MACULAR DEGENERATION

GENERAL CONSIDERATIONS

The MACULA is the area of the retina where images are focused. It is the portion of the eye responsible for fine vision.

Degeneration of the macula is the leading cause of severe visual loss in the United States.

The major risk factors for macular degeneration are smoking, aging, atherosclerosis (hardening of the arteries), and high blood pressure.

The treatment of the wet form of age-related macular degeneration is immediate laser photocoagulation.

The treatment goals in the dry form and prevention of the wet form involve the use of antioxidants and natural substances that protect against free radical damage and improve blood and oxygen supply I to the macula.

Measures designed to reduce the risk of atherosclerosis are of great significance in the prevention (and treatment) of macular degeneration.

A diet rich in fruits and vegetables is associated with a lowered risk for macular degeneration.

Antioxidant formulas have been shown to halt and even reverse macular degeneration.

Pre-Disposing Factors:

a. Atherosclerosis.

b. Zinc, vitamin B6, vitamin A or vitamin C/Bioflavinoid deficiency.

c. Food/environmental sensitivity.

d. Genetic pre-disposition.

c. Diets deficient in antioxidants.

d. Poor calcium metabolism resulting in carbonate formation.

DIETARY RECOMMENDATIONS

Eliminate all refined carbohydrates, alcohol and caffeine containing foods such as cola, coffee, tea and chocolate.

Eliminate hydrogenated fats and oils. Use only extra virgin olive oil, coconut oil and fish oils as your only dietary source of oils

Drink one mouthful of distilled water every 30 minutes while awake to keep you properly hydrated.

Increase raw and fresh foods and quality protein especially fish and sea vegetables.

Avoid iron cooking utensils and iron containing food supplements.

Avoid fried and grilled foods and other sources of free radicals.

Increase consumption of legumes (high in sulfur-containing amino acids), yellow vegetables (carotenes), flavonoid-rich berries (blueberries, blackberries, cherries, etc.), and foods rich in vitamin E and vitamin C (fresh fruits and vegetables).

NUTRITIONAL SUPPLEMENTS

Primary Nutrients:
1. BIO-MULTI PLUS – 1 tablet, 3 times daily after meals.

2. BIO-C PLUS 1000 ? 1 tablet, 3 times daily after meals.

3. M S M POWDER – 1/2 teaspoonful 2 to 4 times daily depending on the severity of symptoms. NOTE: Try to take MSM with your Vitamin C.

4. BIOMEGA-3 – 4 – 5 capsules, twice daily after meals for 1 month, then 4 – 5 capsules once daily thereafter M – F of the week.

Specific Nutrients: You will probably need to be on all these nutrients the rest of your life.
65. OPTIC PLUS – 2 tablets, 3 times daily after meals.

6. COQ-ZYME 30 – 2 tablets, once daily after a meal.

7. GINKO BILOBA ? 1 tablet, 3 times daily after meals.

8. E-MULSION 200 – 2 capsules, once daily after a meal.

9. BIO-CYANIDINS? 1 tablet, 3 times daily after meals.

SUMMARY

As with most diseases, prevention and treatment at an early stage are the most effective approaches to ARMD. The treatment of the wet form of ARMD is clearly laser photocoagulation, applied as soon possible. Since free-radical damage and lack of blood and oxygen supply to the macula appear to be the primary causes of macular degeneration, consumption of antioxidants and promotion of retinal blood flow are the keys to effective treatment.

Anyone with any vision loss should see a physician for complete evaluation, especially if the loss is progressing rapidly.

ADDENDUM

Types of ARMD

There are two types of age-related macular degeneration (ARMD). One form is known as “wet” and the other is “dry”. It is possible to experience both forms at the same time, in one or both eyes. It is not uncommon for a patient with the “dry” form to develop the “wet” form later. The onset and progression of either type do not follow any particular pattern. In its earliest stages, ARMD can be difficult to diagnose. Sometimes it progresses so slowly that people do not notice a change in their vision. Years may go by before they see an ophthalmologist or eye care professional. In other cases, the deterioration is very rapid and can appear to happen overnight.

