“Acquired vision loss associated with these conditions can be devastating to the individual through its detrimental impact on quality of life, and also impart substantial societal burden. Although the pathogenesis of these conditions is not fully understood, there is increasing evidence that their impact can, to some extent, be mitigated by targeting modifiable risk factors. Since diet and nutrition have been linked with the most common diseases affecting the elderly, dietary modification and nutritional supplementation for the prevention and treatment of these diseases has attracted a considerable amount of scientific attention.” (1)
This is what Dr. John G. Lawrenson of the University of London and Dr. Laura E. Downie of the University of Melbourne wrote in the medical journal Nutrients, September 2019 in assessing the role of diet and supplementation in combating vision problems in the aging population.
One aspect of diet and nutrition’s in the role of Age-Related Macular Degeneration is as anti-inflammatory
In November 2018, a team of medical university researchers in Italy published their findings in the journal Nutrients (2) on the role of inflammation and oxidation in the progression of age-related macular degeneration, or AMD. One potential approach, they write, to reduce the risk of AMD is the prescription of vitamins and other anti-oxidative micronutrients. The main reason for this choice resides in the theory that macular degeneration can be managed with an anti-inflammatory and anti-oxidant health program. Although the precise causes of AMD remain unknown, there is a clear role of inflammation in the pathophysiology of this disease.
Further, they contend, doctors should explore the role of high-fat and high simple-sugar diets on the development of AMD through damage of the gut microbiota that leads to systemic low-grade inflammation. Furthermore, recent evidence indicates a robust interaction between the gut microbiota and retina that is referred to as the “gut-retina axis”. A better understanding of the mechanisms that underlie this connection may help clinicians to prompt new models of personalized care of AMD based on the promotion of healthy nutritional habits and adequate micronutrient intake. These practices could modulate the gut microbiota toward a reduction of dysbiosis, leaky gut and lower gastro-intestinal distress and, consequently, retinal damage.
This research suggested benefits of Vitamin C, vitamin E, Zinc, Carotenoids, the pigments responsible for the yellow, orange, and red colors of many fruits and vegetables, and Beta-Carotene
Macular degeneration is characterized by the deterioration of the macula, a small part of the central retina where the eye’s photoreceptors (rods and cones) are most highly concentrated. The leading cause of legal blindness, macular degeneration affects more than 10 million Americans — more than cataracts and glaucoma combined — according to the American Macular Degeneration Foundation. The disease affects a person’s central vision, which is needed for common tasks such as reading and driving. The effect is similar to that of a raindrop on the center of a camera lens.
The role of Vitamin D
An international team of scientists published their findings also in the journal Nutrients.(3) Here they write that vitamin D can control the expression of genes involved in oxidative stress, inflammation, and angiogenesis (the formation of new blood vessels that can carry inflammatory factors). In the macula, vitamin D may preserve the function of the retina. Further, they suggest, there is an association between vitamin D deficiency and a higher risk of early and/or late AMD.
Researchers at the University at Buffalo recently discovered that vitamin D may play a significant role in eye health, specifically in the possible prevention of age-related macular degeneration among women who are more genetically prone to developing the sight-damaging disease.
In a paper published in JAMA Ophthalmology online, the University at Buffalo researchers found that women who are deficient in vitamin D and have a specific high-risk genotype (a specific part of their DNA) are 6.7 times more likely to develop AMD than women with sufficient vitamin D status and no high risk genotype. The vitamin D supplementation being a key factor in both groups of women.
Melatonin for Macular Degeneration
In recent research, Melatonin was cited as it prevented the structural and functional changes in retina cells, reduced the severity of microcirculatory disorders and prevented destruction of neurosensory cells, associative and gangliolar neurons in the retina, thus highlighting the therapeutic potential of Melatonin for treatment and prevention of age related Macular Degeneration.(4) Research published in the journal Investigative ophthalmology & visual science confirms Melatonin’s protective role in the retina.(5)
Antioxidants for Macular Degeneration
In other research, a study reported in the journal Molecular Vision (6) suggested that zinc oxide combined with a detergent extract of rosemary powder or rosemary oil was found effective in treating eye damage related to age related Macular Degeneration.
A combined team of Canadian and Pakistani researchers also suggest that Phytonutrients such as lycopene, lutein, and zeaxanthin are particularly helpful in retarding macular degeneration. This study was published in the journal Nutrients.(7)
- Taurine is a very powerful antioxidant, which is of specific benefit to the eye. Taurine may also be beneficial for the heart. We have treated several patients who have suffered decreased loss of vision due to macular degeneration.
In the first published study we cited above, the researchers also made suggestion that nutrition and supplementation, as demonstrated by research, may not help not help certain individuals. Research is not in agreement. They were able to not one study as follows:
“However, one large, multi-centre Random Controlled Trial conducted in the USA, the Age-Related Eye Disease Study (AREDS), randomised 3640 individuals with AMD to take supplement formulations containing combinations of vitamin C, E, beta-carotene, zinc, and copper, or a placebo, each day. A major conclusion from the AREDS was that daily, long-term supplementation with vitamin C (500 mg), vitamin E (400 international units (IU)), beta-carotene (15 mg), zinc (80 mg, as zinc oxide), and copper (2 mg, as cupric oxide) reduced the relative risk of progression to late-stage AMD from 28% (observed with placebo) to 20% at 5 years, in people with at least intermediate AMD. This means that for people with intermediate AMD, who are at the highest risk of progression to late AMD, 80 fewer cases would progress for every 1000 people taking the supplement. However, safety concerns were raised regarding high-dose supplementation of the carotenoid used in the original AREDS supplement, beta-carotene, in people who smoke.”(1)
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1 Lawrenson JG, Downie LE. Nutrition and Eye Health. Nutrients. 2019 Sep 6;11(9):2123. doi: 10.3390/nu11092123. PMID: 31489894; PMCID: PMC6771137.
2 Rinninella E, Mele MC, Merendino N, et al. The Role of Diet, Micronutrients and the Gut Microbiota in Age-Related Macular Degeneration: New Perspectives from the Gut⁻Retina Axis. Nutrients. 2018;10(11):1677. Published 2018 Nov 5. doi:10.3390/nu10111677.
3 Layana AG, Minnella AM, Garhöfer G, et al. Vitamin D and Age-Related Macular Degeneration. Nutrients. 2017;9(10):1120. Published 2017 Oct 13. doi:10.3390/nu9101120
4 Millen AE, Meyers KJ, Liu Z, et al. Association between vitamin D status and age-related macular degeneration by genetic risk. JAMA Ophthalmol. 2015;133(10):1171-9.
5 Stefanova NA, Zhdankina AA, Fursova AZh, Kolosova NG. [Potential of melatonin for prevention of age-related macular degeneration: experimental study]. Adv Gerontol. 2013;26(1):122-9.
6 Gianesini C, Hiragaki S, Laurent V, Hicks D, Tosini G. Cone Viability Is Affected by Disruption of Melatonin Receptors Signaling. Invest Ophthalmol Vis Sci. 2016 Jan 1;57(1):94-104. doi: 10.1167/iovs.15-18235.
7 Organisciak DT, Darrow RM, Rapp CM, Smuts JP, Armstrong DW, Lang JC. Prevention of retinal light damage by zinc oxide combined with rosemary extract. Mol Vis. 2013;19:1433-45. Published 2013 Jun 27.