What about Macular Degeneration Prevention?

Do you have a loved one with Macular Degeneration who has experienced debilitating vision loss? You probably have many questions about this Eye Disease, not least of which: Are there Macular Degeneration Prevention measures available?

Dry ARMD can progress to advanced ARMD marked by Geographic Atrophy of the Macula. Other terms used to describe Dry ARMD are Nonexudative or Atrophic ARMD. Unfortunately, FDA approved Macular Degeneration Treatment options are not readily available for the dry type.

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Because it is recognized that the progression of ARMD is a process resulting from a combination of genetic predisposition and environmental risk factors, the treatment regimen, particularly for early stages of ARMD, centers on Macular Degeneration Prevention measures and early detection.

Antioxidant therapy is one of the main Macular Degeneration Prevention measures recommended by eye doctors to reduce your risk of progression.

The Age-Related Eye Disease Study (AREDS) was the first randomized placebo-controlled clinical trial evaluating vitamin supplementation for ARMD.

The study used an oral supplementation of a combination of:

  • Vitamin C (500 mg)
  • Vitamin E (400 International Units)
  • Beta-carotene (15 mg often labeled as equivalent to 25,000 International Units)
  • Zinc oxide (80 mg)
  • Cupric oxide (2 mg)
  • The study demonstrated that oral supplementation with this AREDS formula in patients with intermediate or advanced ARMD in one eye had a 25% relative risk reduction of developing advanced ARMD in the other eye (over a five-year period).

    The study also showed a 19% reduction in the relative risk of vision loss of three or more lines in individuals determined to be at high risk of developing advanced forms of the disease.

    Use of this nutritional supplementation has become the gold standard in the US and remains the only therapy for intermediate and advanced Dry ARMD. Evidence and data from other studies have motivated a sequel to this study, the AREDS 2 Clinical Trial. The AREDS 2 Clinical Trial will investigate the effect of other nutrients like omega-3 fatty acids and two xanthophylls (lutein and zeaxanthin). The study will also evaluate the effect of eliminating beta-carotene and reducing zinc in the original AREDS formula.

    Is Macular Degeneration Prevention linked to Early Detection?

    The AREDS Study revealed a possible link between genetics and supplementation when compared to placebo. In particular, the greatest benefit was seen in those individuals with the low-risk CFH genotype, among whom the rate of ARMD progression was reduced by approximately 68%.

    By contrast, the rate of ARMD vision loss in those individuals with the high-risk CFH genotype was reduced by only 11%. Also, an interaction was noted in the AREDS treatment groups taking zinc when compared with the groups taking no zinc, but not in groups taking antioxidants compared with those taking no antioxidants.

    These findings suggest that the strong genetic predisposition to ARMD progression of the high-risk CFH genotype group limits the benefits available from zinc and antioxidants.

    A case may be made for genetic screening of those individuals at high risk for developing advanced ARMD in order to identify those likely to achieve the greatest benefit and for increasing motivation to take the supplements.

    If you are identified as one who may be less likely to respond, however, supplementation may still have some benefit. You may also consider modifying environmental factors and avoiding undesirable side effects.

    Is Macular Degeneration Prevention linked to Lifestyle?

    Since ARMD progression has been associated with a number of modifiable external risk factors, there are several tips to follow to minimize your risk of vision loss:

  • Smoking cessation
  • Maintaining a healthy weight with good nutrition (green leafy vegetables, fish, walnuts) and exercise
  • Always wearing UV protection sunglasses while outdoors
  • Getting routine eye exams annually, especially after age 55

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