
Vol.3, # 3
January 21, 2006
Q: What is macular degeneration and what are some natual therapies? - Layperson
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A: Macular degeneration is a painless, degenerative eye disease
that affects more than 10 million Americans. It is the leading cause of
legal blindness in persons over the age of 55 in the United States. While
complete blindness does not occur in most people with the disorder,
macular degeneration often interferes with reading, driving, or performing
other daily activities.
There are two forms of macular degeneration. Dry macular degeneration
affects about 90% of those with the disease and causes gradual loss of
central vision, initially only in one eye. Wet macular degeneration, which
accounts for 90% of all severe vision loss from the disease, involves a
very sudden loss of central vision. |
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| Signs and Symptoms |
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Macular degeneration is accompanied by the following signs and
symptoms:
- Slightly blurred vision
- Dry type: a blurred spot in the central field of vision, which may
become larger and darker
- Wet type: straight lines that appear wavy and the rapid loss of
central vision; sometimes, wet macular degeneration starts with a sudden
blind spot
| What Causes It? |
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Dry macular degeneration occurs from the breakdown of the light
sensitive cells in the center of the retina, called the macula. Wet
macular degeneration occurs when new blood vessels behind the retina
grow toward the macula and leak blood and fluid. |
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| Who's Most At Risk? |
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People with the following conditions or characteristics are at
risk for developing macular degeneration:
- Age—the risk increases with age
- Cigarette smoking
- Family history of macular degeneration
- Cardiovascular disease
- Elevated levels of cholesterol
- Light eye color
- Excessive exposure to sunlight
| What to Expect at Your Provider's Office |
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Your eye care professional can detect macular degeneration
during an eye examination that includes the following:
- Testing with an eye chart to measure your ability to see
at various distances.
- Pupil dilation—drops are placed in your eyes to widen
the pupils and reveal more of the retina.
- Checking for presence of drusen (tiny yellow deposits in
the retina).
- Testing with Amsler's grid, which involves covering one
eye and staring at a black dot in the center of a
checkerboard-like grid. If the straight lines in the pattern
appear wavy or some of the lines appear to be missing, these
may be signs of wet macular degeneration.
Amsler Grid Testing of Central Vision
K. Bailey Freund, MD
An Amsler grid is a useful tool for monitoring
your central visual field. It is an important way to detect
early and sometimes subtle visual changes in a variety of
macular diseases such as age-related macular degeneration
and diabetic macular edema. It is also helpful in monitoring
changes in vision once they have been detected. With the
Amsler grid, each eye is tested separately by you. This
helps you to recognize visual symptoms which are in one eye
only. Amsler grids can be obtained from your eyecare
practitioner or through our research department at
(212)605-3777.

Examples of two different Amsler grids. Both
are useful for monitoring central vision. The grid on the
right is a modified Amsler grid (Yannuzzi card) intended to
be carried in the wallet or purse for daily
self-assessment.
Instructions for using the Amsler grid
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Test your vision with adequate lighting.
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Wear your reading glasses or look through
the reading portion of your bifocals (if you normally read
with spectacles).
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Hold the Amsler grid at normal reading
distance (about 14 inches).
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Cover one eye at a time with the palm of
your hand.
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Stare at the center dot of the chart at all
times.
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Do not let your eye drift from the center
dot.
Ask yourself the following questions as you
check each eye separately:
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Are any of the lines crooked or bent?
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Are any of the boxes different in size or
shape from the others?
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Are any of the lines wavy, missing, blurry,
or discolored?
(Note: If using a rectangular card like the
one above on the right (Yannuzzi card), you should check
each eye with the card held both vertically and
horizontally.)
If the answer to any of these questions is
"yes" (and this is a new finding for you), you should
contact your doctor immediately for an examination.
Sometimes these changes may mean that there is leakage or
bleeding in the back of the eye causing swelling of the
retina
- Fluorescein angiography—a special dye is injected into
a vein in the arm and pictures are taken as the dye passes
through the blood vessels in the retina.
| Treatment Options |
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| Prevention |
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If you have wet macular degeneration, you will test
your eyes daily at home using an Amsler's grid. You
should report any distortion immediately to reduce the
risk of vision loss. Other preventive measures include
increasing your dietary intake of flavonoids and
carotenoids (see section on Nutrition), using
ultraviolet eye protection, estrogen replacement
therapy, and moderate red wine
consumption. |
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| Treatment Plan |
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There is no known cure for macular degneration;
however, there are procedures that can help slow vision
loss.
Complementary Treatment and Recommended
Vitamins, Supplements, Herbs & Other
Nutritional Products
Essential: Pure Focus - Pure Focus
liquid based formula for vision health.
