If you are diagnosed with macular degeneration, especially age-related macular degeneration, you may be concerned about the best method for preserving your eyesight. (Learn More) While AMD is a chronic condition, medical studies have shown that there are several treatments that can slow its progression or reduce the risk of it developing. (Learn More) Eating a diet high in omega-3 fatty acids, low in saturated fats and cholesterol, low in refined sugar or processed carbohydrates, and high in specific vitamins and minerals not only improves your overall health, but can reduce the risk of AMD. A landmark study found a specific combination of vitamins and minerals can also slow down intermediate and advanced dry AMD. Different treatments are required for wet AMD. (Learn More)
Macular Degeneration: How Does It Start and Can It Be Slowed?
There are three basic layers of the eye, with the retina at the back. This part of the eye, especially a cluster of photoreceptive cells called the macula, receives light that comes in through the pupil and is refracted by the cornea onto the retina, where it is transmitted up the optic nerve to the brain and processed as images of the world.
In a healthy eye, the second layer of the organ, the vitreous gel, helps to remove old cells and detritus from around the retina, including the macula, to keep that entire part of the eye clear. Small yellowish particles called drusen collect around the macula and the rest of the retina, and these must be routinely removed. There is also a series of blood vessels around the retina that provide nutrients and oxygen to the organs, and remove waste.
A healthy macula helps you process faces, colors, and contrasting images such as black writing on a white background. It allows you to drive safely. When a condition called macular degeneration develops, the center of your vision may begin to get fuzzy, clouded, gray, dimmer, or otherwise go away; at the same time, your peripheral vision will remain intact.
Macular degeneration begins when photoreceptive cells in the macula degrade and die. This could be due to abnormal growth and leaking of blood vessels into the retina, or it could be caused by a buildup of drusen on the macula, preventing the removal of dead cells and waste.
When blood vessels grow on the macula, it is called wet macular degeneration; when drusen collects in and around the macula, this is dry macular degeneration. Dry macular degeneration is the more common condition. In rare cases, it leads to wet macular degeneration, but this second condition can appear first in some cases.
For the most part, macular degeneration occurs in people who are 50 or older, and it is more likely to appear in people who are at least 65 years old. This is age-related macular degeneration (AMD), which is the most common form. There are a few rare diseases that can lead to macular degeneration in children and adolescents, but this impacts very few individuals, and there is a different course of treatment compared to AMD. The Centers for Disease Control and Prevention (CDC) reports that about 1.8 million people have AMD, and about 7.3 million are at risk for substantial loss of vision due to AMD.
If you are diagnosed with AMD, changing your diet is one way to slow the progress of the condition, especially for dry AMD. While all forms of macular degeneration are considered chronic conditions and do not have a cure, studies have shown that treating the eye condition with lifestyle changes, especially dietary supplements full of specific vitamins and minerals, can help to slow the progression of AMD so you retain your vision for a long time.
Scientific Studies on Treatment to Slow Macular Degeneration Focus on Dietary Changes
According to the National Institutes of Health (NIH), medical studies show that reducing the amount of carbohydrates with a high glycemic index helps to slow the progress of AMD. This means eating less refined sugars and carbohydrates, like white bread, white rice, and sugar. These foods cause a quick spike in blood sugar. In comparison, whole grains take more time to digest, so they do not spike your blood sugar, and they are better for your gut microbiome.
This switch improves health overall, but seems to improve eye health too. High levels of cholesterol and insulin have been linked in studies in mice to retinal damage, including development of AMD.
In the 2017 study, when the mice were switched from a diet with a high glycemic index to one with a low glycemic index, metabolic factors that negatively impacted eye health slowed down, stopped, or even reversed in rare cases. These metabolic factors are also associated with risk of macular degeneration in humans.
A survey examining other studies on AMD reported that, in addition to lower glycemic index carbohydrates in the diet, omega-3 fatty acid foods can help to slow down AMD. Carotene may also have preventative properties.
Among these studies, the most important so far has been the Age-Related Eye Disease Study (AREDS), which led to the creation of a specific formula for a dietary supplement that slows down the progress of dry AMD. This vitamin and mineral supplement, called the AREDS2, contains:
- 6 to 10 mg of lutein.
- 500 mg of vitamin C.
- 200 to 400 IU of vitamin E.
- 1000 to 2000 IU of vitamin D3.
- 20 to 80 mg of zinc (optional).
- 1000 mg of omega-3 or fish oil supplements, if diet does not contain fish already.
