Does Your Diet Reduce Risk for Macular Degeneration? Part 1

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September 16, 2009
Does Your Diet Affect Macular Degeneration? Part II
September 18, 2009
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Does Your Diet Reduce Risk for Macular Degeneration? Part 1

The truth about vitamins, your eyes and macular degeneration. What has been proven and yet to be proven.

Good Morning!  I am going to review, over the next 2-3 days, the dietary and vitamin recommendations for patients that have been diagnosed with Macular Degeneration.

Today’s Post:  What has been proven and not proven to work.  Focusing on the AREDS study and the supplements.

Next:  Part II:  What looks promising from a dietary standpoint, i.e. what things to eat that may help AMD, but not proven.  Read Part II.

Last:  The AREDS 2 study, what questions it hopes to answer.

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A few years ago in 2001, the Age Related Eye Disease Study (AREDS or AREDS 1) study results were published. You can read the actual press release here…Click To Read AREDS Press Release.  It was a huge study that analyzed the risk of developing macular degeneration and cataract when given certain supplements.  The AREDS study has been the only study testing the effects of supplements on your eyes.  The AREDS 2 study is underway.

The Direct and Honest Answer.

1.  No diet has been proven to alter the chances of developing macular degeneration so far.  NOTHING!

2.  The only supplement/vitamin proven to be effective is the so-called AREDS formula (containing vitamin C, vitamin E, beta-carotene, and zinc) and this supplement/vitamin was only effective in patients with moderate to high-risk characteristics of macular degeneration (i.e. those with diagnosed macular degeneration).  Patients with low or no risk characteristics of macular degeneration did not benefit from the AREDS formula.

3.  Lutein and zeaxanthin have also not been studied directly (they will be in AREDS 2), that is, they have yet to be proven to work.

The Translation.

1.  Patients that have so-called high risk characteristics of macular degeneration had a 25% decrease in the likelihood of developing the ‘wet’ form of macular degeneration in one eye.  The chance of developing the wet form decreased from 28% to 21% while taking the supplements.  Patients at “intermediate risk” showed a 19% decrease in developing the wet form.

2.  No other benefit was shown from taking these vitamins.

3.  These high/intermediate risk patients should take the AREDS formulation (available over the counter) as long as they don’t smoke.  There is a smoker’s formulation, too.

The Not so Direct and Honest Answer. Beware of the hype.

There are a ton of vitamins available that claim to “cure” macular degeneration.  All of this is hype with exception of the AREDS study and formula.  Many doctors recommend taking vitamins to prevent macular degeneration, but there is no data or study to support this.  The AREDS study simply says that patients taking high doses of certain anti-oxidants, with zinc, may be beneficial.  Be careful when you read advertisements or listen the TV or radio.

There are also many products touting they contain the key ingredient “lutein” for macular degeneration.  There was an association in the AREDS 1 study, but there is no proof yet.

Read Part II

“Randy”

Randall V. Wong, M.D.
www.TotalRetina.com
Ophthalmologist, Retina Specialist

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Comments
  • Maureen September 19, 2009 at 6:52 pm

    Hi,
    I was diagnosed a few weeks ago with dry MD in both eyes. I am a 62 year old woman but very young-looking – good skin genes I guess. My husband is much younger and we have been married for 22 years! No one guesses we are different ages. People think I am in my late 40’s.
    Anyway, I am nervous of course. My optometrist has me seeing a retinal specialist next month. She saw a “membrane” or something in the right eye. Scared.

    She put me on “MacuTrition” vitamins, new. They do not have beta-carotene which the company says does not help MD. They cost $36.00 per month and have high doses of vitamin E, C, D, etc. Green Tea, Lutein other stuff.

    Are these the right ones to take? No beta-carotene? My optometrist didn’t even know that all wet MD starts out as dry.
    Disappointed in her.

    The RS I am seeing though is Harvard graduate and Mass Eye and Ear affiliated. Thanks for reading.

    • Randall V. Wong, M.D. September 19, 2009 at 8:12 pm

      Dear Maureen,

      Thanks for the comment. First, don’t be scared. I would be curious to determine upon what basis the diagnosis of dry ARMD was made. I am also wondering if the “membrane” is an epiretinal membrane or a membrane related to ARMD. Did you go see your eye doctor as a matter of routine or have you recently noticed any change in your vision?

      With regard to “Macutrition,” I am not familiar with most of the formulations as I rarely recommend any vitamins except in cases outlined by the AREDS 1 study.

      I would say that anyone without any significant symptoms of decreased vision or new distortion probably has a good prognosis.

      Since I have no idea the basis for your referral, I would encourage you to keep your appointment with RS. It would be a good time to ask about the “membrane” and to clarify the presence of the “membrane.”

      I thank you for reading and look forward to hearing from you again, be it tonight, tomorrow or whenever.

      Stay well,

      Randy

  • Maureen September 22, 2009 at 8:46 am

    Thank you for replying! Sorry I am late – family health issues. Anyway, I went for a yearly exam. She also told me I am getting a cataract on the right eye. When she took the pictures she showed me the drusen in each eye which did not look as bad as some pictures I have seen on the web of dry MD. I have had a yellowish tinge to my right eyesight when I look at the eye charts (I would say 7-8 yrs) and always told the eye doctor but no one every said anything, except I had pigmented spots and should eat a lot of spinach!

    The only symptom I have is that the right eye seems to be a bit less clear when looking at amslar grid seems to be straight lines but not as clear as the left eye. Could that be the cataract?

    I am going to call today and try to see the RS earlier than 10/21 as I am so worried that I will lose my sight.

    Do you think there is promise for the implantable telescope? I have been trying to find out all I can about the condition and possible hope to keep my central vision. What about stem cell use from skin? Will that happen in the next couple of years?
    I know I am jumping ahead of things here. Thanks.

  • Randall V. Wong, M.D. September 22, 2009 at 9:03 am

    Hmm. Lots of issues. Have to be careful about offering true medical advice.

    Amsler grids are good devices for screening. Usually used to test for distortion that may be related to macular degeneration, but can be used to assess other macular conditions as well.

    I would guess that if both of your retinas are similar in appearance, that possibly the only difference between your two eyes might be cataract.

    Again, I am hindered by the fact that I can not examine you.

    Regardles of whatever is going on, the telescope probably is of no use for you, now or in the future. Stem cells certainly seem promising, but we are far from using them. It is one thing to grow stem cells, it is another getting them to your target tissue.

    Get back to me after the appointment with the RS.

    Take care, good luck and thank you,

    Randy

  • Toby Tobin September 23, 2009 at 5:56 pm

    Randy, great infromation, I look forward to reading your posts.

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