Retina of an Eye with Dry ARMD

This most common type of ARMD affects 90% of the people who have the condition. In the dry form, there is a breakdown or thinning of the retinal pigment epithelial cells (RPE) in the macula. These RPE cells are important to the health of the retina. They are light sensitive and contain hundreds of photoreceptors. The death or degeneration of these cells is called atrophy. Hence, dry AMD is often referred to as atrophic ARMD. It is characterized by the presence of drusen (dots of yellow crystalline deposits that develop within the macula) and thinning of the macula. Dry or atrophic MD reduces one’s central vision and can effect color perception. Generally, the damage caused by the “dry” form is not as severe as that of the “wet” form. Unfortunately, there is no proven cure or treatment.

Retina of an Eye with Wet ARMD

This is the more severe type of ARMD. Although it afflicts only 10 percent of those who have the condition, it accounts for 90 percent of the blindness caused by this disease. With this type, the membrane underlying the retina thickens, then breaks. The oxygen supply to the macula is disrupted and the body responds by growing new, abnormal blood vessels. These begin to grow through the breaks of the membrane behind the retina towards the macula, often raising the retina.

To visualize this, imagine the roots of a tree growing and spreading until they actually uproot a sidewalk. Then imagine rainwater seeping up throughout the cracks. These abnormal blood vessels (the “roots) tend to be very fragile. They often grow, leak or bleed, causing scarring of the macula. This damage to the macula results in rapid central vision loss. Once this vision is destroyed, it cannot be restored.

Most patients report that their first sign of ARMD was the rapid onset of prolonged, distorted vision. Straight lines like telephone wires and doorframes appear to be wavy. If you notice any distorted or missing areas of vision, consult your ophthalmologist promptly. A certain percentage of patients with wet ARMD can benefit from laser treatment if the blood vessel leak is caught early enough. Newer treatments are being developed which may be better and less damaging than conventional laser.

Treatment Update: Dry Macular Degeneration

Macular degeneration (MD) remains the leading cause of blindness in the United States. There are two forms of MD, “dry” and “wet”. While the majority of patients with severe vision loss have wet MD, significant impairment can occur with dry MD as well. In addition, dry MD is the precursor to wet MD. Dry MD begins with deposits beneath the retina called drusen, which accumulate with age in susceptible patients. A few fine drusen may be considered normal. The presence of larger drusen, also called soft or semi-soft drusen, may reduce vision to a mild to moderate level and appear to increase the risk for developing the abnormal blood vessels of wet MD. The drusen may interfere with nutrient and oxygen transport that in turn may lead to the growth of new vessels to support the retina. Another manifestation of dry MD is atrophy. In some patients with MD, there is diffuse loss of the supportive cells of the retina (retinal pigment epithelium or RPE) which leads to thinning of this supportive layer followed by thinning and loss of the overlying retina. This thinning of the retinal layers is termed atrophy. It often occurs in a pattern like land masses on the globe, hence the term geographic atrophy. Large areas of geographic atrophy may lead to significant vision loss and even legal blindness in some patients. In this article we review the latest proven and experimental treatments for dry MD. Our next article will focus on the latest therapies for wet MD.

Antiangiogenesis Drugs block the growth of abnormal blood vessels and may be used in patients with dry MD to prevent the development of wet MD. The Agouron matrix metalloprotease inhibitor, AG3340, shows promise and the results of a controlled study are pending. Another drug, Thalidomide, caused significant side effects. Several companies are developing other antiangiogenic drugs and conducting laboratory tests before they begin clinical studies

Antioxidants reduce the incidence and progression of dry MD. The Eye Disease Case-Control Study found that higher dietary intakes of Carotenoids, specifically Lutein, Zeaxanthin, and Cryptoxanthin, was associated with a lower risk of age-related MD. A lower risk of MD was also suggested for those with higher levels of vitamin C, particularly from foods.

Laser for Drusen may improve vision and reduce the risk for developing “wet” MD. Drusen are deposits beneath the retina that accumulate with age in dry MD. A light grid of laser to the macula can decrease drusen. Several different studies are underway to determine safer and more effective laser treatments for drusen.

