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Specific Vitamins, Healthy Lifestyle Can Help Slow Progression of Age-Related Macular Degeneration

February 02, 2023
A woman squints at her cell phone.

About 20 million people in the United States are living with early or late-stage age-related macular degeneration (AMD),a disease that affects the retina in older people and is among the leading causes of blindness, according to research findings published in JAMA, the American Medical Association’s journal that features original research findings.

The numbers show an increase in reported cases of early-stage AMD and about the same for late-stage AMD, says Dr. Jeffrey Blice, an ophthalmologist who specializes in diseases of the retina and vitreous and intraocular tumors at MUSC Health’s Storm Eye Institute. Macular degeneration is a result of damage to the macula and has two forms: dry and wet.

Dr. Jeffrey Blice
Dr. Jeffrey Blice

“The dry form, which is more common, causes the center of the retina to deteriorate and it progresses slowly. It is characterized by three stages: early, intermediate and late,” he says. “The wet form involves the growth of new blood vessels behind the retina. These vessels leak and harm the macula. It can advance and damage the eye more rapidly.”

Although AMD in its earliest stage may not have symptoms, as it progresses it affects the central vision, limiting one’s ability to see straight ahead and recognize faces, read, or drive. Because AMD affects only central vision, people don’t lose their peripheral vision.

Early symptoms of AMD include difficulty seeing in dim light and mild blurriness. These symptoms are common to many eye disorders, Dr. Blice says, and advises people to have their eyes examined by their ophthalmologist or optometrist.

People can develop AMD in one or both eyes, and it’s possible to have wet and dry AMD at the same time. In its most advanced stage, the dry form can turn into the wet form.
“Someone can have only the dry form or just the wet form, and some might have both forms at the same time,” he says. “It’s unusual for a patient to have wet macular degeneration without some form of dry macular degeneration going on in the background.”

No treatment for dry AMD exists, but it can be slowed by taking vitamins and lowering one’s risk factors by quitting smoking, engaging in physical activity, and following a healthy diet that includes fatty fish, fruits and vegetables high in antioxidants such as leafy greens.

The Age-Related Eye Disease Study (AREDS) demonstrated AREDS2 vitamins, a specific combination of vitamins C, E, lutein, copper, zinc and zeaxanthin minerals, are recommended for patients diagnosed with intermediate or advanced dry AMD.

“There’s good scientific evidence that shows AREDS2 vitamins lower the risk of progression to advanced macular degeneration in patients who meet certain criteria,” he says. “The only way to tell is to have your eyes examined by someone who can determine if you would benefit.”

People who can’t take the AREDS2 formula could take lutein in a regular multivitamin or separately. Lutein’s antioxidant properties have been found to be beneficial for eye health.

Wet AMD can be treated with anti-vascular endothelial growth factor, or VEGF 2, that is injected into the eye. “These injections can be administered at various intervals, usually from two to four months or for the duration of one’s life,” Dr. Blice says.

Risk factors for AMD include a strong family history of AMD, smoking and being Caucasian. “AMD is more common in Caucasians,” Dr. Blice says. “Someone who had a parent and an aunt or uncle with AMD has a heightened risk. Smoking raises one’s risk because it exposes people to substances that can damage their retina.”

Keeping cholesterol in check and managing high blood pressure are additional ways to lower one’s risk for AMD, he says.

For people concerned about their risk for macular degeneration, Dr. Blice has this advice: “I tell my patients that worrying whether they will develop AMD isn’t helpful for them. Many advances have been made over the last 15 years, and some treatments are revolutionary.

“The best thing you can do is get your eyes examined annually if you’re 60 or older and 50 or older if you have a strong family history of AMD and take vitamins if recommended. This way, if something changes or you slip into a high-risk category, you can be monitored regularly and be placed on any available therapies.”

MUSC Health’s Storm Eye Institute specialists provide comprehensive eye care for a variety of eye conditions, from common eye problems to complex medical conditions. To make an appointment with Dr. Blice or another ophthalmologist, or to learn more about our services, call 843-792-2020.