What are the treatments for dry macular degeneration?

Age-related macular degeneration (AMD), also known as dry macular degeneration, is a chronic eye condition that damages the macula, the area of the retina in the center of the eye that provides clear central vision. Sadly, there is no known treatment for dry AMD. To help reduce its progression and control its symptoms, there are several therapies and interventions available. Here are a few typical methods:

Nutritional Supplements

In some instances, it has been demonstrated that a specific formulation of nutritional supplements called AREDS2 (Age-Related Eye Disease Study 2) can halt the course of dry AMD. These supplements often include a mix of carotenoids like lutein and zeaxanthin together with antioxidants like vitamins C and E, zinc, and copper. Before beginning any supplements, it is crucial to speak with a qualified eye care specialist.

Changes in Lifestyle

Leading a healthy lifestyle may help dry AMD progress more slowly. This entails keeping up a balanced diet full of fruits, fish, and green leafy vegetables; exercising frequently; quitting smoking; and controlling health issues including high blood pressure and cholesterol levels.

Low Vision Aids

As dry AMD worsens, it can lead to vision loss and make daily tasks more challenging. People with visual impairments can make the most of their remaining eyesight by using low vision aids including magnifying glasses, large-print publications, and electronic devices with larger text or text-to-speech features.

Monitoring and routine eye exams 

Routine eye exams are essential for keeping track of the development of dry AMD. Implementing suitable actions and therapies on time can benefit from early detection of any changes.

These therapies cannot save vision that has already been lost; rather, they work to stop the disease’s progression and control its symptoms. It is essential to speak with an ophthalmologist or eye care professional for individualized guidance and treatment options depending on the unique circumstances if you or someone you know has dry AMD.

Causes of dry macular degeneration

There is still some debate on the precise etiology of dry AMD. There are, however, a number of recognized causes for the onset and development of the illness. These consist of:

Age

AMD is more likely to develop as people get older, and people over 50 are more likely to experience it. As a result, age-related macular degeneration is a common name for it.

A genetic component may play a part in the development of AMD, according to studies. A higher risk of AMD has been linked to specific genetic variants. You may be more likely to get AMD if you have a family history of the disease.

Smoking

Smoking tobacco increases the risk of AMD significantly. Compared to non-smokers, smokers are more prone to get AMD and suffer the disease’s progression more quickly.

Oxidative Stress

Oxidative stress, which is brought on by an imbalance between the body’s ability to produce reactive oxygen species (free radicals) and do so, may have a role in the development of AMD. The macula and other retinal cells are susceptible to oxidative stress damage.

Inflammation

It is hypothesized that chronic inflammation, especially inflammation in the eye, plays a role in the onset and progression of AMD. The immune system and inflammatory processes may be involved in retinal cell injury and dysfunction.

Environmental Factors

AMD risk may be increased by prolonged exposure to ultraviolet (UV) light, particularly blue light. Wearing sunglasses or hats with brims to shield the eyes from UV rays may help lower the risk.

Although these factors are known to raise the likelihood of having AMD, it’s important to remember that not everyone with these risk factors will experience the condition. On the other hand, some people without these risk factors can still get AMD. For a better knowledge of how these characteristics interact with a person’s vulnerability to the disease, more research is necessary.

How does each of these causes affect ARMD?

Age-related macular degeneration (AMD) can develop and advance in different ways as a result of each of the variables I outlined. Let’s investigate the roles that each aspect plays:

Age

As we grow older, the cells in our macula may gradually change, which may result in AMD. The retina’s molecular and biochemical pathways are impacted by aging, making it more prone to harm and dysfunction with time.

Genetic Variations

Some genetic changes have been linked to a higher risk of getting AMD. These differences can affect a number of retinal processes, including inflammation, oxidative stress, and the creation of aberrant blood vessels—all of which play a role in AMD development.

Smoking

Smoking has a negative impact on one’s health in general and has a particular impact on the blood vessels in the retina. Smoking has been linked to blood vessel constriction, decreased oxygenation of the macula, and an increase in oxidative stress. These consequences may influence the onset and progression of AMD.

