When Macular Health Gets Worse

Choroidial Neovascularization Symptoms   CNV Causes

Although mild forms of macular degeneration are quite responsive to nutrition, the advanced, or "wet" form is more serious. As blood vessels grow into the space between the retinal layers and the layers with blood vessels the resulting crowding begins to seriously distort natural functioning and results in serious loss of vision or blindness. The new blood vessels form as a result of the body's attempt to supply more of deficient nutrients through additional blood vessels.

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How to Help Prevent Macular Damage

  • Nutrition. The most important step is to try to keep macular degeneration from advancing to the more serious form. Because the health of the macula is closely linked to deficiencies in nutrients, including the antioxidant carotenoids found in the retina, your vision can be protected through diet and nutrient supplementation. Researchers have found that supplementation with specific minerals, vitamins, may slow progression and inhibit retinal disease1, 2, 3, 4, 8, and may specifically inhibit formation of new blood vessels.5
    • AREDS. The 2001 AREDS study identified nutrients to support the macula; AREDS2 revised the recommended formulation. These nutrients protect the macula from damage. The recommended nutrients from AREDS are 500mg vitamin C; 400 IU vitamin E, 10mg lutein, 2mg zeaxanthin, 350mg DHA, 650mg EPA, 25mg zinc and no beta-carotene. 1,2 Zinc supplementation might be needed for vegetarians since the body does not store zinc very effectively and it is not readily absorbable from nuts, grains and legumes. So you should consult with your health care professional.
    • Other nutrients Other research has determined that astaxanthin10, and meso-zeaxanthin, other potent antioxidants, are important. Vitamin C has been found to enhance the absorption of lutein.
    • Resveratrol has been found to inhibit the growth of new blood vessels.16, 17
    • Omega 3 fatty acids. Omega 3s have the ability to regulate the new formation of extra blood vessels.9 Eating fish is a great way to increase omega 3 in your diet.
    • Omega 6 to Omega 3 Ratio. The standard western diet tends to be very high in omega 6 fatty acids, with a ratio of about 10-20:1. The Mediterranean diet has a higher proportion of omega-3; the ratio is about 4-5:1. This ratio is associated with a protective effect against the severe neovascular form of ARMD.15
    • Less Vitamin A Don't take extra vitamin A. Some research suggests that excessive retinal intake can increase all-trans-retinal in the eye, contributing to lipofuscin accumulation, increases growth of extra blood vessels in the retina.8 Vitamin A also apparently plays a role in creating "vitamin A dimers" that reduce the retina's response to light and increase extra blood vessel growth.14
    • Vitamin D3. Low vitamin D3 in the body is tied to macular health. D3 is especially important for people with a genetic risk of macular problems.11
    • Diet. See the recommendations for macular support with respect to essential leafy greens, a low fat diet, and juicing.
  • Lose Weight. Researchers find that the unbalanced gut microbiota in the digestive systems of people (especially men) who are obsese increases development of extra blood vessels as the macular condition gets worse.13
  • Stop smoking. Smoking is one of the most significant contributing causes of macular degeneration and the worsing of the condition.6, 7
  • Protect against blue light. If you have been diagnosed with macular degeneration it is essential to always wear good quality UV resistant, wrap-around sunglasses to protect your eyes against blue, blue-violet and ultra violet light. Amber or brown colored glasses are better than green, blue, or grey glasses.
  • Drugs. Pay attention to drugs that damage the macula.
  • Exercise is the single-most important thing you can do for many health conditions.

Conventional Treatment

While there is no "cure" for CNV specific anti-angiogenic drugs like thalidomide, metalloproteinase inhibitors and angiostatic steroids are being tested inhibit the growth of extra blood vessels.

Testing using surgery has determined that partial removal of CNV is useless. So the focus has instead been on the FDA approved photodynamic therapy.

Photodynamic therapy attempts to stop the intrusion of fluid and inhibit further growth of the blood vessels. Photodynamic consists of two phases: First a special dye that attaches only to anomalous blood vessels is added by injection. Then a non-damaging laser activates a compound to closes the abnormal blood vessels. The condition disappears 24 hours after this procedure, but relapses 2-3 months later in nearly all patients. However, in a year-long treatment of Age-related Macular Degeneration study of 609 patients 16% of treated patients and 7% of placebo patients had visual improvement.

Sources

1. AREDS, Major nationwide study, by National Institutes of Health, National Eye Institute, October 2001, Archives of Ophthalmology.
2. AREDS2, Major nationwide study, by National Institutes of Health, National Eye Institute, 2006.
3. Ties between Intermediate Age-Related Macular Degeneration, Lutein and Zeaxanthin, University of WI, Departments of Opthalmology and Visual Science, et al, Archives of Opthaloogy, 2006.
4. Massachusetts Eye and Ear/Schepens Eye Research Institute, et al, Cytochrome P450-generated metabolites derived from omega-3 fatty acids attenuate neovascularization, Ryoji Yanai, et al, Proceedings of the National Academy of Sciences, June 2014.
5. A. Ivanescu, P. Fernandez-Robredo, et al, Modifying Choroidal Neovascularization Development with a Nutritional Supplement in Mice, Nutrients, July, 2015.
6. J. Thornton, et al, Smoking and age-related macular degeneration: a review of association, Eye, September, 2005.
7. T.D. Keenan, et al, Assessment of Proteins Associated With Complement Activation and Inflammation in Maculae of Human Donors Homozygous Risk at Chromosome 1 CFH-to-F13B, Investigative Opthalmology and Visual Science, July, 2015
8. X. Tan, H. Takahashi, Excessive retinol intake exacerbates choroidal neovascularization through upregulated vascular endothelial growth factor in retinal pigment epithelium in mice, Experiments in Eye Research, February, 2015.
9. Massachusetts Eye/Ear, Schepens, Harvard Medical, et al, Cytochrome P450-generated metabolites derived from omega-3 fatty acids attenuate neovascularization, Ryoji Yanai, et al, Proceedings of the National Academy of Sciences, June 2014
10. T. Otsuka, et al, Protective effects of a dietary carotenoid, astaxanthin, against light-induced retinal damage, Journal of Pharmaceutical Science, October, 2013.
11. Association between Vitamin D status and Age-Related Macular Degeneration by Genetic Risk, 2015
12. See other research on advanced macular degeneration.
13. E.M. Andriessen, A.M. Wilson, et al, Gut microbiota influences pathological angiogenesis in obesity-driven choroidal neovascularization, EMBO Molecular Medicine, December, 2016.
14. J. Penn, D. Mihai, et al, Morphological and physiological retinal degeneration induced by intravenous delivery of vitamin A dimers in rabbits, Disease Models & Mechanisms, February, 2015.
15. T.C. Mance, D. Kovacevic, et al, The role of omega6 to omega3 ratio in development and progression of age-related macular degeneration, Collegium, Antropologicum, September, 2011.
16. Resveratrol Inhibits Hypoxia-Induced Vascular Endothelial Growth Factor Expression and Pathological Neovascularization.
17. SIRT1 mediated inhibition of VEGF/VEGFR2 signaling by Resveratrol and its relevance to choroidal neovascularization

Macular Degeneration Symptoms   AMD Causes   Treatment