Unfortunately, age-related macular degeneration (AMD) is a chronic condition for which there is no cure. However, AMD comes in different stages, as it now seems that it is possible to take action to slow down the progression through these stages. In fact, there are certain steps you can take in order to make sure you reduce the chances of developing it in the first place. If you know that you have a family history of AMD, it is particularly important that you consider these steps. You must also go for regular checkups, particularly if you start to notice changes in your vision, whether you have a family history of AMD or not.
The Stages of AMD
The table below explains the different stages of AMD to be aware of.
| Type of AMD | Characteristics |
| Early dry AMD | Some small to medium sized drusen, no symptoms, normal vision |
| Intermediate dry AMD | Many medium sized drusen, including underneath the retina, some visual blurring |
| Advanced AMD | Same drusen as with the intermedia stage, breakdown of macular tissue and light-sensitive cells, central vision becomes blurred |
| Wet AMD | The retina grows abnormal vessels behind it, straight lines appear wavy, macula displacement |
Research has shown that taking vitamins is recommended for intermediate dry AMD. It is also recommended for advanced dry and wet AMD, but only if it appears in one eye only. Let’s take a look at some of the things you can do to avoid AMD from happening, or to slow down its progression.
- Stop Smoking
The advice to everybody around the world is to not smoke. If you do smoke, you must stop as soon as possible in order to avoid AMD or AMD progression. This has been conclusively proven in various pieces of research:
The chance of smokers developing AMD is four times more likely than for non-smokers. This was concluded after a study in the United Kingdom, where some 53,900 people over the age of 69 had AMD and were smokers. 17,900 of these were legally blind.
A similar study was conducted in this country by the Massachusetts Eye and Ear Infirmary. They found that the risk of developing AMD was between 1.9 and 1.7 times bigger in smokers.
One of the reasons why smokers are at such an increase chance of developing AMD is because the oxygen consumption in the retina is very high and smoking is known to disrupt oxygen delivery across the body. If oxygen delivery is disrupted, therefore, the retina will suffer.
- Eat Lots of Green Vegetables
If your diet is low on green leafy vegetables and antioxidants, but high in sugar, cholesterol and fat, you have an increased chance of developing AMD. The Massachusetts Eye and Ear Infirmary demonstrated through a study that the chance of developing AMD in people who ate high amounts of green leafy vegetables was reduced by 43%. Collard and spinach were found to be particularly beneficial.
- Take Multiminerals and Multivitamins
As stated previously, taking multivitamins and minerals is specifically recommended during certain stages of AMD. However, it is never harmful to take them before as well, particularly in older people who often struggle to obtain the vitamins and minerals they need through their diet alone. Once AMD progresses, as shown in the table above, physicians may prescribe higher dosages of multivitamins and multiminerals. These include:
- Vitamin C
- Vitamin E
- Lutein
- Zeaxanthin
- Zinc
- Copper
Two clinical trials have been shown that, if given in the right dosage and once someone develops intermediate AMD, it may help slow down progression. One study (AREDS1) demonstrated that doing so lowered the chance of intermediate AMD progressing to advanced stages by 25%.
However, AREDS1 also showed that people who took supplements that contain vitamin A might increase the chance of developing lung cancer. This is why it is important to only take nutritional supplements that have been prescribed to you and, whenever possible, to avoid supplements with vitamin A (also known as beta-carotene).
After AREDS1 was completed, the National Eye Institute launched AREDS2 in 2006. They wanted to see whether it would be possible to further improve the supplement, for instance by lowering the amount of beta carotene found in zinc. The same reduction in chance (25%) was noted, and it was highest in those who took lower levels of beta-carotene. Most importantly, it also showed a reduction in the chance of developing lung cancer.
- Eat More Fish
There have been a number of studies that showed eating fish is beneficial for people who suffer from AMD. Specifically:
The Massachusetts Eye and Ear Infirmary demonstrated that people who ate at least two portions of fish each weak lowered their chance of developing AMD by 45%.
A study in Australia showed the same results, looking more specifically at advanced AMD. They also found that the chance of AMD progressing was reduced in people who consumed fish at least twice per week.
- Exercise Regularly and Maintain a Healthy BMI
If your BMI is over 30, your chance of developing AMD is increased 2.5 times. One of the reasons for this is that people who exercise increase the amount of oxygen their retina receives. This was also demonstrated by a study in the United Kingdom, which looked at some 4,000 people over a 15 year time period. They found that people who were more active had a 70% lower chance of developing AMD.
