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Jane's Blog Wet Macular Degeneration AMD

Posted by Jane Jansen on

Age Related Macular Degeneration (AMD) is very common. It is a leading cause of vision loss in people 50 years or older.

According to the American Macular Degeneration Foundation about 85 to 90 percent of AMD diagnoses are the dry form and 10 to 15 percent are the wet form. Although wet AMD is less common, it is much more serious, because you can lose your vision faster.

With AMD you lose your central vision. You cannot see fine details, whether you are looking at something close or far. But your peripheral (side) vision will still be normal. For instance, imagine you are looking at a clock with hands. With AMD, you might see the clock’s numbers but not the hands.

The retina is the surface at the back of each eye that captures images and sends them along the optic nerve to your brain. At the center of each retina is an area called the macula. Your macula processes your central vision and helps you focus. A healthy macula is flat. With wet AMD, leaked blood and fluids cause a bulge in your retina. The leaking blood vessels can also cause scar tissue to form and damage cells in your retina. That damages your central vision. 

Three of the main pathways that undermine the health of the retina are inflammation, oxidation, and angiogenesis (formation of blood vessels). The protein Vascular Endothelial Growth Factor (VEGF) promotes the growth of the abnormal, unhealthy blood vessels that leak fluid under the macula which leads to wet macular degeneration and the loss of central vision.

Wet macular AMD is generally caused by abnormal blood vessels that leak fluid or blood into the macula. Sometimes abnormal new blood vessels grow from the choroid under and into the macula. The choroid is the layer of blood vessels between the retina and the outer, firm coat of the eye. These abnormal blood vessels may leak fluid or blood, interfering with the retina's function.

Vision loss can also be caused by fluid buildup in the back of the eye. When fluid leaks from the choroid, it can collect between the thin cell layer called the retinal pigment epithelium and the retina or within the layers of the retina. This may cause a bump in the macula, resulting in vision loss or distortion.

It is called “age-related macular degeneration” (AMD) because it is most common in people over 50 and becomes even more common in your 70s and 80s.  If you have family members with wet AMD you may have inherited certain genes that increase your likelihood of getting it. Wet AMD almost always starts as dry AMD.

Smoking doubles your odds of developing wet AMD. In addition to cutting off oxygen to your eyes, researchers think smoking may damage cells and make it harder for nutrients to reach your eyes through your bloodstream.

Blood thinners, such as Aspirin, Coumadin and Eliquis, can make the bleeding worse for those with wet macular degeneration worse. In patients taking warfarin is that green leafy vegetables can decrease the drug’s anti-clotting effects by providing vitamin K. Some patients on warfarin will be told not to eat leafy greens because this makes it harder to regulate the warfarin dose. Yet, eating these same leafy greens has been shown to decrease the risk of vision loss from AMD.

According to a study published November 2009, in the American Journal of Ophthalmology, results indicate that anticoagulants and antiplatelet agents are strongly associated with the development of large subretinal hemorrhages in AMD patients. Moreover, arterial hypertension is a strong risk factor for large subretinal hemorrhages in AMD patients receiving anticoagulants or antiplatelet agents.

Left untreated, wet AMD progresses quickly and can lead to complete central vision loss. Inflammation, angiogenesis, and fibrosis have been found to play a role in the pathogenesis of AMD and therefore need to be addressed for prevention as treatment after diagnosis is very difficult at best.

Lack of Vitamin D may increase the risk of early and late AMD and may also be associated with subretinal fibrosis. Studies have shown Vitamin D is a circulating steroid hormone that counteracts inflammation, angiogenesis, and fibrosis. Vitamin D is a potent inhibitor of angiogenesis due to its effects on endothelial cells and interruption of the angiogenesis signaling pathway.

Oxidants are also thought to be partly responsible for the ageing process in the eye by speeding up cell degeneration.

Antioxidants reduce this harmful effect. Vitamins A, C and E are antioxidants. Carotenoids are also effective against oxidants. Lutein and zeaxanthin are important carotenoids. Eating foods with a high amount of lutein is beneficial including safflower oil, peanuts, hazelnuts, almonds, spinach, broccoli, and avocado. A single ounce of avocado contains 80 micrograms of lutein. omega-3 fatty acids including oily fish like salmon, walnuts, almonds, and extra virgin olive oil.  

 Several studies suggest that eating at least 10mg of lutein a day has the most beneficial effect on macular pigment levels. Risk of age-related macular degeneration was increased in people with the lowest plasma concentrations of lutein plus zeaxanthin. Lutein and zeaxanthin supplements are helpful too.

Curcumin/Turmeric Studies have found, Curcumin, the yellow pigment derived from turmeric has been shown to inhibit VEGF by several studies.” Published in March 2019 International Ophthalmology, reports curcumin has significant therapeutic potential use in ophthalmology and especially in retinal disorders. The review article states,” Curcumin has found a role in slowing, and in some cases even reversing, age-related macular degeneration, diabetic retinopathy, retinitis pigmentosa, proliferative vitreoretinopathy, and retinal cancers.”

Grape Seed Extract: Proanthocyanidins in grape seed extract strengthen the walls of all blood vessels, they may also help to keep damaged, stretched, or stiff blood vessels from leaking. In one area of research, grape seed extract may be effective for slowing retinopathy, the gradual break-down of the retinas in the eyes, usually due to blood vessel damage. Individuals with high blood pressure, plaque buildup in the arteries, and diabetes, increase the likelihood for damage to the small blood vessels in the eyes are more likely to have serious vision problems such as AMD because of that damage.

Appointments either by telephone or in-office are available at the Tree of Life Wellness Center 508-336-4242.

Jane Jansen Holistic Practitioner

Host Holistic Healthline Radio tune in every Saturday 9am-10am on IHeartRadio or holistichealthline.com


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