What Causes AMD?

The exact causes of early (or dry) and wet (or late stage) age-related macular degeneration (AMD) are not completely understood. However, scientists have made great progress in this area in recent years. The good news is that there are things you can do to reduce your chances of developing AMD and to slow the progression of the disease once it has developed. Research has demonstrated that there are a number of risk factors that increase a person’s chances of developing AMD.

Smoking
Research has demonstrated that AMD is two to three times as frequent among tobacco smokers, and the risk is dose dependent. In other words, the more you smoke, the greater the risk and the faster the progression of the disease. Saving your sight is another good reason to quit smoking.

Nutrition
A high-fat, high-cholesterol diet can lead to fatty plaque deposits in the macular vessels, which can hamper blood flow and increase the risk of AMD. A diet low in fat promotes good eye health Several research studies have also suggested that certain vitamins and nutrients may actually reduce vision loss. Diets rich in antioxidant vitamins C and E; the carotenoids lutein, zeaxanthin and beta-carotene; and the mineral zinc may help prevent or delay AMD progression. People who should consider taking the combination of antioxidants plus zinc include those who are at high risk for developing advanced AMD. These people are defined as having either: 1. Intermediate AMD in one or both eyes. Intermediate AMD is defined as the presence of either many medium-sized drusen or one or more large drusen. 2. Advanced AMD in one eye, but not the other eye. Advanced AMD is defined as either a breakdown of light-sensitive cells and supporting tissue in the central retinal area (advanced dry form), or the development of abnormal and fragile blood vessels under the retina (wet form) that can leak fluid or bleed. Either of these forms of advanced AMD can cause vision loss. Ask you doctor if taking this special formulation is right for you and where you can obtain the specific formula in your country.

Obesity and Inactivity.

particularly ultraviolet (UV) light. . AMD is also more prevalent with blue-eyed people. National Eye Institute (NEI) estimates that while in their 50s. This risk increases to nearly 30% in those over age 75. The genetic complexity of AMD is becoming increasing clear. Vigorous exercise has shown to decrease risk. Researchers are finding that although there is a high frequency of known AMD-causing gene variants in the population.Research suggests a link between obesity and the development of AMD. severe farsightedness is uncommon and related to an extreme distortion of the shape of the eye possibly affecting the retina. Others risk factors are outside of our control: Genetics Those with immediate family members who have AMD are at a higher risk of developing the disease. Severe Farsightedness While many people become farsighted as they age.S. people have a 2% chance of getting AMD. Studies also show that obesity increases the progression of early and intermediate stage AMD to advanced AMD. many people with these variants do not develop AMD. Age The incidence of AMD increases with age. In other words. but we don’t know exactly what triggers the gene and causes development of AMD. Hypertension Patients with dry AMD on anti-hypertensive drug therapy coupled with high serum cholesterol levels and low serum carotenoid are at a greater risk for developing wet AMD. we now know that having a certain gene in your DNA makes you more likely to develop AMD than somebody who does not have the gene. Sun exposure Excessive exposure of your eyes to sunlight. The U. is considered to be a risk factor for AMD. Sunglasses and hats should be worn as protection. Light skin or eye color AMD occurs more frequently in Caucasians than other races.

