I?m sorry to hear about your grandmother?s loss of vision, but I
commend you for looking out for her! From my research, I have learned
that there are no medical treatments other than those your
grandmother?s physician has tried or ruled out. Beware of any
alternative therapy other than nutritional and when seeking online
information, stick to reliable websites and not snake-oil merchants.
You should also refer to your grandmother?s physician before starting
a regimen of alternative nutritional therapies.
Every reliable site I found repeated the same advice; no smoking!, eat
green leafy vegetables, avid high fat foods, especially junk foods,
and take a vitamin supplement. Details on recommended nutrients and
supplements are posted below.
Possible Risk Factors for wet AMD:
? Exposure to sunlight especially blue light
? Cardiovascular Risk Factors - high cholesterol, obesity
? Female gender
? Non-hispanic Whites
? Hyperopia (far sightedness)
?Dietary Fat & Macular Degeneration Risk
High fat intake is associated with an increased risk of macular
degeneration in both women and men. Our diet contains two types of fat
(saturated and unsaturated). Trans fat is made when manufacturers add
hydrogen to vegetable oil--a process called hydrogenation.
Hydrogenation increases the shelf life and flavor stability of foods
containing these fats. Both types (saturated & unsaturated) are
associated with an increase in risk of macular degeneration.
Surprisingly, even increased intake of polyunsaturated fats (the good
fat), which have a protective effect against heart diseases, do not
have a similar protective against macular degeneration. Recent
research has shown that although increasing the intake of all types of
polyunsaturated fats does not help in macular degeneration,
preferentially increasing intake of one type of polyunsaturated fat
and simultaneously reducing intake of another type of polyunsaturated
fat does help.
Linolenic acid (omega-3 fatty acid), which is a type of
polyunsaturated fat found primarily in fish and flaxseed oil, is
associated with lessening of macular degeneration risk, but only among
individuals with lower intake of linoleic acid (omega-6 fatty acid).
Therefore, intake of food sources with high linolenic acid (omega-3
fatty acid) and low linoleic acid (omega-6 fatty acid), as is found in
Canola oil may help in macular degeneration. (View the 'Trans Fat'
video 56K or cable/DSL ).
Of the food sources, intake of beef, pork, or lamb as a main dish
increases the risk of macular degeneration. More than 1 serving/week
of beef, pork, or lamb as a main dish is associated with a 35%
increased risk of macular degeneration as compared with less than 3
servings/month. A high intake of margarine is also significantly
related to an increased risk of macular degeneration. 1 serving per
day of high-fat dairy food (whole milk, ice cream, hard cheese, or
butter) increases risk of macular degeneration progression by 1.91
times. 1 serving per day of meat food (hamburger, hot dogs, processed
meat, bacon, beef as a sandwich, or beef as a main dish) increases
risk of macular degeneration progression by 2.09 times. 1 serving per
day of processed baked goods (commercial pie, cake, cookies, and
potato chips) increases risk of macular degeneration progression by
?People who eat fish more than 4 times/week have a lower risk of
macular degeneration than those who consume it less than 3
times/month. This is especially true for Tuna fish. People who eat
canned tuna more than once per week are 40% less likely to develop
macular degeneration as compared with those who consumed it less than
once per month.?
?Nutrition is a valuable treatment for dry macular degeneration. It
may also help prevent both wet and dry types related to aging.?
Antioxidants that protect your retina?such as carotenoids, selenium,
zinc, and vitamins C and E?may delay or prevent macular degeneration.
Some studies have shown that these nutrients help, but not all studies
agree. In one study of 356 patients with advanced macular
degeneration, diets high in carotenoids lowered risk for the
condition. Two particular carotenoids, lutein and zeaxanthin, had the
greatest effect; results also suggested that dietary vitamin C may be
beneficial for prevention of macular degeneration as well. Three large
studies, however, found no connection between macular problems and
dietary or supplementary intake of carotene, zinc, or vitamins A, C,
Other research reviews, which summarize data from several studies,
suggest that eating a diet high in vitamins C and E and carotenoids
may reduce your risk of macular degeneration. Vegetables rich in
carotene include orange and yellow squash, and dark, leafy greens,
such as kale, collards, spinach, and watercress. Although the
scientific information is somewhat conflicting about supplements in
particular, eating a diet rich in the nutrients mentioned above may be
effective in preventing macular degeneration.