Essential: Vital Eyes Complete - Vital
Eyes Complete 60 capsules
Essential: Microcurrent Stimulation
100ile Purchase Option - Microcurrent Stimulation
(MicroStim or MCS)
Essential: CoQ10 & L-Carnitine 60
softgels - CoQ10 & L-Carnitine 60 softgels
Very Important: Taurine (L-Taurine) - 2
oz bottle - Taurine (L-Taurine) reduces the
oxidative damage caused by sunlight to the eyes,
and stimulates the body's ability to clean up
waste by-products that accumulate in the
retina.
Helpful: Macular Degeneration Magistral
Homeopathic Formula - Macular Degeneration
Magistril 1 oz Homeopathic Formula
Helpful: Astaxanthin 4 mg 60 softgels
(ASTA2) - Astaxanthin is a fat-soluble carotenoid
and antioxidant that kills off free radicals in
the body
Helpful: Digestive Enzymes - Digestive
Enzymes-V 60 Vcaps
Helpful: PaleoGreens - PaleoGreens 265
gms - excellent Green drink combining a variety of
organic vegetables, organic fruits and
wheatgrasses.
Helpful: Vizu-All Plus
contains the herbs:
Vaccinium myrtillus (bilberry)
is the principal ingredient in Vizu-All Plus and
has an impressive history in the natural treatment
of eye disorders. It is routinely recommended in
Europe as an addition to conventional medical
treatment, particularly for eye disorders.
Medically active components of bilberry include
flavonoid compounds known as anthocyanosides,
which work to counteract cell damage caused by
free radicals. By strengthening the tiny blood
vessels of the eye, bilberry helps to facilitate
delivery of essential oxygen and nutrients to the
eye and has been shown to be effective in the
prevention and treatment of degenerative diseases
of the retina. It also reduces the incidence of
hemorrhage in the eye, often associated with
diabetes. Further studies have demonstrated the
effectiveness of bilberry in treating and
preventing cataracts and glaucoma - two very
common eye disorders in older people. Because of
this, it is recommended that all people over the
age of 50 take Vizu-All Plus daily to prevent eye
disorders and promote optimal visual health.
Aspalathus linearis
(Rooibos) is found only on the slopes of the
Cedarberg mountains in the Western Cape of South
Africa and has been used medicinally for thousands
of years by the indigenous people of that area. It
is used as an effective all round tonic and
restorative, to reduce digestive complaints,
improve liver functioning and balance blood sugar
levels. Like bilberry, Rooibos also has powerful
anti-oxidant properties, mainly due to its
superoxide dismutase (SOD) mimetic properties. SOD
is an enzyme in the body which is especially
designed to neutralize unstable oxygen molecules
(free radicals) as soon as they occur and can
therefore help to prevent a broad spectrum of
diseases. Due to its high mineral content, Rooibos
is also instrumental in the maintenance of healthy
metabolism, bones, skin and teeth. Rooibos can
help to control blood sugar levels, lower blood
pressure and enhance immune functioning. It is an
extremely nutritious herb, containing Vitamin C,
Alphahydroxy Acid, potassium, copper, magnesium,
calcium, iron, zinc, manganese and fluoride.
Sutherlandia
frutescens, (also called Kanker Bossie or
Cancer Bush) was originally used by the indigenous
Khoi and San peoples of Southern Africa and is
indigenous to this region. Although it is well
known in the traditional treatment of internal
cancers, Sutherlandia is also effective in a wide
range of ailments, including diabetes. Research
has shown that Sutherlandia contains the active
ingredients canavanine, pinitol, and ,the amino
acid GABA. Pinitol is a well-known anti-diabetic
agent (Narayanan et al, 1987). Recent research has
confirmed the adaptogenic properties of
Sutherlandia as well as its anti-oxidant effects
(Swaffer et al. 1995, Crooks and Rosenthal, 1994,
Ostlund and Sherman, 1996) |
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Nutrition is a valuable treatment for dry
macular degeneration. It may also help prevent
both wet and dry types related to
aging. |
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| Nutrition |
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Antioxidants that protect your retina—such as
carotenoids, selenium, zinc, and vitamins C and
E—may either delay the progression of macular
degeneration if you already have the eye condition
(meaning that your vision won't get worse as
quickly) or prevent the development of this
serious eye disorder. Two particular carotenoids,
lutein and zeaxanthin, may be particularly
beneficial. Antioxidants can be obtained from
foods or supplements.
Eating a diet high in vitamins C and E and
carotenoids is likely all that you need to lower
your chances of developing macular degeneration in
the first place. (In other words, supplements are
probably not necessary for prevention.) Vegetables
rich in carotene include orange and yellow squash,
and dark, leafy greens, such as kale, collards,
spinach, and watercress.