Oxidative Stress

Oxidative stress happens when there is an imbalance between the body’s capacity to neutralize free radicals (also known as reactive oxygen species) and their creation. Due to its high metabolic activity and exposure to light, the retina, including the macula, is especially susceptible to oxidative stress. AMD can result from retinal cell damage from oxidative stress, including damage to the cells in the macula.

Chronic inflammation is thought to be a major factor in the emergence and development of AMD. The proper function of retinal tissues can be harmed by inflammation. The development of abnormal blood vessels (neovascularization) and the buildup of drusen (tiny yellow deposits) in the macula, both of which are defining characteristics of AMD, can be triggered by inflammatory processes in the eye.

Environmental Factors

AMD may develop as a result of prolonged exposure to ultraviolet (UV) radiation, particularly blue light. Reactive oxygen species, which are produced by oxidative stress brought on by UV and blue light, can harm retinal cells, particularly those in the macula.

The precise methods by which these elements exert their effects are still being researched, despite the fact that they can all contribute to AMD. AMD’s onset and progression are likely complicated processes that entail intricate interactions between these variables as well as unique genetic and environmental influences.

What nutrients are known to help each of them from happening?

In order to address the variables that contribute to the development of age-related macular degeneration (AMD), several nutrients have been investigated for their potential involvement in halting or delaying the disease’s progression. The following essential nutrients have demonstrated promise:

Antioxidants

Antioxidants work to reduce oxidative stress and shield cells from free radical damage. Antioxidants that have been investigated in relation to AMD include:

Vitamin C

Vitamin C has been linked to a lower risk of AMD progression and is found in fruits and vegetables.

Vitamin E

When paired with other antioxidants, vitamin E, which is found in nuts, seeds, and vegetable oils, has the ability to halt the progression of AMD.

Zinc

This mineral, which is present in foods like shellfish, lean meats, and legumes, contributes to the action of antioxidant enzymes. Antioxidants and zinc supplements have both been investigated as AMD treatments.

Carotenoids

Plant pigments called carotenoids have antioxidant qualities that are good for the health of the eyes. Specifically linked to AMD are the following carotenoids:

The macula contains high levels of the carotenoids lutein and zeaxanthin. They serve as filters for dangerous blue light and have been associated with a lower risk of advanced AMD. Green leafy greens, such as spinach and kale, and colored fruits and vegetables are good nutritional sources.

Healthy fats

Healthy fats with anti-inflammatory qualities and benefits for retinal health are omega-3 fatty acids. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are the two primary kinds. Fatty fish (such as salmon, mackerel, and sardines) and specific nuts and seeds are sources of omega-3 fatty acids.

Vitamins B6, B9 (folate), and B12

Vitamins B6, B9 (folate), and B12 are necessary for the metabolism of homocysteine. A higher risk of AMD has been linked to elevated homocysteine levels. Fortified grains, legumes, leafy greens, and animal products including fish, chicken, and eggs are good nutritional sources.

Although these nutrients may have potential benefits for AMD, it’s crucial to remember that neither a preventive strategy nor a treatment is 100% certain to work. It’s always a good idea to speak with a doctor or eye care specialist before taking any new supplements or making any dietary changes. Based on your unique requirements and medical background, they can offer advice that is tailored to you.

Dry Macular Degeneration Treatment Breakthroughs

New treatment for dry macular degeneration: Microcurrent therapy for AMD

Low-level electrical currents are applied to the body as part of a therapeutic method called microcurrent therapy, which is sometimes referred to as transcutaneous electrical stimulation (TES) or low-level electrical stimulation (LLE). Age-related macular degeneration (AMD), among other medical problems, has been studied as a potential treatment option. 

Studies that have looked into the use of microcurrent therapy for AMD have suggested potential advantages such as increased contrast sensitivity, better visual acuity, and fewer drusen (abnormal deposits in the retina linked to AMD). 

