Age-Related Macular Degeneration (AMD) is the leading cause of irreversible severe vision loss in patients over 60 years of age in the Western world. The frequency of the disease increases with age, resulting in about one-third of the population over the age of 75 having some clinical or subclinical form of the disease. Although the disease was first presented to the medical community in 1874, its etiology has not been fully clarified, and only recently has its management started to show promising signs. It is a condition that affects the macula, a small area of the retina about the size of a grain of rice, located at the back of the eye. When the macula is affected, central vision becomes blurry, objects appear distorted, straight lines become wavy, and colors may appear faded. Activities such as reading, driving, threading a needle, or even recognizing faces can become difficult or even impossible.
The primary risk factor for the disease is advanced age. The incidence progressively increases over time, with more than 10% of patients over the age of 80 presenting with severe damage. Another significant risk factor is smoking, which has been shown to increase the likelihood of developing the disease up to 4 times. Other risk factors include ethnicity, with Caucasians being more susceptible, obesity, gender, with females being more vulnerable, hypertension, poor diet, prolonged exposure to sunlight, and family history. Today, it is believed that the disease is 50% hereditary, with more than 20 genes implicated.
There are two types of age-related macular degeneration: dry (80-90% of cases) and wet (10-15% of cases). In the dry form, small yellow deposits known as drusen accumulate beneath the macula, leading to aging, thinning, and atrophy of the affected area. Gradually, the functions of the macula decline, resulting in the gradual loss of central vision in the affected eye. The wet form, also known as neovascular AMD, is the more severe type. It is caused by the growth of abnormal blood vessels beneath the macula. These pathological vessels are very fragile and leak fluid and/or blood, destroying the light-sensitive cells of the macula, ultimately resulting in significant vision loss. It is important to note that these two types of the disease are interrelated, with almost all patients who develop wet AMD initially having dry AMD.
Another characteristic of the disease is that, although it affects both eyes, it can manifest with varying severity in each eye. This results in many patients delaying their recognition or even completely ignoring the presence of the disease. With the assistance of your ophthalmologist, the disease can be diagnosed even in its early stages, allowing steps to be taken for the preservation or restoration of vision. Simple tips such as quitting smoking, improving dietary habits, and protecting yourself from ultraviolet radiation by wearing sunglasses can reduce the risk of disease progression. Ophthalmological examinations with fundoscopy, optical coherence tomography (OCT), OCT angiography, and fluorescein angiography aid in disease staging and therapeutic intervention.
A decade ago, the disease was considered incurable. However, in recent years, especially after 2006 with the discovery of new drugs, it is possible to halt the progression of the disease in 95% of cases, with 40% of patients experiencing improved visual acuity. These drugs are exclusively applicable to the wet form of the disease, where intravitreal injection achieves the restriction of the activity of pathological vessels, resulting in the preservation of part of the patient's central vision. Especially for the wet form of the disease, early diagnosis and prompt initiation of treatment are crucial to achieve the best possible results. However, if the disease remains undiagnosed and without immediate treatment, it can continue to damage vision, leading to even greater loss of central vision. Early diagnosis in the early stages and treatment of the wet form can halt the disease, which, otherwise, progresses rapidly and can lead to legal blindness.
The treatment of wet age-related macular degeneration has seen significant advances in the last decade. Where we still need to make progress is in raising awareness of the disease's characteristics within society, as well as ensuring the right of all patients to immediate and swift access to treatment.
Dietary Supplements for Age-Related Macular Degeneration (AMD)
Recent reports have led to investigations into the benefits of dietary supplements for age-related macular degeneration (AMD). These reports followed the publication of the Age-Related Eye Disease Study (AREDS), sponsored by the National Eye Institute (NEI) in the United States in October 2006.
Findings
The AREDS study found that high doses of specific dietary supplements reduce:
- Vision loss by 19%
- The risk of advanced macular degeneration by 25%
These supplements do not lead to a cure for macular degeneration, nor do they restore already lost vision. However, they can play a significant role in helping individuals who are at high risk of developing advanced macular degeneration.
Should I take dietary supplements?
You should seriously consider it if you have:
- Μεγάλα DRUSEN
- Vision loss in one eye due to wet age-related macular degeneration
Your doctor can determine if it is safe for you to take them.
If I have early-stage drusen, should I take supplements to prevent its progression to intermediate stage?
Research did not show the benefit of using supplements in individuals with early stages of the disease. An annual examination can determine the rate of progression of your condition.
Are there reasons not to use high-dose supplements?
Yes. Using vitamins and minerals without a doctor's prescription is not recommended. It's very important to discuss with your doctor before taking high-dose supplements and to follow the dosage instructions provided by them. Some supplements may interact with other medications you may be taking.
What are the side effects based on the study's formulation?
Most patients did not experience side effects from the doses of zinc and antioxidants they were administered. Some who were given zinc alone had issues with their urinary system and were hospitalized for further treatment. Some patients who received high doses of antioxidants experienced skin paleness. The long-term side effects of taking these supplements are not yet known.
Smokers and former smokers should not take Beta-Carotene, as research has shown a connection between Beta-Carotene use and lung cancer in smokers.
The daily dosage of the supplements used in the study:
- 500 mg of vitamin C
- 400 IU of vitamin E
- 15 mg of Beta-Carotene
- 80 mg of zinc or zinc oxide
- 2 mg of copper
- Copper, in the form of copper oxide, was added to prevent copper deficiency, which can be caused by high levels of zinc supplements.
