Strategies for warding off macular degeneration
In the realm of eye health, age-related macular degeneration (AMD) is a significant concern, particularly for older adults. This irreversible eye disease affects the macula, a part of the retina responsible for sharp, central vision. AMD is the leading cause of vision loss in older adults in the United States.
The direct cause of AMD remains unknown, but certain risk factors have been identified. People over age 55 are at a higher risk, as are those with a family history of AMD. Having high cholesterol levels, high blood pressure, being overweight, and a diet high in saturated fats may also increase the risk of developing AMD.
Fortunately, there are strategies to prevent or slow the progression of AMD. The recommended approach centers on a combination of lifestyle changes, dietary habits, regular eye exams, and, in some cases, supplement use or medical treatments.
Lifestyle modifications are key. Quitting smoking, which is a major risk factor for AMD, is a crucial step. Protecting eyes from ultraviolet (UV) radiation by wearing sunglasses with UVA/UVB protection outdoors is also essential. Maintaining healthy cardiovascular health by managing blood pressure, cholesterol, obesity, and diabetes, as well as regular exercise, support overall and eye health.
Dietary recommendations focus on a whole foods diet rich in leafy green vegetables, which provide lutein and zeaxanthin, antioxidants known to benefit eye health. Including omega-3 fatty acids from fish and a variety of colorful fruits and vegetables, and considering a Mediterranean-style diet, are associated with reduced AMD risk.
Supplements play a role for individuals with intermediate AMD. Taking AREDS2 supplements (vitamins C and E, zinc, copper, lutein, and zeaxanthin) has been shown to slow disease progression. However, these supplements are not recommended for prevention in people without AMD or those with only early-stage AMD.
Regular eye exams are crucial for early detection and monitoring of AMD progression. Early detection allows timely management to help preserve vision. An OCT test, a specialized test performed by a doctor to take pictures of the inside of the eye, is also important for diagnosis and monitoring.
Medical treatments for wet AMD (advanced stage) include anti-VEGF injections (e.g., Lucentis, Eylea, Avastin) which can slow vision loss by inhibiting abnormal blood vessel growth. These treatments are administered under specialist care and are not preventive but therapeutic.
In the early stages of dry AMD, regular eye appointments or using an Amsler grid at home can help monitor eyesight. Distortion on an Amsler grid may indicate visual problems, including AMD, and should be reported to a doctor. In late wet or dry AMD, a person may notice straight lines appear to be wavy or curvy, which is a warning sign and should be reported to a doctor immediately.
In summary, the best approach to preventing or slowing AMD progression centers on quitting smoking, protecting eyes from UV, maintaining a healthy diet rich in antioxidants and omega-3s, regular exercise, controlling systemic health factors, frequent eye examinations, and for those diagnosed with intermediate AMD, evidence-supported supplementation and medical treatments as needed. Regular eye tests are important for early detection of AMD, as the first stages may not display symptoms.
