Age Related Macular Degeneration (AMD)

Macular degeneration is the deterioration of the cells in the macula, a tiny area near the centre of the retina (lining of the eye) that is responsible for the most detailed vision.

The deterioration therefore affects your central vision that is used for reading, writing, watching television driving and recognizing faces. Macular degeneration causes progressive loss of central vision. Your peripheral vision is not affected.

What causes macular degeneration?

Damage to the retinal cells occurs from free radicals. Free radicals are caused by ultra-violet and blue light incident on the retina and also as natural products of metabolism. They cause oxidation and destabilization of the retinal cells.

Free radical damage is cumulative with age; therefore the incidence of macular degeneration increases with age, (hence the term AMD). Risk factors include:

  • Smoking increases the risk by up to 5 times.
  • Diabetes.
  • Uncontrolled high blood pressure
  • Poor diet or conditions causing difficulty-absorbing nutrients from the diet.
  • Certain types of medication.
  • Women are twice as likely to suffer from AMD
  • Excess exposure to UV

What are wet and dry AMD?

There are two types of AMD. The more common type is non-exudative AMD also known as dry AMD but this may be the precursor in 10 to 20% of patients to the more serious exudative or wet AMD in which new blood vessels begin to grow in the macula area, which may cause severe central visual loss.

What treatment is currently available for AMD?

There is no conventional medical treatment for dry AMD. Recent research has found that there can be a preventative and protective effect from using various micronutrients and vitamins in eye disease. The use of specific dietary components called carotenoids help the retina to protect and even repair itself in age related macular degeneration.

A Carotenoid called Lutein is known to protect the retina from blue light that causes free radicals and Lutein levels are higher in the retina of people without AMD than those suffering from the disease.

Pure Focus Spray is recommended for patients suffering from AMD. The sub-lingual (under the tongue) spray is absorbed by the mucus membranes of the mouth and allows good levels of Lutein in the blood system and therefore at the macula.

The Pure Focus spray is recommended for patients with macula disease. Supplements such as I Caps vitamin tablets which contain Lutein are useful for prevention in younger patients who are at risk of developing the problem, but not so effective in treatment of the disease.

What can happen to the vision with AMD?

In the very early stages you may not notice much change in the vision. You may notice it takes longer for you eyes to adjust to changes in illumination outdoors/indoors.

As AMD progresses you may notice

  • Words appear blurred and difficult to read
  • It may be difficult to recognize people across the road
  • There may be a blank or dark area blocking the centre of your vision (scotoma)
  • Colours may seem dim
  • Straight lines may seem wavy

The wet or proliferative type of AMD causes more severe symptoms and deteriorates more quickly and loss of vision can occur over a matter of a few weeks or months.

We recommend all patients regularly have our advanced retinal screening images taken. The system we use is a revolutionary retinal photography machine which enables the macula to be examined. It can show early macula changes before visual loss is apparent. This helps to detect patients who are at risk much earlier and initiate nutritional therapy.

Is there a hereditary component in AMD - what should I tell my children?

At the moment, our gene set is fixed: it is possible in the future that genes will be manipulated to avoid the tendency to certain disease.

In the meantime, if you have a family history of eye disease, you are more likely to get the same problems. Those at risk should alter their diet and lifestyle to reduce their exposure to some of the causative factors and reduce the likelihood of suffering the same problems.

Diet plays a key role in depositing the required Lutein at the macula and ensuring adequate Lutein is regarded as likely to help prevent AMD. Up to the age of 40, a good diet including the above is probably protection enough.

Anti-oxidants include vitamins A, C and E and attention to the diet to ensure healthy quantities of fresh fruit, and vegetables is advised as a preventative measure. Carotenoids particularly are found in green leafy vegetables with raw spinach being a particularly good source. Other useful vegetables are Brussel sprouts, broccoli, green beans and green peas, egg yolks and red, yellow and orange peppers.

If there is a family history of AMD, a multivitamin and mineral tablet containing vitamins A, C and E with zinc, selenium, manganese and copper may be usefully recommended as a preventative measure for the (non smoking) over 40s. I Caps are recommended as they have the necessary vitamins as well as Lutein and Zeaxanthin.. For smokers, an ACE vitamin supplement and sublingual (Pure Focus) Lutein is recommended because smoking is a major risk factor.