From the Guidelines
Macular degeneration is an eye disease that affects the macula, the central part of the retina responsible for sharp, central vision, and is typically characterized by two main types: dry (atrophic) macular degeneration and wet (neovascular) macular degeneration. The disease causes progressive damage to the macula, leading to blurred or distorted central vision while peripheral vision typically remains intact. Age is the primary risk factor, which is why it's often called age-related macular degeneration (AMD), typically affecting people over 50. Other risk factors include smoking, family history, obesity, high blood pressure, and light-colored eyes. Some key points to consider about macular degeneration include:
- The prevalence, incidence, and progression of AMD increase significantly with age, as noted in studies such as 1.
- Early treatment of AMD is associated with a more favorable prognosis, with anti-VEGF treatment given within 2 years after diagnosis of neovascular AMD in non-Hispanic white patients shown to reduce legal blindness and visual impairment 1.
- Nutritional supplements containing vitamins C and E, lutein, zeaxanthin, zinc, and copper (AREDS2 formula) may slow progression in intermediate to advanced cases of dry AMD, as supported by research such as the Age-Related Eye Disease Study (AREDS) 1.
- Early detection through regular eye exams is crucial, as symptoms often appear only after significant damage has occurred, highlighting the importance of comprehensive eye examinations for identifying patients at higher risk of developing choroidal neovascularization or advanced AMD 1.
- Treatments for wet AMD include anti-VEGF injections like ranibizumab (Lucentis) or aflibercept (Eylea) to stop abnormal blood vessel growth, with the "treat and extend" approach being a common strategy in clinical practice 1. Considering the most recent and highest quality evidence, the use of anti-VEGF injections and nutritional supplements, along with regular eye exams, is crucial for managing macular degeneration and reducing the risk of vision loss.
From the Research
Definition of Macular Degeneration
- Macular degeneration is a degenerative condition of the back of the eye that occurs in people over the age of 50 years 2.
- It is also known as age-related macular degeneration (AMD) 3, 4, 5, 6.
Causes and Risk Factors
- The exact cause of macular degeneration is not fully understood, but oxidative injury is thought to play a significant role 4.
- Risk factors for macular degeneration include age, smoking, and a diet low in antioxidant vitamins and minerals 3, 6.
Symptoms and Progression
- Macular degeneration can cause vision loss and blindness if left untreated 2, 5.
- The progression of macular degeneration can be slowed down with antioxidant vitamin and mineral supplements, such as the Age-Related Eye Disease Study (AREDS) formulation 2, 5.
- The AREDS formulation includes vitamins C and E, beta-carotene, and zinc, and has been shown to reduce the risk of progression to advanced AMD by 25% 2.
Treatment and Prevention
- There is no cure for macular degeneration, but antioxidant vitamin and mineral supplements may help prevent or slow down its progression 2, 3, 4, 5, 6.
- A healthy diet rich in fruits, vegetables, and omega-3 fatty acids may also help reduce the risk of macular degeneration 4.
- Vitamin E and beta-carotene supplements have been shown to have no benefit in preventing macular degeneration, and may even increase the risk of lung cancer in smokers 6.