- Eat Nuts and Fruits Every Day
Two specific studies demonstrated that eating fruits and nuts every day is beneficial to those at risk of developing AMD:
The Harvard Medical School concluded a study in 2004 that demonstrated that the chance of developing wet AMD, which is also the more serious type of AMD, was reduced in people who consumed daily portions of fruit and nuts.
The Massachusetts Eye and Ear Infirmary conducted study and were able to show that eating fruits and nuts daily also helped to slow down the progression of intermediate AMD.
- Get Rid of Refined Carbs
We are starting to understand just how bad our lifestyle and diets of processed foods actually are to our overall health. It now appears that people who eat a lot of refined carbohydrates also increase their chance of developing AMD. It is believed that this is because these foods are classed as ‘high GI’ (glycemic index), which means they rapidly release insulin and increase blood sugar levels.
However, researchers were keen to inform people that this did not mean they had to avoid all high GI foods. Rather, it is about the highly refined carbohydrates. Foods like white bread, white potatoes, white rice and so on are generally high in refined carbohydrates as well as having a high GI. What is more important, therefore, is the glycemic load.
- Keep Cholesterol and Blood Pressure in Check
When people have high blood pressure, their blood vessels become constricted. This means it becomes difficult for the retina to receive the amount of oxygen that they need. Cholesterol and high blood pressure often go hand in hand. However, cholesterol specifically can also contribute to the development of AMD. A number of studies have shown that high blood pressure, cholesterol and advanced forms of AMD are highly related.
- Protect Your Eyes from Blue Light and UV Light
The idea that the sun can contribute to AMD is widely accepted, although still unproven. It is believed that overexposure to HEV (blue) light, UV-B and UV-A can cause damage to the eye, potentially leading to AMD. While this link is not 100% proven, or in any way conclusive, logic and reason says that this type of light can be damaging to the eye. Wearing sunglasses that protect your eyes from both blue light and UV-A and UV-B rays is never going to do any harm.
- Check Your Eyes Out
Our eyes are our most precious organs. They are, as people say, the ‘windows to our souls’. We use lots of makeup and other products to make them stand out and we use them to convey emotions. Yet, when something goes wrong with them, we are very quick to self-diagnose and self-medicate, instead of seeking the right, and necessary, medical attention. You must, if you notice any changes in your vision, have this checked out by a professional. Additionally, anyone aged between 45 and 60 should have a full eye examination every two to three years. Once you reach 60, you should have a yearly examination.
The 10 steps above will help you to reduce your chances of developing AMD in the first place. If you already have AMD, they may help you to slow down the progression. Most importantly, however, you must seek medical advice about the condition. AMD can significantly reduce your overall quality of life, but it doesn’t have to do that if you are able to address it in time. Remember to have your eyes checked regularly as well.
Resources and References:
Age-Related Eye Disease Study – Results – Results of the AREDS study. (National Eye Insitute)
Prospective Study of Intake of Fruits, Vegetables, Vitamins and Carotenoids and Risk of Age-Related Maculopathy – Diet and age-related maculopathy. (NIH.gov)
Glycemic Index Defined – Information on the glycemic index. (Glycemic Research Institute)
AREDS1 – Age-Related Eye Disease Study (NIH.gov)
AREDS2 – Age-Related Eye Disease Study 2 (NIH.gov)
Cardiovascular Risk Factors and Age-Related Macular Degeneration: The Los Angeles Latino Eye Study – Cardiovascular risk factors for age-related maculopathy. (NIH.gov)
Dietary Carbohydrate and the Progression of Age-Related Macular Degeneration: A Prospective Study from the Age-Related Eye Disease Study – Carbohydrates and age-related macular degeneration. (NIH.gov)
Smoking and Age-Related Macular Degeneration: A Review of Association – Connection between smoking and age-related maculopathy. (NIH.gov)
Physical Activity and the 15 Year Cumulative Incidence of Age-Related Macular Degeneration: The Beaver Dam Eye Study – Physical activity and age-related maculopathy. (NIH.gov)
Dietary Fatty Acids and the 5-Year Incidence of Age-Related Maculopathy – Fatty acids and age-related maculopathy (NIH.gov)
Cigarette Smoking, Fish Consumption, Omega-3 Fatty Acid Intake, and Associations with Age-Related Macular Degeneration – Effects of smoking and certain foods on age-related maculopathy. (NIH.gov)
Progression of Age-Related Macular Degeneration: Association with Dietary Fat, Transunsaturated Fat, Nuts, and Fish Intake Effects of certain foods on progression of age-related maculopathy. (NIH.gov)
Dietary Carotenoids, Vitamins A, C, and E, and Advanced Age-Related Macular Degeneration. Eye Disease Case-Control Study Group – Effects of carotenoids and vitamins on age-related maculopathy. (NIH.gov)
