is a disease that damages the eyes and causes vision loss. It is often referred to as age-related or adult macular degeneration (AMD). It is a common cause of severe visual impairment in Americans, affecting over 15 million people. There is no cure for AMD, and treatment is somewhat limited.
The macula is the central part of the retina of the eye that makes it possible to see the fine detail needed for reading, driving, and recognizing faces. AMD causes the macula to malfunction or deteriorate. The result is loss of sight in the center of the visual field.
Although the cause of AMD is unknown, it is thought to be a combination of genetic and environmental factors.
AMD is more common in women, and those who are older. Other factors that may increase your risk of developing AMD include: Family history of AMD
Asian or Caucasian race
Excessive exposure to sunlightCurrent or former smokerBlood vessel damage or health conditions that interfere with blood circulation
The increased presence of free radicals may also increase the risk for macular degeneration. Free radicals are naturally produced when your body processes food for energy. They can also result from other oxidative stresses on the body, such as exposure to ultraviolet rays of the sun, smoking, and environmental pollution. Free radicals are unstable molecules that may cause damage to DNA and other molecules. Over the course of your lifetime, this damage may lead to AMD.
Nutritional supplements have been the focus of much research on the prevention of AMD. Antioxidants are thought to protect cells, in the eye and elsewhere, from free radical damage. High levels of antioxidants are found naturally in fruits and vegetables, as well as in other foods, such as egg yolks, nuts, grains, and some meats. They can also be concentrated in supplements.
Though the benefits of supplementation are often extolled in the media, clinical studies have had inconsistent results. While some studies reveal a link between higher levels of antioxidants and lower risk of AMD, many do not.
A recent review of over 62,000 people in 4 large studies showed that the use of vitamin E, beta-carotene, vitamin C, lutein, zinc, selenium, or zeaxanthin doesn't prevent or delay the development of AMD. However, a more promising review of over 6,100 people with AMD in 13 studies, showed that the same supplements may delay the progression of the disease. Depending on the study, supplements were taken individually or together.
In the bigger picture, it is difficult to tell how the supplements work across different populations. Taking supplements can also have harmful effects, especially if you take other medications. If you want to take supplements for AMD or any other reason, talk to your doctor before starting them.
Eat right—Although the evidence is inconclusive, a diet rich in nutrients may lower your risk of AMD. Try to include antioxidants in your diet by eating a variety of fruits and vegetables. Green leafy vegetables, such as spinach, kale, and collard greens, are particularly recommended. Eating fish and other foods that contain omega-3 fatty acids may also help to lower your risk of AMD as well as other chronic conditions.Exercise regularly—Cardiovascular exercise improves the body’s overall health and helps maintain a healthy circulatory system.Reduce sun exposure—Always wear a hat when outdoors, and wear sunglasses or protective lenses all year.See your doctor—If you have a chronic condition, get proper treatment. Also make sure that you have your eyes examined on a regular basis.
Although evidence relating supplements, diet, and AMD is mixed, it is always best to strive to live a healthy lifestyle. Here are some ways to boost your eye health:
Age-related macular degeneration. American Academy of Ophthalmology. Available at:
http://www.geteyesmart.org/eyesmart/diseases/amd.cfm. Accessed November 18, 2013.
Age-related macular degeneration. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated October 17, 2013. Accessed November 18, 2013.
Chong EW, Kreis AJ, Wong TY, et al. Dietary omega-3 fatty acid and fish intake in the primary prevention of age-related macular degeneration: a systematic review and meta-analysis. Arch Ophthalmol. 2008;126:826-833.
Evans JR, Lawrenson JG. Antioxidant vitamin and mineral supplements for preventing age-related macular degeneration.
Cochrane Database Syst Rev. 2012:CD000253.
Evans JR, Lawrenson JG. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration.
Cochrane Database Syst Rev. 2012:CD000254.
Hammond BR Jr, Wooten BR, Snodderly DM. Density of the human crystalline lens is related to the macular pigment carotenoids, lutein and zeaxanthin. Optom Vis Sci. 1997;74:499-504.
Landrum JT, Bone RA, Kilburn MD. The macular pigment: a possible role in protection from age-related macular degeneration. Adv Pharmacol. 1997;38:537-556.
Macular degeneration. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary. Updated August 22, 2013. Accessed November 18, 2013.
Macular degeneration treatment. American Academy of Ophthalmology Eye Smart website. Available at: http://www.geteyesmart.org/eyesmart/diseases/amd-treatment.cfm. Accessed November 18, 2013.
Richer S, Stiles W, Statkute L, et al. Double-masked, placebo-controlled, randomized trial of lutein and antioxidant supplementation in the intervention of atrophic age-related macular degeneration: the Veterans LAST study (Lutein Antioxidant Supplementation Trial). Optometry. 2004;75:216-230.
3/6/2013 DynaMed's Systematic Literature Surveillance.
Available at: https://dynamed.ebscohost.com/about/about-us: Sui GY, Liu GC, Liu GY, et al. Is sunlight exposure a risk factor for age-related macular degeneration: A systematic review and meta-analysis. Br J Ophthalmol. 2012 Nov 10. [Epub ahead of print].
Last reviewed November 2013 by Michael Woods, MD
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