The retina contains the layer of cells which are sensitive to light (photoreceptors) and lies in the back of the eye like a thin sheet of plastic. The types of photoreceptors called rods are very sensitive to light but not color. The 3 types of cones function in bright light and each type mediates color vision of one of the primary colors, the blue receptors being the fewest and the red outnumbering the green about 2:1. The rods and cones are not evenly distributed over the whole retina. The most sensitive part of the retina contains only cones and they are very close together enabling us to see colors and things about 100 times more detailed than can be distinguished by the outer area of the retina. This area, called the fovea [about 300-400 micrometers] is surrounded an area about the size of a pencil erasure which is called the macula. The rest of the retina gives us our side vision and cannot distinguish fine details.
Age-Related Macular Degeneration [ARMD] is characterized by degenerative changes in the macular region of the retina and in the retinal pigment epithelium which provides its nutritional support and waste disposal. It is the most common cause of legal blindness, in people over 65 years living in most of the industrial world. As people get older this is a common cause of losing a driver's license and the ability to read. It is particularly important to prevent this disease because there is no satisfactory treatment to reverse it.
The dry form accounts for about 90% of cases of ARMD. This form usually advances more slowly and is characterized by a loss receptor cells and clumps of waste material that clump together and may block part or all of the macula Although the etiology of this disease is not clear, recent research reveals that there are a number of factors associated with risk.
Some of the latest research shows that those who have more lutein and zeaxanthin in the macula have less ARMD. Other studies indicate that a majority of people who eat a diet rich in lutein and zeaxanthin will have an increase in their blood and in the retina but that there are others who do not show an increase in blood levels and some in whom the blood level increases but not the retinal levels
One of the most encouraging investigations revealed that those who ate diets rich in carotenoids had a lower risk and those who specifically ate spinach or collards at least 2-4 times per week had about half the risk of those who ate them once per month. A few who ate them six or more time per week had very low risks Helpful investigation followed with lists of fruits and vegetables like spinach, kale, parsley, collards, cress, guava juice which have large amounts of the protective carotenoids and others which have significant amounts.'
A recent report adds some variety with a list of 33 fruits and vegetables and their content of 8 carotenoids including corn, orange bell peppers, oranges, red seedless grapes, and honeydew as excellent sources of the macular pigments.
Some other significant risk factors have been identified:The risk rises quite a lot, as you get older; as you would expect from the name. However other potent risk factors that have been statistically associated with ARMD can be influenced by lifestyle.
If arteries that supply blood to the eyes, become narrowed by disease [Cerebrovascular disease], the risk of ARMD increases markedly. Plugging up of the carotid arteries is related to high cholesterol and there are ways to help keep it under control.
Some ways to help lower colesterol are:
Decrease the amount of cholesterol you eat by choosing foods without cholesterol.
Decrease the amount of saturated fat that you eat by substituting foods with better quality fat. Monounsaturated fats which are a major part of the fat in olives, some nuts, seeds, and avocados do not tend to raise the harmful cholesterol but do maintain the HDL "good cholesterol" and provide valuable nutrients.
Limit the total fat in your diet by using very sparingly free fats like margarine, cooking oil, regular salad dressing and mayonnaise.
Increase the HDL ["good cholesterol"] by physical exercise like walking, cycling, swimming, etc. because it helps to carry the cholesterol out of your body.
Include in your diet plenty of soluble fiber by eating plenty of whole grains, fruits and vegetables. Some excellent sources are oats, dried beans, soy beans, garbanzos [chick peas], and apples. This helps to carry the cholesterol away.A stress reaction in the body can also increase cholesterol in the blood and research indicates that it increases the risk of disease in other ways also. Limiting stressful situations as much as possible and modifying your reaction to them can be helpful. Many people find spiritual resources and supportive friends are a great help in dealing with difficult situations.
Smoking is another potent risk factor; raising the risk from 3 to over 5 times. Even though some increased risk remains with one who has been a smoker, the risk drops off very sharply when you stop smoking.' There are various ways to help a person stop smoking. A good group plan is called Breath Free. This plan is offered in many communities. A vigorous physical exercise program can be a great help. If you have symptoms that are very disrupting they may be eased by special gum or a patch with nicotine. Drinking plenty of water, eating simple light meals, avoiding coffee and alcohol, getting plenty of fresh air, setting up a buddy system and changing your habits all help. One is usually over most of the physical withdrawal within about 5 days. To break the behavior pattern takes longer. Do not be discouraged if you break your resolve. Many people who have stopped smoking tried several times before success.We also believe it is wise to wear sunglasses that block the ultra violet light A and B especially when out in bright sunlight glare.
Although the lowest risk was observed in those who ate specific greens (spinach and collards) low odds ratios were also observed in those with high levels of carotenoids in their diet and in their blood. There are supplemental preparations now available that some people report have given them relief and may be helpful in preventing ARMD. We do not have enough evidence to know if they are effective or not but do not believe them to be harmful and would like to inform of their availability.
There are reports that some people are getting some relief by taking preparations containing bilberry. Many health food stores and some drug stores carry these. Bilberry is related to blueberries, cranberries, and huckleberries and contains anthocyanins which are reputed to strengthen blood vessel walls. We do not know of scientifically controlled studies that give us reliable information as to what percentage of people might be benefited. It may be that they. would be helpful in preventing ARMD, especially for people with the wet form of ARMD.
Some of these products are:
Lutein Eyes: with lutein as well as [spinach and bilberry]
PhoVision: with Bilberry 25 mg., Grape seed 25 mg., Ginkgo 30 mg., Flavanoids, Zeaxanthin, Lutein 40 mg. of 5%
Perspective: 90 mg. lutein 5%, 6000 mg. Bilberry 100:1, Citrus bioflavonoid 200 mg., Quercetin 50 mg., Rutin 100 mg., N acetyl Cystein 20 mg., Glutathione 10 mg.
Ocu-force: Lutein 2mg, Zeaxanthin 88mcg, Vit C 150mg, Vit. E 5010, Vit. A (f3 car.) 6666IU, Vit A 1000 IU, Vit. B2 15mg, Folic Acid 50pg, Niacin 10mg, Biotin 20 pg, Pant. Acid 10mg, Zinc 5mg, Selenium 20pg, Calcium 50mg, Magnesium 50mg, Chorine 25 mg, L-Glutamine 10 mg, Taurine 20mg, ~. L-Methionine 25mg, Bioflavonoid 50 mg, Bilberry 30mg, Spirulina 10mg, Carrot powder 10mg, Schisandra Berrry 25 mg
Available from Physicians in the U.S.
Ocular: Vit C 220 mg, Vit. E 120 IU, Vit. A (1! car.) 5000 IU, Vit A (Palmitate) 2500 IU, Vit. B1 3 mg, Vit. B2 4 mg, Vit. B6 5 mg, Vit. B12 20 pg, Vit. D 400 pg, Folic Acid 400 pg, Niacin 40 mg, Biotin 300 pg, Pant. Acid 20 mg, Copper 2 mg, Zinc 15 mg, Selenium 150 pg, Manganese 2 mg, Calcium 180 mg, Phosphorus 96mg, Iodine 150 mg, Magnesium 160 mg, Chromium 120 pg, Molybdenum 75 pg, Bilberry 30 mg, Ginkgo Biloba 40mg, Hespiridin Complex 100 mg, Lipoic Acid 50pg, Taurine 1000mg, Chorine 50 mg, Xanthophylls[lutein,zeaxanthin,cryptoxanthin] 5 mg.