If, with the advice of your healthcare provider, you decide to take
supplements, the following are some suggested amounts of key
? Mixed carotenoids, 25,000 to 50,000 International Units (IU) a day
? The carotenoid lutein, 5 milligrams (mg) a day
? Selenium, 200 to 500 micrograms (mcg) a day
? Zinc, up to 50 mg a day
? Vitamin C, 60 to 2000 mg a day in divided doses; doses over 1000 mg
a day may cause gastrointestinal problems, including nausea and
? Vitamin E, 50 to 1000 IU a day (usually 400 to 800 IU a day)
Also Omega-3 fatty acids, flavonoids, Ginkgo, Bilberry extract, Grape seed.
According to this site, nutritional changes and supplements are good
for both wet and dry macular degeneration, and recommends the
Medications that are harmful to macular degeneration patients:
Plaquenil (hydroxchloriquine sulfate) is a drug routinely prescribed
by rheumatologists for rheumatoid arthritis. It has caused
irreversible retinal damage.
Chloridine (brand name catapres) is used to lower blood pressure
The whole family of NSAIDS (non-steroidal anti-inflammatory drugs) can
cause visual side effects such as cataracts, dry eyes, and retinal
hemorrhages that may result from long-term use. These include aspirin,
ibuprofen (Advil, Motrin, Bayer, Aleve), flurbiprofen, ketoprofen and
naproxen sodium. Also Tylenol (acetaminophen), though not an NSAID,
can be harmful.?
Recommended (see the actual site for detailed information):
Daily juicing of vegetables and fruits
Reduce or eliminate drinking caffeine and sodas
Eliminate deep fat fried foods
Limit your alcohol consumption
Supplement your diet with a good multivitamin
Limit the amount of medications
Managing your emotional health
Recommended supplements are listed on this page as well.
A more comprehensive list of harmful drugs for wet AMD patients can be found here:
?? Eat foods containing antioxidants. A nutritionally balanced diet
with plenty of leafy greens, fruits and other vegetables may be among
the most important factors in promoting good retinal health. People at
high risk of the advanced stages of macular degeneration may be able
to lower that risk with a dietary supplement of antioxidants, zinc and
copper. Antioxidants are substances that prevent oxidative damage to
tissue such as the retina. Talk with your doctor before using any
dietary supplements, particularly in large doses, because they may
interact with other medications you're taking, or they may not be
right for you. Foods with antioxidants are those rich in vitamins A, C
and E. And it helps to eat a nutritionally balanced, low-fat diet
containing five or more servings of fruits and vegetables every day.
People who eat diets rich in vegetables, particularly leafy, green
vegetables may have a lower risk of macular degeneration.
High levels of the antioxidants lutein and zeaxanthin in your blood
may help protect your retina, although there are no conclusive studies
demonstrating that supplements of these nutrients can slow vision
loss. Lutein and zeaxanthin are nutrients found in high concentrations
in egg yolk, corn and spinach.
? Take supplemental vitamins and minerals. A study called the
Age-Related Eye Disease Study (AREDS) compared the daily use of
high-dose vitamin and mineral supplements to the use of a placebo. The
study showed that a daily supplement of 500 milligrams (mg) of vitamin
C, 400 international units (IU) of vitamin E, 15 mg of beta carotene
(often as vitamin A ? up to 25,000 IU), 80 mg of zinc (as zinc oxide),
and two mg of copper (as cupric oxide) reduced the risk of advancing
to moderate to severe vision loss by up to 25 percent. For people with
signs and symptoms of moderate to advanced macular degeneration, AREDS
indicates that taking high doses of zinc, beta carotene, and vitamins
C and E is effective in reducing the risk of further vision loss.
