What really is AMD?

AMD is an abbreviation for Age-related Macular Degeneration.  

The ‘macula’ (‘stain’ in Latin) is the part of the retina situated near the optic nerve.  This is the part that the doctor will take a look at when examining the back (fundus) of the eye. 

 

 

A chain reaction... 

The inner eye (cornea and lens) form a type of magnifying glass which helps to focus light rays onto the retina.  

These light rays stimulate the retinal cells which relay information to the brain via the optic nerve. This is what enables us to see, but it also means that the retina is 10 to 100 times more exposed to rays than the skin! 

 

Luckily, nature does things well and the retina contains a particularly high amount of yellow pigments: lutein and zeaxanthin.

These carotenoids are doubly effective:  

  • They are powerful antioxidants
  • They filter blue light, which is  most harmful to the retinal cells.   

Unfortunately as we age, the density of these pigments is reduced.  

 

Due to light rays, there can be chronic inflammation of the retina and a build up of pigments (lipofuscin), responsible for oxidative stress and retinal atrophy - also known as atrophic or ‘dry’ AMD.  

At a later stage, there will be an uncontrolled growth of certain blood vessels and an oedema will form at the back of the eye. This is also known as ‘wet’ MDA. 

 

Everything which encourages oxidative stress will only make this condition worse:  

  • Tabacco
  • Obesity
  • Exposure to sunlight 
  • Vascular disorders 
  • Lack of antioxidants in diet 

 

Early screening test for AMD

Sight problems may only begin to develop several years after retinal damage. So it’s important to be aware of any warning signs that might appear.. 

 

Do you experience one or several of the following symptoms?

 

      Never = 0     Sometimes = 1     Often = 2    
Distortion of objects and lines      
Flashes, dark stains in field of vision      
Reduction in visual acuity in one eye, blurry vision      
Double vision      
Need for increased light/contrast      
Reduced night vision, car headlight glare      

 

If your score is over 5, it’s a good idea to visit your eye doctor as soon as possible for a thorough examination.  

 

Prevention rather than cure !

Detecting the problem is a good start, preventing it is even better.. 

Luckily there are several ways in which MDA can be effectively prevented.

 

 

Protect your eyes 

Remember to protect your eyes from the sun, especially when at the beach or in the mountains where sun reflection can be particularly dangerous. 

 

Also take extra care when using a welding arc or when watching a solar eclipse. 

 

 

Mediterranean diet

According to a study undertaken in 2018, a Mediterranean diet rich in fruit and vegetables, fish, whole grains and unsaturated fats could reduce the risk of developing AMD by 41%. 

 

 

Antioxidants

Oxidative stress is strongly linked with AMD. Carotenoids have proven to be particularly effective is slowing down the development of atrophic AMD (45% reduction).

 

The following are therefore strongly recommended for the prevention of AMD:  

  • Lutein found in chicory, endives, salad, mango, green soya. 
  • Zeaxanthin found is corn, squash, peaches, citrus fruit pips
  • Lycopene found in grapes, watermelon, tomatoes, papaya, guava, grapefruit.  
  • B-carotene found in carrots, peaches, apricots  
  • Vitamin C and E
  • Zinc, selenium and copper 

 

Long-chain omega-3 acids : targeted action

ADH represents 15% of total fatty acids and 93% of omega-3 found in the retina.

 

According to a ‘LAST’ study carried out in 2003, individuals with a higher intake of polyunsaturated fatty acids showed a reduced risk of developing AMD.

 

Furthemore, omega-3 fatty acids have clearly proven their effectiveness in reducing the risk of developing cataracts and in preventing dry eye syndrome - so it really is worth making sure that you’re getting enough of them in your diet! 

 

 

References

  • Merle BMJ, Colijn JM, Cougnard-Grégoire . Mediterranean Diet and Incidence of Advanced Age-Related Macular Degeneration: The EYE-RISK Consortium. Ophthalmology. 2018 Aug 13 [Epub ahead of print]. doi: 10.1016/j.ophtha.2018.08.006. PMID: 30114418

  • The Age-RelatedEye DiseaseStudy 2 (AREDS2) Research Group. JAMA. 2013; 309:2005-15.

  • étude LAST: Lutein Antioxydant Supplement Trial

  • Johanna M. Seddon, MD, ScM; Jennifer Cote, MPH; Bernard Rosner, PhD Progression of Age-Related Macular Degeneration: Association With Dietary Fat, Transunsaturated Fat, Nuts, and Fish Intake Arch Ophthalmol. 2003;121:1728-1737