Macular Degeneration October 2013

Macular Degeneration is among one of the leading causes of blindness in the elderly. Over 1 million Canadians over the age of 50 are affected.  Top risk factors include age and smoking. Some studies have suggested a possible reduced risk in people who consume more fish and dark green leafy vegetables.

Age Related Macular Degeneration (AMD) is a disease that affects the macula, the central part of the retina that’s involved in seeing fine details and seeing what’s in the center, not around the edges of your view. It results in the loss of cones in the center of the macula which makes it difficult to drive, read and recognize faces.

The first Age Related Eye Disease Study (AREDS) in 2001 found a combination of antioxidants vitamins and zinc reduced the risk of progression of intermediate AMD to advanced AMD by 25%. The formulation was:

  • 500mg Vitamin C
  • 400 IU Vitamin E
  • 15mg Beta Carotene (25000 IU vitamin A)
  • 80mg zinc
  • 2mg Copper

Side effects of this supplement included an increased risk of lung cancer for smokers taking high doses of vitamin A and urinary tract infections with high levels of zinc.

In May 2013 the AREDS2 study was published. It looked at the effect of lutein, zeaxanthin and omega 3 fats on the progression to advanced AMD.  It also assessed the need for high levels of Vitamin A and zinc. High levels of Vitamin A interfere in the absorption of lutein and zeaxanthin. Those who did not take the vitamin a but did get lutein and zeaxanthin reduced the risk of progression by 20% and those who weren’t getting enough lutein and zeaxanthin in their diet who also took it as a supplement without vitamin A saw a 25% reduced risk of progression.

The addition of EPA and DHA Omega 3 fats did not affect the risk of progression in the study. EPA and DHA are major building blocks of the retina and also play a role in inflammation so there is some question as to the amounts used in the study, the ratio and the content already in the diet of the subjects. However, a diet rich in fish did indicate a reduced risk of getting macular degeneration.

Reducing the zinc did not seem to affect the results.

The Bottom Line: Eat dark green leafy vegetables and fish regularly.  Be sure to get your eye exam with the dilation drops every year or two. If you have intermediate macular degeneration take:

  • 10mg lutein
  • 2 mg zeaxanthin
  • 25mg zinc
  • 500mg vitamin C
  • 400 IU vitamin E

Remember that a multivitamin does not have the required antioxidants needed for eye health but it does have vitamin D so you may need both.

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