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NY & CT Seniors at Risk of Age-Related Macular Degeneration

10 Sep Macular Degeneration Happens Quietly with Age for Westchester Seniors.

It's easy for us to take healthy vision for granted until one day our eyesight is diminished. My 93 year old father, a former surgeon in Westchester, NY, had keen eyesight his entire life, but in the past few years noticed his vision was blurry with distorted spots in the center. When he was diagnosed with Age-related macular degeneration (AMD), he learned that in a few years he would not be able to see the details of someone’s face or the road in front of him on the highway. As AMD progresses, it causes wavy, blurred or lost central vision. This past month my father no longer could drive his beloved red convertible and felt the profound sadness of losing his independence.

AMD is the leading cause of severe, permanent vision loss in people age 50 and older. AMD vision loss progresses over the years, leading to damage to the macula, the center of the retina, which is responsible for sharp central vision. Blurry central vision makes it harder to drive, see faces clearly and read small print or see fine details. AMD may be related to a combination of heredity and environmental factors, including smoking and a poor diet. 

Here is what you need to know about AMD and its two types, dry and wet.

Eight five percent of AMD cases are called “Dry” AMD when the center of the retina deteriorates over time. They eye doctor can detect a mottled appearance that's caused by Drusen, yellow deposits that form under the retina. It sometimes affects only one eye and the unaffected eye may compensate so the vision loss is not so obvious in early stages. The remaining cases are called “Wet” AMD as leaky blood vessels grow and leak under the retina and cause permanent vision loss.

Amsler Grid AMD

According to Barbara Moran, RN, Director of Patient Care,  ”AMD vision loss is not noticed until the later stages, so regular preventive eye checkups are essential to protect eye health."

Dry AMD Symptoms

According to the Mayo Clinic, Dry AMD symptoms usually develop gradually and without pain. They may include:

images-Sep-01-2020-07-18-49-79-PM

  • Visual distortions, such as straight lines seeming bent
  • Reduced central vision in one or both eyes
  • The need for brighter light when reading or doing close work
  • Increased difficulty adapting to low light levels, such as when entering a dimly lit restaurant
  • Increased blurriness of printed words
  • Decreased intensity or brightness of colors
  • Difficulty recognizing faces

"Like most of the chronic diseases that affect us as we age, research shows that we may be able to lower our risk of AMD (or slow its progression) by making healthier  lifestyle choices," added Barbara. 

  • Quit smoking — or don’t start 
  • Get regular physical activity 
  • Maintain normal levels of blood pressure, cholesterol and blood sugar
  • Eating a majority of healthy foods, including leafy green vegetables such as kale, spinach, and collard greens, and fresh fruit. Fish high in omega-3 fatty acids at least once or twice a week, like salmon, sardines, mackerel, and herring.

Treatment of Dry AMD

There is no cure for Dry AMD and there are limited treatments including a healthful diet and dietary supplements which may halt further progression. Nothing to date will reverse the damage.

Vitamin and Mineral Supplements

The current recommended dietary supplements for AMD include a combination of antioxidants, carotenoids,* and omega-3 fatty acids based on  findings from two National Eye Institute studies called the Age-Related Eye Disease Study (AREDS). The Clinical trials showed that people at high risk of developing advanced stages of AMD lowered their risk by about 25% when treated with a high-dose combination of vitamin C, vitamin E, beta-carotene and zinc. In the same high-risk group – which included people with intermediate AMD, or advanced AMD in one eye but not the other eye – the nutrients reduced the risk of vision loss caused by AMD by about 19%. For those study participants who had either no AMD or early AMD, the nutrients did not provide an apparent benefit. 

There are two AREDS studies and the following supplement recommendations are based on AREDS2:

  • 500 milligrams (mg) of vitamin C
  • 400 international units of vitamin E
  • 80 mg zinc as zinc oxide
  • 2 mg copper as cupric oxide (to avoid anemia with high zinc intake)
  • 10 mg lutein*
  • 2 mg zeaxanthin*

Some of these supplements may also contain Omega-3 fatty acids (fish oil) up to 1000 mg and vitamin D. As with all vitamins and nutritional supplements, speak with your physician before taking the AREDS Formula. 

*Beta carotene, lutein and zeaxanthin are all a specific type of micronutrient found in plants called carotenoids, which are structurally related to vitamin A. Plants make them, in part to serve as antioxidants that protect them from potentially harmful sunlight. Studies show that the retina contains large amounts of two carotenoids, lutein and zeaxanthin. Beta-carotene, while used in the AREDS study,  is not recommended as a supplement. 

Treatment for Wet AMD

A variety of treatments are available for wet age-related macular degeneration. Successful treatment may not restore normal vision, but it will improve sight and prevent central vision loss from worsening.

Photodynamic therapy uses a non-heat-generating laser to treat abnormal blood vessels. While laser procedures can destroy the abnormal blood vessels, there is a risk they can also damage neighboring retinal tissue.

Medications such as Eylea, Lucentis, and Macugen have become the preferred treatment for acute wet macular degeneration, helping to prevent the growth of leaky blood vessels in your eye.


AMD Treatment Research on the Horizon

Nanoparticles Deliver Steroids....

https://www.brightfocus.org/research/macular-degeneration-research-program

UVA’s Center for Advanced Vision Science, found that the absence of a particular enzyme could drive both forms of AMD. The enzyme, called Dicer, is lost with age, and that loss leads to an overgrowth of blood vessels in the retina and other damage, he and his team determined.


Resources

Westchester, NY AMD Physicians and Services Directory 

My Home Insight Kit  

Recommended by the Macular Degeneration Association and sponsored by Novartis, this kit helps those with low vision to adapt their home. A helpful guide with room-by-room suggestions

  • An interactive audio guide
  • Plus, hands-on tools to help you apply the 5 principles

Macular Degeneration Association

MD Support

From the moment of his own diagnosis in 1994, educator and musician Daniel Roberts made it his mission to provide the most up-to-date information about AMD through his website at www.mdsupport.org. As a “patient expert,” Roberts applies his wealth of knowledge to The First Year® series, providing crucial information for the newly diagnosed, including therapies and tips on how to navigate everyday tasks with diminishing eyesight. An essential resource for everyone who wants to be an informed, active participant in the management of their condition, This web site offers free information and personal assistance for people dealing with macular degeneration and similar retinal diseases. 

National Eye Institute - NIH

Living with Low Vision: Personal Stories on Video

 

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