Macular Degeneration (ARMD / AMD)
The macula is responsible for central, most highly focused vision. It is a small yellowish area at the center of the retina. colored yellow by the pigments of the antioxidants lutein and zeaxanthin. Zeaxanthin is most highly concentrated in the macula and lutein predominates in other areas of the retina. The yellow color of the macula allows it to absorb blue to UV light and behave like sunglasses for the center of the retina, protecting the most important part of the retina from UV's damaging effects.
Macular Degeneration (AMD, ARMD) is the gradual breakdown of the cells of the macula cells which are responsible for your central vision, the point where your vision is most exact. The deterioration weakens your ability to read, write, drive, and recognize faces, which are all activities requiring healthy central vision. Peripheral, or side vision isn't damaged.
Next: Nutritional support, diet, & lifestyle tips for macular degeneration.
Blindness is not inevitable for people who have ARMD. There is a large amount of peer review research showing ARMD to be a nutritional and lifestyle responsive eye disease, and that you can stabilize and possibly even improve your vision with healthy lifestyle choices.
Most people with ARMD have dry macular degeneration. In dry macular degeneration tiny, yellow drusens develop. Drusens are accumulations of fatty, yellow material that form in the macula and people with ARMD have more and larger drusens than what is common with aging. They are thought to be comprised of waste proteins and lipids (oily material) that begin to accumulate due to poor circulation and waste-flushing in the eye. Antioxidants are important for the normal waste-clearing process. The drusen slowly crowd, distort, or break the cells in the macula leading to deterioration and resulting in blurred vision. Because drusen also include immune-system regulating molecules, it is thought that they are part of the immune system.3
The second type of macular degeneration is the "wet" form, (also known as choroidal neovascularization) in which new blood vessels begin to develop near the macula, causing fast and serious vision loss. Wet macular degeneration can result from progression of dry macular degeneration, left untreated, and affects about 10% of macular degeneration patients.
- Lines look distorted or wavy. (try the amsler test) In more developed AMD, the amsler grid can look quite distorted
- Shapes look blurred, fuzzy, or hazy in central vision
- Colors appear more dim and less distinct
- Words are hard to read because they are blurred
- Blank or dark areas hide the center area of your vision
- The center of vision looks foggy or cloudy
- Heredity is a risk factor. People who have a family history of AMD are more at risk to develop the condition.
- Free radicals can damage the eyes. They are formed when the blue and ultraviolet sunlight passes through the crystalline lens of the eye. Free radicals also result as natural metabolism byproducts. These chemical are highly reactive and cause oxidation. The result is destabilization of healthy macula cells in the eyes.
- Hypertension. People with high blood pressure are more likely to develop AMD than those with normal blood pressure.
- Smoking, chronic fatigue and a weak immune system hasten damage from free radicals. Smoking increases the risk of AMD by 200-300%.
- Poor digestion and nutritional deficiencies - People with ARMD are often deficient in a number of nutrients that are essential to eye health such as lutein, essential fatty acids, zeaxanthin, taurine, antioxidants, zinc, bioflavonoids, selenium, and vitamin B-complex.
- Low carotenoid levels. Read more about how carotenoids protect your vision.
- Systemic inflammation, indicated by high levels of c-reactive protein has been tied to increased macular degeneration risk.2
- Women are more at risk at developing AMD.
- Diabetics are more at risk to develop AMD.
- Drugs that can damage the retina:
- Plaquenil (hydroxychloroquine sulfate), often prescribed for rheumatoid arthritis, has been found to cause permanent damage to the retinal.
- Chloridine (Catapres), for high blood pressure
- NSAIDS (non-steroidal, anti-inflammatory drugs) side effects from regular use include retinal hemorrhages. This group includes ibuprofen, aspirin1, ibuprofen, ketoprofen, flurbiprofen, and naproxen sodium. In addition acetaminophen (Tylenol), though not an NSAID, can harm vision.
- Also see a list of harmful drugs tied to macular degeneration.
About the Macula
The macula contains two areas of unusually high concentrations of cones, which are the photoreceptors responsible for color vision, fine detail and central vision. There is a slightly depressed area in the center of the macula called the fovea where there are no retinal cells - only photoreceptors - about 199 to 300 thousand cones per square millemeter. At the center of the fovea is the foveola where there are only cones - no rods.
The gradual breakdown of the these cells in the macula results in damage to or loss of your central vision. The macula provides focus in the center of vision where your vision sharpness is most acute. Such deterioration reduces the ability to read and recognize faces, two important tasks that use the central vision.
- Poor Circulation
- Elevated Homocysteine
- Choroidal Neovascularization
- Macular Pucker
- Stargardt's Disease
- Retinitis Pigmentosa
Studies and Information
1. The Association of Aspirin Use With Age-Related Macular Degeneration; Gerald Liew, PhD, et al; JAMA Internal Medicine, Feb 25, 2013, Vol 173, No. 4
2. C-Reactive Protein and the Incidence of Macular Degeneration, Vinod P. Mitta, MD, MPH; et al, JAMA Ophthalmol. 2013;():1-7
3. "An integrated hypothesis that considers drusen ... macular degeneration", Hageman GS, et al, Progressive Retina Eye Res., November 2001, 20(6), p 705-32