If you already have macular degeneration,
especially if it is somewhat advanced, and you
decide, with the advice of your healthcare
provider, to take supplements, the following are
some suggested amounts of key nutrients:
- Mixed carotenoids, 25,000 to 50,000
International Units (IU) a day
- The carotenoid lutein, 5 milligrams (mg) a
day
- Selenium, 200 to 500 micrograms (mcg) a day
- Zinc, up to 50 mg a day
- Vitamin C, 60 to 2000 mg a day in divided
doses; doses over 1000 mg a day may cause
gastrointestinal problems, including nausea and
diarrhea
- Vitamin E, 50 to 1000 IU a day (usually 400
to 800 IU a day)
Flavonoids (such as quercetin, rutin, and
resveritrol) may also play a role in preventing
macular degeneration. A study of 3,072 adults with
macular changes showed that moderate red wine
consumption may offer some protection against the
development or progression of macular
degeneration. Red wine is high in certain
flavonoids (including quercetin, rutin, and
resveritrol) that have antioxidant activity;
damage from oxidative stress is thought to
contribute to the development of macular
degeneration. Dark berries, such as blueberries,
blackberries, and dark cherries, are high in
flavonoids as well.
Omega-3 fatty acids may also offer some
protection against macular degeneration. In a
study of more than 3000 people over the age of 49,
those who consumed more fish in their diet were
less likely to have macular degeneration than
those who consumed less fish. (Most types of fish
are rich in omega-3 fatty acids). Similarly, a
study comparing 350 people with macular
degeneration to 500 without found that those with
a proper ratio of omega-3 to omega-6 fatty acids
and higher intake of fish in their diets were less
likely to have this particular eye disorder.
Another larger study found that consuming
docosahexaenoic acid (DHA) and eicosapentaenoic
acid (EPA), two types of omega-3 fatty acids found
in fish, four or more times per week may reduce
the risk of developing macular degeneration.
Notably, however, this same study suggests that
alpha-linolenic acid (ALA; another type of omega-3
fatty acid) may actually increase the risk of this
eye condition. |
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| Herbs |
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Ginkgo (Ginkgo biloba), which contains
flavonoids, may help halt or lessen some retinal
problems. Clinical studies suggest that it may be
useful in treating vision problems specifically
due to macular degeneration. If you use
anticoagulants, do not use ginkgo without close
monitoring by your healthcare provider.
Bilberry (Vaccinium myrtillus) and grape
seed (Vitis vinifera) are also high in
flavonoids; therefore, they may help prevent and
treat macular degeneration. Clinical studies
suggest that these herbs may stop vision loss and
improve visual sharpness. Here are the recommended
doses:
- Ginkgo standardized to 24%, 120 mg once or
twice a day
- Bilberry extract standardized to 25%, 120 to
240 mg twice a day
- Grape seed, 50 to 150 mg once or twice a day
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| Homeopathy |
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Although scientific research does not
necessarily support the use of homeopathy to treat
or prevent macular degeneration specifically, an
experienced homeopath would consider your
individual case to decide whether treatment may be
beneficial for you. |
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| Acupuncture |
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Studies on acupuncture and macular degeneration
have been mixed. In a study of 51 patients with
macular problems, researchers found little change
in visual sharpness or other symptoms after 12
acupuncture treatments. Another study showed a
connection between low blood flow to the head and
macular degeneration. Restoring normal blood
pressure with acupuncture improved
vision. |
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| Prognosis/Possible
Complications |
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Blindness is a possible outcome of macular
degeneration. Low vision aids may help if you have
partial blindness. Sometimes blood vessels build
up underneath the retina, causing the retina to
become detached or scarred. If this happens, the
chances of preserving your central vision are
poor. This condition, called subretinal
neovascularization, occurs in about 20% of cases
of age-related macular degeneration. The condition
will likely recur even after laser treatment.
In short, eating a healthy diet high in
minerals, vitamins, essential fatty acids, and
amino acids may help slow down and possibly even
prevent macular degeneration. Consult a healthcare
professional familiar with macular
degeneration
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DISCLAIMER: The information in this column, is NOT intended to diagnose and/or treat any health related issues and is provided solely for informational purposes only. Consult the appropriate healthcare professional before making any changes to your healthcare regime. Even what may seem like simple changes in the diet for example, can interact with, and alter, the efficiency of medications and/or the body's response to the medications. Many herbs and supplements exert powerful medicinal effects. Neither the author, nor the website designers, assume any responsibility for the reader's use or misuse of this information.
© 2002 Nature's Corner
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