While some studies have suggested that beta carotene (found most famously in carrots) may have some protective factors against macular degeneration, it is not recommended once AMD, especially dry AMD, has developed. People who have a diet rich in beta carotene will need to speak with their general physician and their ophthalmologist to reduce the amount of beta carotene in their diet.
Additionally, eating a healthy diet and maintaining an average weight, blood pressure, cholesterol level, and blood glucose level reduce the risk of developing AMD and slow down the progress of the disease from intermediate to advanced stages. However, if you have early stage AMD, taking the AREDS supplement has not been found to slow down the disease’s progress.
Fortunately, in the early stages of macular degeneration, you are not likely to notice any vision loss or issues with your central vision. You are more likely to receive a diagnosis of early stage AMD at a routine eye exam. If your optometrist notices higher levels of drusen collecting around the retina or sees blood vessels growing around this area, they will refer you to an ophthalmologist who specializes in retinal health.
Still, it is important to make dietary changes if you are diagnosed with AMD regardless of the stage. Ask your ophthalmologist for specific guidance, but the guidelines below are approved by the National Eye Institute (NEI).
New Study Shows Eye Health Impact of the Mediterranean Diet
New research suggests that focusing your diet along the guidelines of the Mediterranean diet can protect against AMD and slow down the progression of dry AMD. This is because many of the foods in the Mediterranean diet are high in omega-3 fatty acids, lutein, zeaxanthin, and other beneficial nutrients, and low in saturated fat, cholesterol, and sugars.
In a new study, participants who followed the Mediterranean diet guidelines were 41 percent less likely to develop late-stage AMD compared to those who ate more refined sugars or prepackaged foods.
Other Dietary Changes to Reduce Risk of Macular Degeneration
Your ophthalmologist may recommend taking a specific supplement or combination of dietary supplements, or you can find ways to increase the amount of each of these nutrients in your diet naturally. The following foods are high in lutein:
- Leafy green vegetables like kale, turnip greens, spinach, and collards
- Broccoli and brussels sprouts
- Peas and green beans
- Citrus fruits, especially oranges, grapefruit, and tangerines
Another nutrient found to be useful in reducing the risk of AMD and slowing it when it develops is zeaxanthin. This nutrient has been associated in medical studies with reduced risk for developing advanced AMD. Many foods that contain zeaxanthin also contain lutein. The following foods are high in zeaxanthin:
- Leafy greens, especially spinach, collards, and lettuce
- Citrus, including oranges and tangerines
- Peas and beans
While dietary changes can help to reduce some risk of wet AMD, they are not associated with slowed progression of the condition once it develops. Lifestyle changes, especially dietary changes and vitamin and mineral supplements, are associated with slowing the progress of dry AMD. There are other medical treatments for wet AMD, which include injections or surgery to remove veins that form around the retina or to stop leakage of veins that are entrenched around the macula.
It is important to get regular eye exams for all kinds of reasons, but spotting early stage AMD means you can ask about treatment plans and take steps to protect your vision. Although many people have been diagnosed with AMD, few people completely lose their vision, especially if they stick to medical recommendations like vitamin and mineral supplements.
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What Is Macular Degeneration? American Macular Degeneration Foundation (AMDF).
What Is Macular Degeneration? (May 17, 2018). American Academy of Ophthalmology (AAO).
Age-Related Macular Degeneration. American Optometric Association (AOA).
Cure vs. Treatment of AMD and Stargardt Disease. American Macular Degeneration Foundation (AMDF).
How Diet May Affect Age-Related Macular Degeneration. (June 6, 2017). National Institutes of Health (NIH).
Nutritional Modulation of Age-Related Macular Degeneration. (2012). Medscape.
An Eye to Health: Diet and Age-Related Macular Degeneration. (June 27, 2017). Medscape.
Recommended Supplements for Age-Related Macular Degeneration. American Macular Degeneration Foundation (AMDF).
Lutein for Preventing Macular Degeneration. American Macular Degeneration Foundation (AMDF).
Study Demonstrates the Essential Role of Zeaxanthin in Eye Health. American Macular Degeneration Foundation (AMDF).
Zeaxanthin for Preventing Macular Degeneration. American Macular Degeneration Foundation (AMDF).
Age-Related Macular Degeneration. (2016). American Society of Retina Specialists (ASRS).
Mediterranean Diet May Help Prevent This Common Cause of Blindness. (October 11, 2018). Healthline.