Macular Degeneration natural therapy

Age related macular degeneration can result in irreversible vision loss and is the commonest cause of blindness in the Western world. Macular degeneration may be recognized by a physician in its early stages by the appearance (with an ophtalmoscope) of pigment changes and drusen within the retina. The retina is particularly susceptible to oxidation as its need for oxygen is large, it is exposed to high levels of light, and its membranes are rich in readily oxidized polyunsaturated fatty acids, particularly DHA found in fish oils. Eating fish could reduce the risk for macular degeneration.  Smoking contributes to macular degeneration. DHA and Lutein are available at Physician Formulas. A helpful product for vision enhancement is Eyesight-Rx.
   People who consume high levels of the yellow plant pigments lutein and zeaxanthin have a reduced risk of developing age-related macular degeneration. See lutein eye for more info.

Risk factors for macular degeneration
Several risk factors are associated with age related macular degeneration. Two of the most important include smoking and lack of antioxidant nutrients such as lutein and zeaxanthin.

Lutein and Zeazanthin for Macular Degeneration
Macular degeneration is a condition in which there is progressive deterioration of the central area of the retina of the eye, resulting in gradual sight loss in the center of the field of vision. There are several carotenoids in the eye, the predominant ones being lutein and zeaxanthin. In a study of healthy women younger than 75 years, whose diets were rich in lutein and zeaxanthin had a lower rate of age-related macular degeneration. Lutein and zeaxanthin are found in green leafy vegetables, corn, and squash. Zeazanthin is also found in Goji berries. There may also be a problem in transport of lutein and zeaxanthin from plasma to the retina in those with macular degeneration.
     Comments: Many people limit their vegetable intake to a few of their favorites, such as carrots, tomatoes, lettuce, etc. It's important to have a wide variety in order to obtain various types of carotenoids. As to using a lutein supplement, most of the capsules come in 20 mg dosage. We don't think this dosage is necessary to take on a daily basis. Taking a 20 mg lutein capsule 2 or 3 times a week should be fine. Fish oils could also be helpful at 1 to 3 capsules a day, especially for those who don't eat much fish.

Effect of dietary lutein and zeaxanthin on plasma carotenoids and their transport in lipoproteins in age-related macular degeneration.
American Journal of Clinical Nutrition, Vol. 85, March 2007. Wei Wang, Sonja L Connor, Elizabeth J Johnson, Michael L Klein, Shannon Hughes and William E Connor. From the Departments of Medicine and Ophthalmology (Casey Eye Institute)  Oregon Health and Science University, Portland, OR, and the Jean Mayer US Department of Agriculture, Human Nutrition Research Center on Aging at Tufts University, Boston, MA
Low dietary intakes and low plasma concentrations of lutein and zeaxanthin are associated with an increased risk of age-related macular degeneration. No studies have challenged age-related macular degeneration patients with a diet high in lutein and zeaxanthin. Seven age-related macular degeneration patients and 5 control subjects were fed a low-lutein, low-zeaxanthin diet ({approx}1.1 mg/d) for 2 wk, which was followed by a high-lutein, high-zeaxanthin diet ({approx}11 mg/d) for 4 wk. Ten subjects continued the diet for 8 wk. The high- lutein, high- zeaxanthin diet resulted in 2- to 3-fold increases in plasma concentrations of lutein and zeaxanthin and other carotenoids, except lycopene, in the age-related macular degeneration patients and the control subjects. With this diet, 52% of the lutein and 44% of the zeaxanthin were transported by HDL; {approx}22% of lutein and zeaxanthin was transported by LDL. Only 20–25% of {alpha}-carotene, ß-carotene, and lycopene was transported by HDL; 50–57% was transported by LDL. The age-related macular degeneration patients and control subjects responded similarly to a diet high in lutein and zeaxanthin; plasma carotenoid concentrations increased greatly in both groups, and the transport of carotenoids by lipoproteins was not significantly different between the groups. This finding suggests that abnormalities in the metabolism of lutein and zeaxanthin in age-related macular degeneration may reside in the uptake of lutein and zeaxanthin from the plasma and transport into the retina.