Genetic Therapies may eventually bypass or compensate for the abnormal genes in MD. Genes causing some forms of MD have now been identified including Sorsby dystrophy, Best’s macular Dystrophy and Stargardt’s disease. Laboratories across the country are searching for the gene or genes that contribute to age-related macular degeneration. Selective screening is underway.

Retinal Transplantation has been attempted to treat patients with both dry and wet MD. In dry MD, retinal pigment epithelial cells have been placed under the retina in areas of cell loss or “atrophy”. While some patients had temporary stabilization of vision, the long-term results have been disappointing with graft rejection a major problem. Graft rejection occurs when the patient’s own immune system recognizeLupue transplanted cells as foreign and trys to destroy the cells. The immunosuppressant, cyclosporine, may promote graft survival and may be tested in future studies.

Rheophoresis removes large proteins from the blood and may improve circulation to the macula in patients with dry MD. A limited study at the University of Utah demonstrated visual improvement in select patients. Patients with high fibrinogen, cholesterol or Immunoglobulin-A levels may benefit. A controlled clinical study is underway.

Macular degeneration remains one of the most challenging conditions we manage. These new treatments should increase our successes and lead the way to a cure for this common, complex and potentially devastating disease. Ask your eye doctor how these breakthroughs may apply to you.

THIS FROM JULIAN WHITAKER, M.D.

Natural Protocol for Macular Degeneration

Eat dark, leafy greens — and drink a glass of red wine
Eating a diet rich in fruits and vegetables is an excellent step toward vision preservation, as these plant foods contain an abundance of health-enhancing carotenoids.

In a study published in the Journal of the American Medical Association, researchers evaluated the diets of 365 men and women with age-related macular degeneration and compared them with the diets of 520 people with normal vision. They discovered that the group with the highest consumption of carotenoid-rich foods had 43 percent fewer cases of macular degeneration than the group with the lowest intake.

The plant foods found to confer the greatest protection were the dark, leafy green vegetables, especially spinach and collard greens. They contain lutein and zeaxanthin, carotenoids that are highly concentrated in the eyes and absorb some of the harmful radiation that enters the eyes. They also increase the thickness of the macula.

Phytochemicals in wine also appear to protect the macula. Researchers at Howard University Hospital in Washington, DC, who examined the association between alcohol intake and the risk of macular degeneration, found that moderate consumption of wine reduced the risk by 19 percent.

Fortify your vision with flavonoids

Bilberry (Vaccinium myrtillus), a cousin to blueberries and cranberries, contains anthocyanosides and other flavonoids that improve circulation, strengthen collagen and discourage inflammation in eye tissues. Bilberry was used by Royal Air Force pilots during World War II to improve nighttime vision and adjustment to darkness and glare. Studies have since confirmed the value of bilberry in the treatment of cataracts, macular degeneration, and diabetic retinopathy.

Ginkgo biloba is another flavonoid-rich herb that is beneficial for the eyes. Ginkgo flavone glycosides and other active constituents enhance vision primarily by neutralizing free radicals and increasing blood flow to the tiny capillaries of the eyes.

“Designer” nutrients for the eyes

Other herbs that benefit the eyes include eyebright, schisandra and periwinkle. Several amino acids are involved in vision. Taurine stabilizes cell membranes in the photoreceptors of the retina. N-acetyl-cysteine (NAC) helps maintain ocular levels of the important antioxidant glutathione. Taken together, these nutrients act like internal sunglasses, protecting your eyes from the hazards of ultraviolet radiation.

Hyperbaric oxygen therapy and targeted IV therapies

At the Whitaker Wellness Institute, we utilize two specialized therapies for the treatment of macular degeneration. One is hyperbaric oxygen therapy, which floods your tissues with healing oxygen. Hyperbaric oxygen is administered in a special chamber in a physician’s office or hospital setting. For more information and to locate a facility that administers hyperbaric oxygen therapy, visit www.hyperbaric-therapy.com. The other is intravenous administration of high doses of antioxidants and some of the other nutrients discussed above.

LINK: MACULAR DEGENERATION SITE