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 James McNabb, M.D., C.N.S. |
Age-related Macular Degeneration, or AMD:
the fear of blindness in the elderly.
Many Ophthalmologists have for years suspected that good nutritional supplements can slow the progression of AMD or macular degeneration. A study done by the National Eye Institutes called the AREDS study published in October 2001 showed that 5 antioxidant vitamins and minerals reduced the progression of AMD by 25% over a ten-year period. These consisted of beta-carotene, vitamin C, vitamin E, zinc and copper. This was very welcome news. Now we had some hope that we could at least slow the progression of AMD.
Researchers
Now a collaborative paper from Italy and Hungary (Feher, et.al., 2005) is giving us another approach to this frustrating disease. Instead of using anti-oxidants, they reasoned that the retina is really central nervous system tissue, since the retina is a direct outgrowth from the developing brain. Secondly, they picked up on the idea that the photoreceptor cells of the retina “are among the most metabolically active cells in the body.” They therefore used three nutrients known to support the mitochondria (the energy producing organelles) in the brain. These are: acetyl-L-carnitine, omega 3 fatty acids, and co-enzyme Q 10 (CoQ10). In fact, they used rather modest dosages for each.
The study
This study lasted a year. All patients were classified as early AMD, meaning that they had what are known as drusen. Drusen are small yellowish bodies that appear in the macula of the retina and are considered to represent pre-macular degeneration by many ophthalmologists. Patients were divided into mild and more advanced groups.
The patients were studied three different ways, one by visual acuity, one by visual field testing, and the third was to photograph the macula and quantify the area of the macula covered with drusen.
Results
Each way they looked at the two groups, it was apparent that the treated group fared better. Looking at the visual field alone, in the more advanced patients, 2% of the treated group deteriorated vs. 17% of the untreated group. The results were more dramatic in the less severe group, 0% of the treated group vs. 11% in the untreated group. Every way they tested visual acuity the treated groups fared better. Most exciting was the analysis of the retinal photographs. The drusen covered area decreased by 23% in the treated group, but increased by 13% in the untreated group. This is a direct physical improvement in the appearance of their retinas due to the extra nutrition.
Significance
This is so exciting because it gives us another way to nutritionally attack AMD, this time from supplements that aid cells in producing more energy. There have been earlier studies that have shown that omega 3 fatty acids such as DHA and EPA have an inverse relationship with AMD, meaning when they are elevated, AMD rates are lower. EPA and DHA are components of fish and cod liver oil. Our human brains, for example, are 1/3 by weight DHA. We cannot manufacture DHA or EPA. They must come into the system by diet or supplementation. Cold-water fish such as salmon are an excellent source. Omega 3 fatty acids have a wide range of benefits, including allergy relief, dry eyes, and heart rhythm irregularities.
What to take
I have for a long time tried to get all of my AMD patients to take a teaspoon of fish or cod liver oil daily. I also recommend a product called Perfect Multi Focus for my over-60 patients, as well as my AMD patients. It is the basic Perfect Multi formula with the addition of 10 ingredients to keep memory sharp. Memory lapses after 60 may be a source of humor, but really the mind is the very last thing we want to see deteriorate. Now with this paper, we have another reason to think of the Focus formula, retinal health. To get the acetyl-L-carnitine, I recommend Designs for Health, 1 daily or every other day. I suspect these recommendations will change over time, as the formulas for eye health are reformulated.
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