Age-related macular degeneration (called AMD for short) is a serious and complicated eye condition that can lead to blindness. It is called “age-related” because as people get older, their chances of developing this disorder increase.
Eye anatomy. Cross section of a human eye with Pupil, Cornea, Iris, Lens, Sclera, Choroid, and Retina. Close-up of Fundus of the right eye with Macula, Fovea and Optic disc. Vector poster
The retina is the back portion of the inner eye; the macula is the central portion of the retina. The retina receives light and transfers the light messages to the brain through the optic nerve. This results in sight. Because the macula is the central portion of the retina, if it undergoes degeneration, central vision is decreased.
AMD affects about 20 million people in the U.S. (about 17% of our population) and about 196 million worldwide (about 4.2%). In the U.S., it is the leading cause of vision loss in those over 60 years old. In 2015, it was estimated that AMD was the 4th most common cause of blindness worldwide and the 3rd most common form of moderate to severe vision loss.
In AMD, protein-lipid deposits form under the macula and build up. They are called drusen and lead to degeneration of the cells of the macula, causing loss of central vision. There are two types of AMD, wet and dry. About 10% of AMD is the wet variety. It is called wet because there is leakage of blood and other fluids under the retina, along with the development of abnormal blood vessels. Dry comprises about 90% of cases and can cause atrophy of the retina. Dry AMD can progress to the wet version. There is no established treatment for dry AMD at the present time, but several therapies are being studied, including red light therapy. The usual treatment for wet AMD is monthly injections into the eyes to decrease the development of the abnormal blood vessels and to prevent leakage from the current abnormal ones. For both types of AMD, a significant amount of research is being conducted to understand the causes and develop more effective treatments.
Risk factors for the development of AMD are multiple. Some of them are:
- Smoking
- Diet related – one high in saturated fat, causing elevated cholesterol & lipids
- Genetic factors – family history of AMD & being white
- Cardiovascular disease and untreated or poorly treated hypertension
- Exposure to sunlight without UV (ultraviolet) eye protection
- Physical inactivity
It is thought that inflammation* is a factor in the development of AMD. For people with the dry type of AMD, taking vitamins called AREDS 2, which contain Lutein and Zeaxanthin (as well as Vitamin C, Vitamin E, Zinc, and Copper), has been shown to reduce the risk of developing advanced disease. Lutein and Zeaxanthin are antioxidants in the carotenoid family that concentrate in the macula, absorbing harmful blue light, thereby eliminating free radicals. It is also always best to have a diet high in these antioxidants, to think of constantly bathing the body in antioxidants. Greens – kale, collards, spinach, Swiss chard – are especially high in Lutein and Zanxanthin.
Besides being closely followed by an ophthalmologist, people with AMD are taught to use the Amsler chart at home. This is a chart with horizontal and vertical lines, one focuses with one eye at a time on a central point and evaluates whether the lines are straight (good) or becoming wavy (possible progression of the disease). Changes are reported to the physician.
About eight years ago, my ophthalmologist told me I had macular degeneration. He knew of my plant-based, whole food diet and my efforts to maintain a normal weight by doing regular exercise. As the years have gone by, what he did not tell me initially was that I was probably at high risk for developing wet AMD. But, much to his amazement, I have been stable with the dry AMD. He believes it is my lifestyle and plant-based diet that have prevented the progression of the disease. During my last visit with him, he mentioned that he shares my story with his other patients as an example to encourage them to adopt a plant-based diet and regular exercise. It seems I have become his “poster child”!
The lifestyle changes that can be made to help reduce the risk of developing AMD, you have heard many times before! They are the same ones that lead to a healthier cardiovascular system, decreased risk of Alzheimer’s, prevention of diabetes, etc., etc., etc.
- Stop smoking.
- Get off your duff and move around. Turn off the TV. If you are at a desk in front of a computer at work, evidence shows that it is important to get up every hour and walk around. Simply walking regularly can be the best exercise. If the weather is too hot or too cold outside or if your neighborhood is unsafe, walk in your home or put on some music and dance. Do whatever you can to be active.
- Wear sunglasses with UVA/UVB protection and protect yourself with wide-brimmed hats when you are outside.
- Control your blood pressure and cholesterol. A diet high in fruits, vegetables, beans, and whole grains is ideal because it contains high levels of antioxidants and fiber. Cholesterol in the diet ONLY comes from animal products (meat of any form – beef, poultry, lamb, pork, seafood and fish, eggs, milk, and cheese). Animal products do not contain any antioxidants or fiber! It is best not to eat animal products every day. Switch out that breakfast egg for oatmeal (a whole grain), have a big salad with beans for lunch, have a hearty vegetable soup with whole grain bread for supper, and dessert of fruit.
- Eat a diet high in antioxidants. Any fruit or vegetable that is deeply colored is high in antioxidants; for example, dark leafy greens, blueberries, blackberries, cherries, carrots, sweet potatoes, and tomatoes. Eat 5 to 6 fruits a day (and tomatoes are really a fruit!). Think of bathing your body in antioxidants every time you eat.
- If you are diagnosed with AMD, follow the directions of your ophthalmologist and keep your schedule of regular visits.
If I were to boil this information down to the essentials:
DON’T SMOKE
EXERCISE
EAT A HIGH ANTIOXIDANT DIET OF FRUITS, VEGETABLES, BEANS, AND WHOLE GRAINS
MAINTAIN A NORMAL WEIGHT
My desire for you is to live a long and healthy life. I hope, through my blogs, that you understand the basics of lifestyle activities and habits that lead to good health. These blogs are intended for basic information only and are not meant to take the place of your health care provider’s advice.
Many thanks to my ophthalmologist extraordinaire for his editorial comments for this blog!
* Please see my previous blog on inflammation: “Out Smart Aging and Inflammation”
