Age-Related Macular Degeneration (AMD)


The macula is located in the retina in the back of the eye and provides central vision, most of the color vision and the fine details of vision. Age Related Macular Degeneration (AMD) is a chronic eye disorder. The earliest symptoms of macular degeneration are blurring of vision, distortion of vision (i.e. lines are no longer straight or letters seem bunched up) or areas of central vision that appear to be blackened, greyed or whited out. There are two types of AMD: wet and dry. Wet macular degeneration is most often caused by blood vessels that leak fluid or blood into the macula. Dry AMD is caused by cells in the macula slowly dying and not being replaced. The term ‘dry’ does not mean the eyes are dry. It means just that the person does not have wet macular degeneration.

Macular degeneration is a total body disease that causes symptoms in the retina. All of the blood markers of inflammation associated with high blood pressure and atherosclerotic disease are also associated with AMD. These are essentially the same risk factors for nearly all chronic diseases such as Alzheimer’s disease, high blood pressure, atherosclerosis and other vascular diseases, diabetes, and age-related muscle loss. AMD is a treatable cause of blindness, and the most common risk factors are age, smoking, obesity, hypertension, a diet high in processed (inflammatory) foods, high glycemic foods and family history of AMD. There are many drugs available today to slow this condition.

The treatment for wet macular degeneration is to reduce the leakage from the abnormal macular blood vessels. All of the drugs that retina specialists inject can be considered as molecular sponges. They absorb one of the major proteins (VEGF) associated with macular degeneration. These drugs include Avastin, Lucentis, Eylea, high dose (hd) Eylea and Vabysmo. A retina specialist will determine which drug to use depending on the nature of the patient’s wet macular degeneration and how the eye damage is being helped by the injections. Currently, there are two different FDA-approved drugs for a certain form of dry macular degeneration called geographic atrophy (GA). In GA, there is significant thinning of the macular either in the very center of the macula or slightly eccentrically. The two drugs, Syfovre and Izervay, limit a certain type of inflammation that is involved in GA thereby slowing the loss of vision.

Over the last 10-15 years, there has been significant evidence that AMD is a nutritionally-controlled disease just like many other chronic diseases. Here are some of the recommendations for treatment:
• a high potency multivitamin
• Omega-3 food sources (such as salmon, halibut or mackerel) at least twice week
• 5-7 servings of dark green vegetables per week, especially kale, broccoli and spinach. Those three are enriched in a compound called sulforaphane which is protective of the retina and brain.
• 5-7 servings of dark fruit like blueberries, blackberries, plums and cherries
• daily exercise, even 30 minutes of walking, can help to slow the diseaseNote: This article is provided by Shalesh Kaushal MD, PhD on Macular Degeneration, based in The Villages, FL. You can contact Dr. Kaushal at 352-775-1010 to obtain handouts and learn about other nutritional recommendations.
More information on AMD from the National Eye Institute