Macular degeneration and fish intake
Dietary fat and the risk of age-related maculopathy: the POLANUT Study.
Eur J Clin Nutr. 2007 Feb 14; Inserm, Research Unit U593 for Epidemiology, Public Health and Development, Bordeaux, France, Universite Victor Segalen Bordeaux 2, Bordeaux, France.
This study aimed at assessing the associations of dietary fat with the risk of age-related macular degeneration, in the framework of a population-based study from southern France. Nutritional data were collected using a dietitian-administered food-frequency questionnaire. High total, saturated and monounsaturated fat intake were associated with increased risk for age-related macular degeneration. Total polyunsaturated fatty acid was not significantly associated with age-related macular degeneration. Total and white fish intake was not significantly associated with age-related macular degeneration, but fatty fish intake (more than once a month versus less than once a month) was associated with a 60% reduction in risk for age-related macular degeneration.

Acetylcarnitine, CoQ10 and fish oils for macular degeneration
Improvement of visual functions and fundus alterations in early age-related macular degeneration treated with a combination of acetyl-L-carnitine, n-3 fatty acids, and coenzyme Q10.
Ophthalmologica. 2005 May-Jun;219(3):154-66. Ophthalmic Neuroscience Program, Department of Ophthalmology, University of Rome 'La Sapienza', Rome, Italy.
The aim of this randomized, double-blind, placebo-controlled clinical trial was to determine the efficacy of a combination of acetyl-L-carnitine, n-3 fatty acids, and coenzyme Q10 (Phototrop) on the visual functions and fundus alterations in early age-related macular degeneration. One hundred and six patients with a clinical diagnosis of early AMD were randomized to the treated or control groups. The primary efficacy variable was the change in the visual field mean defect (VFMD) from baseline to 12 months of treatment, with secondary efficacy parameters: visual acuity (Snellen chart and ETDRS chart), foveal sensitivity as measured by perimetry, and fundus alterations as evaluated according to the criteria of the International Classification and Grading System for macular degeneration. The mean change in all four parameters of visual functions showed significant improvement in the treated group by the end of the study period. Decrease in drusen-covered area of treated eyes was also statistically significant as compared to placebo. These findings strongly suggested that an appropriate combination of compounds which affect mitochondrial lipid metabolism, may improve and subsequently stabilize visual functions, and it may also improve fundus alterations in patients affected by early macular degeneration.

Macular Degeneration Research Update
Double-masked, placebo-controlled, randomized trial of lutein and antioxidant supplementation in the intervention of atrophic age-related macular degeneration: the Veterans LAST study (Lutein Antioxidant Supplementation Trial).
Richer S, Stiles W, Statkute L et al. Optometry. 2004;75:216-30.
Age-related macular degeneration is the leading cause of vision loss in aging Westem societies. The objective of the lutein antioxidant supplementation trial (LAST) is to determine whether nutritional supplementation with lutein or lutein together with antioxidants, vitamins, and minerals, improves visual function and symptoms in atrophic Age-related macular degeneration. The study was a prospective, 12-month, randomized, double-masked, placebo-controlled trial conducted at an urban midwestern Veterans Administration Hospital from August 1999 to May 2001. Ninety patients with atrophic macular degeneration were referred by ophthalmologists at two Chicago-area veterans medical facilities. Patients in Group 1 received lutein 10 mg (L); in Group 2, a lutein 10 mg/antioxidants/vitamins and minerals broad spectrum supplementation formula (L/A); and in Group 3, a maltodextrin placebo (P) over 12 months. RESULTS: In Groups 1 L and 2 L/A, mean eye macular pigment optical density increased approximately 0.09 log units from baseline, Snellen equivalent visual acuity improved 5.4 letters for Group 1 L and 3.5 letters for Group 2 L/A, and contrast sensitivity improved. There was a net subjective improvement in Amsler grid in Group 1 L. VFO-14 questionnaires conceming subjective glare recovery were nearly significant at 4 months for Group 2 L/A. Patients who received the placebo (Group 3) had no significant changes in any of the measured findings. CONCLUSION: In this study, visual function is improved with lutein alone or lutein together with other nutrients. Further studies are needed with more patients, of both genders, and for longer periods of time to assess long-term effects of lutein or lutein together with a broad spectrum of antioxidants, vitamins, and minerals in the treatment of atrophic age-related macular degeneration.

