Age-related macular degeneration is one of the most common eye diseases. It concerns the yellow spot, which is the point of sharpest vision in the inner eye. Macular degeneration is responsible for about one third of all blindness and the main cause of blindness in people over 50. While there is no cure, there are some effective approaches to treatment and prevention, especially through micronutrient supplementation.
Any cell damage near the yellow spot is called macular degeneration. The yellow spot looks yellowish because of carotenoid deposits, which are yellow dyes such as lutein, xanthine or beta-carotene. These dyes contain antioxidants and bind toxic oxygen radicals in the eye, making them extremely important to the health of the eye.
Macular degeneration is the main cause of blindness in people over 50 years of age and is responsible for one third of all blindness.
There is a dry form of macular degeneration, which occurs much more frequently (85%) and in which vessels atrophy, and a moist form (15%). Unfortunately, the dry form can sometimes turn into a moist one. The precursors of macular disease are called drusen – small accumulations of fats and degradation products from cells below the retina.
In macular degeneration, the cells responsible for sharp and colored vision usually die in the middle of the retina. These rods and are responsible for color and twilight vision. As a result, the region of sharpest retinal vision slowly loses its function causing severe visual impairments and can even lead to blindness.
How does retinal calcification develop?
Macular degeneration occurs mainly as a result of the aging process. Advancing age can cause vascular calcification. During macular degeneration the fine vessels of the choroid calcify, known as “retinal calcification”. The causes of this disease are not yet completely known, but they have genetic changes in the proteins that are often found in macular degeneration.Smokers are also more often affected by age-related macular degeneration (AMD), potentially due to the effects of UV light, which also contains damaging radiation. A lack of minerals and/or vitamin A and carotenoids (precursors of vitamin A) can have an additional damaging effect. Macular degeneration occurs less frequently in adolescents (juvenile macular degeneration), when it is caused by genetic changes.
First symptoms of a disease
The disease is painless and therefore often not diagnosed easily. Since the receptor cells (cones) for color vision and twilight vision (rods) no longer react correctly in the middle of the retina, letters and words are increasingly difficult to recognize when reading. If plaid grids are distorted when reading, the first signs of this disease must be clarified by the ophthalmologist. Over time, one may lose your reading skills completely. In the moist form, the accumulation of fluid (edema) in the retina can initially lead to distorted vision. For example, the rectangular pattern of tiles is perceived as wavy and bulbous.
If the first signs of visual impairment appear, a doctor should be consulted as soon as possible for a detailed examination and clarification of the disease.
The diagnosis can be made by the ophthalmologist using the ophthalmoscope or magnifying glasses. A dye is injected into the vein and its distribution in the choroid and retina is recorded on video (angiography) to detect new blood vessels formed during the disease. An exact analysis of the individual retinal layers is possible with a laser method (optical coherence tomography OCT), with which drusen, small bubbles, fluid accumulations and vascular membranes can be seen. Since the pigment epithelium, which lies between the receptor cells and the choroid and is responsible for the removal of waste products, is also affected, the changes in pigment density are apparent.
What role does nutrition play?
Various studies suggest that the ingestion of various antioxidant micronutrients can halt or at least delay the progression of the disease. This is especially true for a combination of beta-carotene, vitamins C, E and zinc, which can help to effectively slow down the disease and reduce moderate vision loss.
High intake of omega-3 fatty acids can reduce the risk of macular degeneration by 40%.
Especially promising, especially in the prevention of AMD, seems to be a proper supply of omega-3 fatty acids. A large-scale study by the National Health Institute in the USA reported a reduction of up to 40% in the risk of developing the disease. These valuable fatty acids such as docosahexaenoic acid (DHA) or eicosapentaenoic acid (EPA) can be easily supplied via appropriate supplements or a diet rich in fish. The fact that only about 5% of the American population consume the recommended amount of omega-3 fatty acids shows the enormous potential hidden in the supply of these valuable nutrients.
Similar influence on AMD progression is attributed to carotenoids such as lutein, zeaxanthin or other successful antioxidant nutrients such as vitamin D or coenzyme Q10.
Patients suffering from AMD had 15 % lower vitamin D levels than healthy patients.
What role does vitamin D play in macular degeneration?
French researchers have found in a large number of studies that patients with a detected macular degeneration had a 15% lower vitamin D level than healthy patients. Furthermore, they observed that concentrations below 50 nmol/l, i.e. an acute vitamin D deficiency, is associated with terminal macular degeneration. At this stage, vision is greatly reduced and care by third parties is often necessary.
It is therefore increasingly assumed that there is a connection between a low vitamin D level and age-related macular disease.
Further studies will show how a supply of vitamin D can stop or at least delay AMD. However, we can definitely look forward to further promising results.
AMD causes high care costs for severely visually impaired patients. A cost-effective supplement with vitamin D therefore saves costs in the health care system.
Vitamins (especially C and E) and micronutrients (beta-carotene, selenium, zinc) may also somewhat alleviate AMD and possibly delay its progression.
How is macular degeneration treated?
In the surgical treatment of the moist form of AMD, new blood vessels are eliminated by laser, if these changes are not exactly in the center of the retina, or by injecting anti-vascular growth factors into the eye. However, the effect of the drugs used to inhibit the formation of new blood vessels lasts only four to six weeks, in which case the injection must be repeated continuously. The injection takes place under drip anesthesia of the eye and is largely painless.
Enlarging visual aids such as magnifying glasses, magnifying glasses or TV readers are an additional aid. Edge filter glasses can also reduce disturbing glare.
Smoking cessation and a generally healthy lifestyle are among the decisive preventive measures against macular degeneration. Wearing sunglasses with UV protection in bright sunlight and a balanced diet with sufficient intake of the above-mentioned carotenoids and omega-3 fatty acids also have a preventive effect. These healthy habits could slow or eliminate the onset of macular degeneration.
