If you have wet macular degeneration, you will test your eyes daily at home using an Amsler's grid. You should report any distortion immediately to reduce the risk of vision loss. Other preventive measures include increasing your dietary intake of flavonoids and carotenoids (see section on Nutrition ), using ultraviolet eye protection, estrogen replacement therapy, and moderate red wine consumption.
If you already have macular degeneration, especially if it is somewhat advanced, and you decide, with the advice of your healthcare provider, to take supplements, the following are some suggested amounts of key nutrients:
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 diarrhea
Vitamin E, 50 to 1000 IU a day (usually 400 to 800 IU a day)
Flavonoids (such as quercetin, rutin, and resveritrol) may also play a role in preventing macular degeneration. A study of 3,072 adults with macular changes showed that moderate red wine consumption may offer some protection against the development or progression of macular degeneration. Red wine is high in certain flavonoids (including quercetin, rutin, and resveritrol) that have antioxidant activity; damage from oxidative stress is thought to contribute to the development of macular degeneration. Dark berries, such as blueberries, blackberries, and dark cherries, are high in flavonoids as well.
Omega-3 fatty acids may also offer some protection against macular degeneration. In a study of more than 3000 people over the age of 49, those who consumed more fish in their diet were less likely to have macular degeneration than those who consumed less fish. (Most types of fish are rich in omega-3 fatty acids). Similarly, a study comparing 350 people with macular degeneration to 500 without found that those with a proper ratio of omega-3 to omega-6 fatty acids and higher intake of fish in their diets were less likely to have this particular eye disorder. Another larger study found that consuming docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), two types of omega-3 fatty acids found in fish, four or more times per week may reduce the risk of developing macular degeneration. Notably, however, this same study suggests that alpha-linolenic acid (ALA; another type of omega-3 fatty acid) may actually increase the risk of this eye condition.
Herbs
Ginkgo ( Ginkgo biloba ), which contains flavonoids, may help halt or lessen some retinal problems. Clinical studies suggest that it may be useful in treating vision problems specifically due to macular degeneration. If you use anticoagulants, do not use ginkgo without close monitoring by your healthcare provider.
Bilberry ( Vaccinium myrtillus ) and grape seed ( Vitis vinifera ) are also high in flavonoids; therefore, they may help prevent and treat macular degeneration. Clinical studies suggest that these herbs may stop vision loss and improve visual sharpness. Here are the recommended doses:
Ginkgo standardized to 24%, 120 mg once or twice a day
Bilberry extract standardized to 25%, 120 to 240 mg twice a day
Grape seed, 50 to 150 mg once or twice a day
Homeopathy
Although scientific research does not necessarily support the use of homeopathy to treat or prevent macular degeneration specifically, an experienced homeopath would consider your individual case to decide whether treatment may be beneficial for you.
Acupuncture
Studies on acupuncture and macular degeneration have been mixed. In a study of 51 patients with macular problems, researchers found little change in visual sharpness or other symptoms after 12 acupuncture treatments. Another study showed a connection between low blood flow to the head and macular degeneration. Restoring normal blood pressure with acupuncture improved vision.
Prognosis/Possible Complications
Blindness is a possible outcome of macular degeneration. Low vision aids may help if you have partial blindness. Sometimes blood vessels build up underneath the retina, causing the retina to become detached or scarred. If this happens, the chances of preserving your central vision are poor. This condition, called subretinal neovascularization, occurs in about 20% of cases of age-related macular degeneration. The condition will likely recur even after laser treatment.
Following Up
Your healthcare provider will see you regularly to monitor your vision and eye health.
http://www.umm.edu/altmed/articles/macular-degeneration-000104.htm
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Review Date: 6/1/2003
Reviewed By: Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University and Senior Medical Editor Integrative Medicine, Boston, MA.