However, if you currently smoke or you're a former smoker, the use of
high doses of beta carotene may significantly increase your risk of
lung cancer. Beta carotene is not recommended for current smokers. If
you're a former smoker, talk with your doctor about the use of beta
?It's difficult to get the levels of vitamins and minerals used in the
study from diet alone. Most people need to take supplements. The
vitamins and minerals used in the study are commercially available at
retail outlets, such as drugstores, supermarkets and health food
stores. They can be purchased individually or in combination. If
you're a smoker, look for a product designed for smokers that doesn't
contain beta carotene, or purchase individual supplements. If you
purchase each vitamin and mineral separately, be sure to also take
copper supplements because high doses of zinc can cause a copper
If you also take a multivitamin daily, check the label to make sure
that you don't exceed the levels used in AREDS for zinc and vitamins A
(beta carotene), C and E.?
Please check the links at the bottom of this page, with additional
advice on diet and supplements. (You don?t want to overdo supplements,
as this could cause additional problems)
?Researchers theorize that lutein and zeaxanthin protect the macula.
This is important information for everyone, not just those diagnosed
with macular degeneration.?
Consumption of fruits and vegetables containing two carotenoid
pigments may be linked to a reduced risk for age-related macular
degeneration, the leading cause of vision loss in people over the age
of 55. According to research, lutein and zeaxanthin comprise a
component of the central region of the retina and may play a role in
some aspects of visual acuity. Increasing the concentration of these
pigments in the eye may prevent the devastating vision loss caused by
age-related macular degeneration.
Carotenoids are phytochemicals (chemicals found in plants) commonly
found in certain fruits and vegetables that provide the red, orange
and yellow colors of these foods. Lutein and zeaxanthin are found
primarly in broccoli, corn, squash and dark green leafy vegetables
like spinach and kale.
Lutein and zeaxanthin are concentrated in the fovea, the central
region of the retina, in a spot known as the macula lutea, or yellow
spot. The macula helps produce the sharp central vision needed for
activities like reading, sewing and driving.?
?Egg yolk and yellow corn contain the highest mole percentage (% of
total) of lutein and zeaxanthin (more than 85% of the total
carotenoids). Yellow corn was the vegetable with the highest quantity
of lutein (60% of total) and orange pepper was the vegetable with the
highest amount of zeaxanthin (37% of total). Substantial amounts of
lutein and zeaxanthin (30-50%) were also present in kiwi fruit,
grapes, spinach, orange juice, zucchini, and different kinds of
squash. The results show that there are fruits and vegetables of
various colors with a relatively high content of lutein and
Most of the dark green leafy vegetables, previously recommended for a
higher intake of lutein and zeaxanthin, have a 15-47% of lutein, but a
very low content (0-3%) of zeaxanthin. This study shows that fruits
and vegetables of various colors can be consumed to increase dietary
intake of lutein and zeaxanthin.?
?Scientists are also conducting large scale studies to determine
whether nutrition might play a role in preventing or minimizing vision
loss from macular degeneration. Preliminary data from one such study
suggest that diets high in saturated fats and cholesterol may increase
the risk of developing macular degeneration. Preliminary data from
another study suggest that diets rich in green, leafy vegetables may
be helpful in reducing the risk of macular degeneration. A third study
is evaluating whether antioxidants can prevent or minimize macular
degeneration by protecting the retina from damage associated with
Antioxidant vitamins and minerals such as C, E, carotenoids, selenium
and zinc are found in many fresh fruits and vegetables.
Although research has not yet established a clear benefit for
antioxidants in the fight against macular degeneration, vitamin
companies have begun marketing antioxidant supplements claiming they
may prevent or slow the disease. However, it is not known whether
supplements confer the same nutritional benefits as do food sources
rich in antioxidants. Moreover, large doses of antioxidant supplements
can have detrimental health effects. Ongoing studies must show that
antioxidants are effective in preventing or slowing the progression of
macular degeneration before dietary recommendations can be made.