New treatment for dry macular degeneration 2023

Pegcetacoplan, also known as Syfovre, is the drug, and the Food and Drug Administration just recently gave it the go-ahead. Geographic atrophy, a severe form of dry AMD, has been demonstrated to be slowed by it. For other forms of dry AMD, it is not approved.

It’s crucial to remember that the medication only delays additional eyesight loss; it does not halt or reverse the trend. We predict that the medication decreases the rate of development by 1-3 months every year based on clinical research. In other words, if the disease were to advance to a specific degree of severity in 24 months, it would do so in 27–30 months while the patient was taking the medication.

Due to the increase in elderly people, the dry type of ARMD is becoming a significant issue. With the exception of the illusory oral dose of antioxidant vitamins, there is no effective treatment for dry ARMD. Although there was skepticism in the medical community, since 1996, the therapeutic impact of ozone therapy had been studied. Specific biochemical, molecular, and pharmacological processes served as the foundation for this evaluation. However, a number of visual scientists continue to avoid conservative ozonetherapy and simply recommend antioxidant vitamins. The University of Siena has conducted two modest clinical studies with 217 individuals that demonstrate how ozonetherapy can slow the disease’s course while also enhancing the patient’s well-being and visual acuity. Additionally, it appears that ozone therapy is a safe method with high compliance.

Many patients in Italy and Germany have successfully undergone this mode of treatment over the past few years. Despite being aware of the outcomes, the majority of ophthalmologists continue to disagree on whether to administer the therapy. Ozonetherapy can only be used to treat the dry type of ARMD, and while it may not totally improve visual acuity, it does provide a defense against the disease’s natural progression and enhance the quality of life.

The intriguing feature of ozone therapy is its capacity to activate a number of protective mechanisms against ischemia and neurotoxic insult, hence preventing photoreceptor degeneration. The following is a summary of these effects:

1. Enhanced blood rheology.
2. Enhancement of the erythrocytes’ glycolytic pathways. A micro-release at hypoxic locations may be made easier by the elevated ATP concentration.
3. An increase in 2,3-DPG levels, especially if the patient previously had low levels, can activate the hexose-monophosphate shunt on erythrocytes. This alteration results in a shift to the right of the HbO2 dissociation curve, which enhances oxygen availability to hypoxic tissues.
4. Vasodilation is brought on by increased prostacyclin and nitric oxide release.
5. Platelet release of growth factors.
6. The increase of antioxidant enzymes, phase 2 proteins, and heme-oxygenase-1 with the release of CO and bilirubin are extremely significant.

The fact that patients should be encouraged to begin ozone therapy as soon as possible is strongly supported by the discovery that visual acuity recovers more quickly in patients with an initial deficit than in patients who are nearly blind. It seems evident that the treatment lessens photoreceptor degeneration. Other retinal degenerative diseases include ischemic optic neuropathies, glaucoma, recessive Stargardt’s disease, retinitis pigmentosa, retinal vascular disorders caused by diabetes, degenerative myopia, and retinitis pigmentosa. 

FAQ’s

How Long Does Macular Degeneration Take to Advance?

Dry AMD often progresses over several years, frequently within ten years, from the initial diagnosis to substantial vision loss. However, many AMD patients can significantly lower their risk of substantial vision loss and prolong their ability to see for many years with the appropriate treatment.

How do you prevent dry macular degeneration from getting worse?

Even after being told you have dry macular degeneration, there are things you may do to potentially halt vision loss.

• Avoid smoking.
• Pick a balanced diet.
• Take care of your other medical issues.
• Keep a healthy weight and engage in regular exercise.
• Routinely have your eyes examined.

Which foods should people who have macular degeneration avoid?

• Trans-fat-containing processed foods.
• Use safflower and maize oil, which are high in vitamin E, in place of tropical oils like palm oil.
• Margarine, shortening made from vegetables, and lard.
• Dairy products high in fat (moderate consumption of eggs is a beneficial source of nutrients for the eyes)
• Fatty pork, lamb, and beef.