Biologic Mechanisms of the Protective Role of Lutein and Zeaxanthin in the Eye.
Krinsky NI, Landrum JT, Bone RA.  Annu Rev Nutr 2003 Feb 27.Department of Biochemistry, Tufts University Medical School, Boston, MA 02111-1837.  
The macular region of the primate retina is yellow in color due to the presence of the macular pigment, composed of two dietary xanthophylls, lutein and zeaxanthin, and another xanthophyll, meso-zeaxanthin. The latter is presumably formed from either lutein or zeaxanthin in the retina. By absorbing blue-light, the macular pigment protects the underlying photoreceptor cell layer from light damage, possibly initiated by the formation of reactive oxygen species during a photosensitized reaction. There is ample epidemiological evidence that the amount of macular pigment is inversely associated with the incidence of age-related macular degeneration, an irreversible process that is the major cause of blindness in the elderly. The macular pigment can be increased in primates by either increasing the intake of foods that are rich in lutein and zeaxanthin, such as dark-green leafy vegetables, or by supplementation with lutein or zeaxanthin. While the concept that increasing the intake of lutein or zeaxanthin might prove to be protective against the development of age-related macular degeneration, a causative relationship has yet to be experimentally demonstrated.

Macular degeneration often returns after photodynamic therapy
Choroidal neovascularization commonly recurs in patients with age-related macular degeneration (AMD) following photodynamic therapy with verteporfin. Intravitreal injection of vascular endothelial growth factor (VEGF) inhibitors has largely supplanted photodynamic therapy as the therapy of choice for AMD.

Ranibizumab for age-related macular degeneration
Ranibizumab may provide some benefits for patients with neovascular age-related macular degeneration (AMD). Dr. Tom S. Chang from the Retina Institute of California, Pasadena investigated the effects of ranibizumab (Lucentis; Genentech) on patient-reported vision-related function in a randomized clinical trial (MARINA) of 716 patients with neovascular ("wet") age-related AMD. They were randomized to monthly intravitreal injections of ranibizumab 0.3 mg or 0.5 mg, or sham injections. Vision-related function at 12 and 24 months improved in patients treated with ranibizumab but declined in sham injected patients. Arch Ophthalmol 2007;125:1460-1469.
   Comments: Could natural supplements also offer significant relief or help for age related macular degeneration without the need for intravitreal injections?

Macular Degeneration questions
Q. Can you tell me which product to take to protect retina and macula or macular degeneration, which one you recommend mostly to people is it eyesight-rx or other i can not decide which one is right.
   A. We cannot make specific recommendations, but you can ask your doctor if using Eyesight Rx and Lutien. Your doctor may approve using a capsule of lutien one day, a third of half a tablet on Eyesight Rx the second day, and alternating lutien and Eyesight. He may also suggest one day a week not taking any supplements. One or two capsules of fish oils a day cold also be helpful..

Q. Could you please let me know if Eyesight RX can help someone who has Macular Degeneration?
   A. The FDA does not allow us to make claims regarding our supplements that they can treat a medical condition, it is against FDA rules. All we are allowed to say about Eyesight Rx is that is supports healthy vision and can help with color perception and focus. We cannot make claims that it cures or treats an eye condition.

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