Individuals with macular degeneration should discuss dietary
considerations with their doctor.?
? Should I consider alternative therapies and/or alternative medicine?
Any therapy or medicine which has not been put through the
scientific process of approved clinical studies is questionable. If
such an approach relies principally upon anecdotal and empirical
evidence, and if it does not seem to be based upon sound scientific
principles, then it should be viewed with a healthy amount of
skepticism. More information may be found in the MD Support library
Will nutritional supplements help my condition?
Two kinds of supplements have been tested and shown to have
positive benefits. One is a formula recommended by the Age-Related Eye
Disease Study (see "Clinical Trial Finds Antioxidants and Zinc
Beneficial in Reducing Risk of Severe AMD") and the other is lutein
(see "Lutein And Zeaxanthin May Offer Protection Against MD"). Your
doctor will tell you if either of these dietary regimes will be
beneficial to you.
Where can I go locally to receive assistance in the use of low-vision devices?
Your doctor should be able to put you in touch with recommended
rehabilitation centers in your area. You may also find information
about low-vision devices, vision centers, and state agencies in the MD
Support resource section.?
?Alternative treatment - Consumption of a diet rich in antioxidants
(beta carotene and the mixed carotenoids that are precursors of
vitamin A, vitamins C and E, selenium, and zinc), or taking
antioxidant nutritional supplements, may help prevent macular
degeneration, particularly if started early in life.
Good dietary sources of antioxidants include citrus fruits,
cauliflower, broccoli, nuts, seeds, orange and yellow vegetables,
cherries, blackberries, and blueberries. Research has shown that
nutritional therapy can prevent ARMD or slow its progression once
established. Some doctors recommend taking beta carotene and zinc as a
precautionary measure. Some vitamins are marketed specifically for the
?A major national trial called the Age Related Eye Disorder Study
(AREDS) sponsored by the National Institutes of Health and National
Eye Institute, looked at several thousand people with macular
degeneration. Patients in the trial took either certain vitamins or a
placebo (sugar pill), and neither the patients nor the doctors knew
what they were taking. At the end of the study period, the patients
who took the high dose vitamins did far better than the patients who
took the placebo. The tested nutritional factors were Beta-carotene,
Vitamin C, Vitamin E, and Zinc.
However, you should discuss the appropriate formula for vitamin
therapy with your ophthalmologist. The therapeutic dosage for these
supplements is very high. There are potential side effects, and not
everyone will benefit from this regimen. The study continues, and
other supplements (lutein, zeaxanthine) are under investigation as
well. Another nutrition supplement, Omega 3 fatty acids, has been
strongly associated with lower levels of macular degeneration. Omega
3's are found in oily fish, fish oil capsules and flax seed oil. Some
nutritional supplements are popular in alternative medicine such as
bilberry, which is a powerful antioxidant. But there are no good,
scientific studies looking at the effectiveness of these other
Treatment at UPMC
The treatment recommended for your macular degeneration will depend on
whether you have juvenile or adult-onset disease, and whether it is
wet or dry, as well as other important factors about your health. The
goal of treatment is to reduce visual and functional impairment.
Treatment involves the following:
? Lifestyle Changes
? Other Treatments
If you have been diagnosed with macular degeneration, the following
lifestyle changes may help to keep your eyes healthy. In some cases,
these changes may even slow the progression of macular degeneration:
? Eat a diet that is low in saturated fat and cholesterol
A diet that is high in saturated fat and cholesterol can cause plaque,
a fatty substance, to build up on the macular vessels, which can
hamper blood flow in your eyes. Therefore, you should cut back on
high-fat foods. Eat more lean meats, poultry, fish and beans, low-fat
or nonfat dairy products, and lots of whole grains, fresh fruits and
vegetables. Avoid eating fatty meats, fried foods, and full-fat dairy
products. Also avoid using lots of butter, high-fat sauces, cheese,
According to a study in the August 2001 issue of the Archives of
Ophthalmology, eating a lot of fat-filled junk food may increase your
risk of developing age-related macular degeneration. These foods often
contain vegetable oil, monounsaturated and polyunsaturated fats, and
linoleic acid. They include margarine, chocolate, pies, cakes,
cookies, potato chips, French fries, and other highly processed,
store-bought junk foods.
