk

Dietary Changes

Certain foods are high in either antioxidants or Lutein. Those patients who would prefer not to take vitamin pills may wish to alter their diet so that the foods indicated below are included more regularly in their diet.

 

 

 

 High Antioxidant Foods
  High Lutein Foods
  • Kale, Spinach
  • Raisins, Blackberries
  • Strawberries, Raspberries
  • Plums, Oranges
  • Brussel Sprouts, Alfalfa Sprouts
  • Broccoli, Red Peppers
  • Egg Yolk, Kiwi Fruit
  • Red Grapes, Maize
  • Orange/Yellow Peppers
  • Butternut Squash, Spinach
  • Mango, Carrots
  • Chicken Skin, Corn

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