My husband has macular degeneration. He is depressed, though he has it only in one eye, and he doesn’t have it severely. His doctor has given him some vitamins, and I would like to know more about it so that I can be appropriate in my response to him.
The macula is the portion of the retina that has the highest concentration of light receptors within the retina, and it is the spot we focus light on when looking directly at something. When the macula degenerates, we lose this ability to see very clearly, and—though not totally blind—we can become severely compromised in our vision.
A few layers of cells make up the macula, and these layers have a diversity of function. Owing to a variety of problems, some of these layers may become damaged in the process called macular degeneration. When the doctor examines the inside of the eye, they may find pale yellow spots called drusen. Nearly everyone over the age of 50 has a few drusen. Excess of these lesions is associated with macular degeneration.
In age-related macular degeneration, inflammation plays a role, as does the growth of new blood vessels. These processes involve the inflammatory complement system. The condition is often described as early macular degeneration (or MD), intermediate MD, or advanced MD. The advanced MD will have atrophy and drusen extending to the center of the macula, as well as new vessels growing there.
Only some 10 to 15 percent of macular degeneration is in the serious category. Those in this group can have rapid loss of vision, but the process is much slower in the other groups. Complete blindness is not usual, but if one eye is severe, the other eye has about a 40-percent chance of deteriorating over five years.
There does not appear to be a single cause for macular degeneration, but several risk factors have been identified. About 1.5 percent of people of advanced age develop the advanced form of macular degeneration, though about 9 percent will have the milder forms. Because the population is aging, it is estimated that in North America there will be a 50-percent increase in macular degeneration by 2020.
Smokers and those exposed to secondhand smoke are at increased risk, but obesity, hypertension, and a high vegetable fat intake are other risk factors.
Low dietary consumption of antioxidants and zinc may be additional factors.
This has led to a formulation of vitamin C, 500 mg; vitamin E, 400 IU; beta-carotene, 15 mg; zinc oxide, 80 mg; and cupric oxide, 2 mg, which was shown to reduce the rate of progress of macular degeneration by 25 percent more than a placebo. Potential problems exist, however, with beta-carotene supplementation (one study showed a 17-percent increase in lung cancer in smokers), and vitamin E supplementation may cause increased heart failure in some.
The typically recommended Adventist diet of reduced fat and salt intake, and increased fruits, green leafy vegetables, whole grains, and nuts goes a long way to reducing the risks of macular degeneration. Several very innovative therapies are currently under evaluation, and show promise in helping restore vision for persons affected with MD.
We hope your husband will be helped by some of these advances. Keep optimistic. Visit an up-to-date specialist regularly. And do not despair—newer therapies are right around the corner.
Allan R. Handysides, M.B., Ch.B., FRCPC, FRCSC, FACOG,