?Eat more leafy green and yellow vegetables
Two yellow pigments found in the macula, known as lutein and
zeaxanthin, are thought to protect the macula from light damage and
free radicals. Free radicals are harmful molecules that can damage
cells in the body. They come from environmental sources (cigarette
smoke, air pollutants, radiation, certain drugs, and toxins) and are
also produced during normal body processes.
Lutein and zeaxanthin are found in dark green leafy and yellow
vegetables. By eating large quantities of these vegetables, you may
slow or prevent the progression of age-related macular degeneration.?
This page also lists foods high in lutein and zeaxanthin.
?One study (9) showed that antihypertensive drug therapy, high serum
cholesterol levels, and low serum carotenoid levels in patients with
macular degeneration are all risk factors for choroidal
neovascularization. This study also found that the use of
postmenopausal exogenous estrogens decreased the risk of neovascular
macular degeneration in women, whereas parity greater than zero
increased the risk.
The role of vitamins, minerals, and antioxidants in the prevention of
macular degeneration has been the source of controversy and
conflicting information (10-13). High serum levels of vitamins E, A,
and C, as well as zinc, may be beneficial, but until their efficacy
has been proved, we do not routinely encourage patients to take these
Another unproven risk factor for macular degeneration is exposure to
ultraviolet light. Studies have failed to demonstrate an association
with macular degeneration. However, since sunlight is associated with
cataract formation (14), it is prudent to encourage patients to wear
sunglasses in bright sunlight.?
In the future: ?Antibodies against vascular endothelial growth factor,
antagonists to the integrins, angiostatin, batimastat, tissue
plasminogen activator, and thalidomide (Synovir) are all of special
interest. One or several of these drugs may prove effective in
revolutionizing the treatment of macular degeneration.?
Also in the near future:
?New Medical Treatment: By far the most exciting and promising
modalities for treatment of wet macular degeneration are the new
biologic therapies. There are new steroid-like drugs that are now
being tested in ongoing trials. These steroids are designed to be more
effective and have fewer side effects than current steroids. Drugs
currently in testing include Retanne« and Posurdex«.?
?Q: Is thalidomide effective?
A: Again, initial studies seemed to indicate that new vessels
decreased after treatment. But subsequently, several statistically
correct studies proved that thalidomide had no beneficial effect. One
large study is still underway.?
Statins and Aspirin
?Vision scientists are working hard to find a way to prevent wet
age-related macular degeneration (AMD) and its associated blindness.
A new report puts statins and aspirin in the spotlight. Statins are
drugs designed to reduce cholesterol in the blood and, according to
the research, reduced the risk of developing the wet form of AMD.
Aspirin, a type of nonsteroidal anti-inflammatory drug, also reduced
the risk of developing wet AMD.
The report appeared in the April 2003 issue of the American Journal of
Ophthalmology (AJO). Statins lower cholesterol levels in the body by
controlling its rate of production. Five common statin drugs on the
market in the United States are lovastatin, simvastatin, pravastatin,
fluvastatin, and atorvastatin. Not only are statins instrumental in
controlling cholesterol, but they also appear to lower the risk of
stroke and Alzheimer's disease. Statin and aspirin users had less wet
Patients are encouraged to consult their own eye doctor for advice,
and to NOT take any nutritional supplements such as these without
their doctor?s approval. Not smoking is also extremely important. See
another report in this issue of FFB InSight, called "Smoking and AMD."
The Foundation Fighting Blindness recommends consulting a doctor
before beginning any therapy to prevent or treat AMD or any other
Other helpful tips:
In the case of partial blindness caused by macular degeneration, ?low
vision rehabilitation? can help you adjust to your condition.
Rehabilitation may include
?adjusting the lighting in your home
?visual aids and voice-activated devices
?seeking assistance from someone with good eyesight in performing
daily work and tasks.
??Avoid driving in certain conditions. Don't drive at night, in heavy
traffic, in bad weather or on a freeway.
?Seek help traveling. Use public transportation or ask family members
to help, especially with night driving.
?Travel with others. Contact your local area agency on aging for a
list of vans and shuttles, volunteer driving networks or ride shares.
?Get good glasses. Optimize the vision you have with the right
glasses, and keep an extra pair in the car.
?Use magnifiers. Large-print books and magazines also can help you
read more easily.
?View with large type on the Internet. Look for Web sites that use
large-sized type fonts, or change the font size on your display.
?Obtain specialized appliances. Some clocks, radios, telephones and
other appliances have extra-large numbers.
?Have proper light in your home. This will help with reading and other activities.
?Remove home hazards. Eliminate throw rugs and other possible tripping
hazards in your home.
?Ask friends and family members for help. Tell them about your vision
problems so that they can help you perform certain tasks and help you
?Don't become socially isolated. A common frustration of people with
macular degeneration is the inability to recognize other people and
greet them by name. If this happens to you, try asking people you know
to say hi and tell you their name when you meet them on the street or
in other situations so that you can greet them back.
?Take advantage of online networks. The Internet is a good source for
support groups and resources for people with macular degeneration.
?Talk to your doctor. Ask your doctor about receiving professional
help to make your home safer and more convenient for you to use.
?Optical aids help improve vision to some extent. These include
Corning and NoIR glasses, prism lenses, telescopes, and magnifiers.
With advancing technology, some of these devices are becoming
increasingly sophisticated, and offer new opportunities for people
with retinal degenerations to maximize their usable vision.
Many tools also exist to allow people to continue to live
independently or pursue leisure activities. Many household items such
as telephone and kitchen timers are available with extra-large
numbers. Large-print playing cards and big-number bingo cards fill the
needs of some people with less severe visual impairments. A radio
reading service is available in most communities and broadcasts to a
special receiver in the home. It usually features volunteers reading
the newspaper every day, as well as many popular magazines. Other aids
include audiotapes and large print books. Patients with severe
bilateral vision loss may benefit from guide dogs.?
Lutein + lung cancer
?Folate, vitamin C, and ▀-cryptoxanthin might be better protective
agents against lung cancer in smokers than -carotene, ▀-carotene,
lutein + zeaxanthin, and lycopene.?
?Lutein helps to prevent breast cancer.
Lutein helps to prevent lung cancer [epidemiological evidence: high
Lutein levels have been inversely correlated with lung cancer
Lutein reduces the risk of prostate cancer.?
?Analysis of dietary carotenoid intake and lung cancer risk in two
large prospective cohort studies in the U.S. that followed more than
120,000 men and women for at least 10 years revealed no significant
association between dietary beta-carotene intake and lung cancer risk?
?Dietary intakes of total carotenoids, lycopene, beta-cryptoxanthin,
lutein and zeaxanthin, but not beta-carotene were associated with
significant reductions in lung cancer in a 14-year study of more than
27,000 Finnish male smokers (18), while only dietary intakes of
beta-cryptoxanthin and lutein and zeaxanthin were inversely associated
with lung cancer risk in a 6-year study of more than 58,000 Dutch men?
I have found no evidence that lutein increases the risk of lung
cancer, in fact, I found the contrary.
I hope this has helped you and your grandmother! If any part of this
answer is unclear, please request an Answer Clarification. I will be
happy to assist you further, before you rate the answer.
Wet AMD + alternative therapies
Wet AMD + diet
Lutein + lung cancer