a key message needs to be the importance of early detection. read or see details. prevention needs to be a key objective. Now that you’ve learned more about risk factors. Prevention and Early Detection Given that there is currently no cure for AMD. With one eye seeing clearly. We recommend some basic strategies. Wet AMD can lead to severe sight loss within as little as three months (anecdotal evidence suggests as little as a few days in some extreme cases). it’s important that you look at some of the preventative actions you can take to decrease your risk. Symptoms of AMD In its early stages. Whether we are dealing with avoidable risk factors (such as smoking or poor diet) or unavoidable risk factors (such as increased age and genetic predisposition) it is essential to raise awareness in the general population so that people can make informed lifestyle choices. which is an excellent reason to have regular eye exams! The rate of progression of AMD. People with dry AMD in only one eye often do not notice any change in their vision. . people are still able to drive. An overall focus on a healthy lifestyle is most important. and cover these in more detail here. and symptoms may occur. others may have gradual onset. Regular eye tests are therefore an absolute necessity. in one eye or both. and it becomes harder to distinguish colors. In most cases. AMD may not cause any noticeable symptoms. regular eye examinations are essential for early detection to ensure the best success for treatment and rehabilitation. Early Detection Whether or not people fall in one of the high risk categories. and the onset of symptoms will vary from person to person.Because many factors cannot be controlled. and treatment options are limited to therapies to halt the progress of the condition. Even though the precise causes of AMD remain unknown. there are a number of risk factors that contribute to the likelihood of developing AMD. Some people may experience rapid deterioration of central vision. Early detection ensures that all treatment options remain available. Vision loss may not be noticed unless AMD affects both eyes. Straight lines appear wavy or fractured. Symptoms may include: • • • A dark or empty spot in your central vision. The disease may be present. Faces may begin to blur. a good degree of usable peripheral vision remains.

it is not a substitute for regularly scheduled eye exams. The chart looks like a piece of paper with dark lines that form a square grid with one dot in the middle. please note that only a trained professional can establish whether or not you have symptoms of AMD. You will be asked to cover one eye and stare at a black dot in the center of the grid. drops are placed into the eye to dilate (widen) the pupil. The eye exam might include the following tests: VISUAL ACUITY TEST This measures how well you see at various distances. In this test. the doctor is looking for the presence of drusen. The presence of drusen alone does not indicate a disease. but it might mean that the eye is at risk for developing more severe AMD. The photos help your eye doctor evaluate leaking blood vessels to determine whether they can be treated. the better the chances of preventing vision loss in those types of AMD that respond to treatment. your vision may remain blurred for several hours. The Amsler Grid is a chart that may be helpful in revealing signs of wet age-related macular degeneration (AMD). These may be signs of wet AMD. Prevention . the most common early sign of AMD. Pictures are then taken as the dye passes through the blood vessels in the retina. You may notice that some of the lines are missing. Amsler Grid While conducting the eye exam. make an appointment with your eye doctor. After the examination. a special dye is injected into a vein in your arm. your doctor may ask you to look at an Amsler Grid. So if in doubt. While staring at the dot. The earlier AMD is diagnosed. However. OPTHALMOSCOPE By shining a small light into the back of your eye.To find out how you can spot first signs of AMD please go to the “Check your eyesight” page of this site. This grid is a pattern that resembles a checkerboard. To do this. If your eye care professional suspects you have wet AMD. you may notice that the straight lines in the pattern appear wavy to you. however. you may need to have a test called fluorescein angiography. PUPIL DILATION Enabling your eye care professional to see more of the retina and look for signs of AMD.

selenium. Foods to Enjoy Eat the freshest and brightest fruits and vegetables. This research further confirms earlier studies that suggested eating fish can help reduce the risk of getting AMD and demonstrates that some of those already affected by the disease can benefit as well. leafy vegetables – foods rich in vitamins C and E. dark green. you may also improve the health of your eyes. and carotenoids (including beta-carotene.red. Research has suggested an association between macular degeneration and a high saturated fat diet. orange. . tuna or mackerel two to three times per week can slow the progression of age-related macular degeneration (AMD) according to a study published in the British Journal of Ophthalmology. There is also evidence that eating fresh fruits and dark green. or yellow. Pick the most colorful vegetables and fruits you can find . These foods play a key role in keeping your eyes healthy: • • • • • • • • • • • • • • • • • • • • • Carrots Corn Kiwi Pumpkin Yellow squash Zucchini squash Red grapes Green peas Cucumber Butternut squash Green bell pepper Celery Cantaloupe Sweet potatoes Dried apricots Tomato and tomato products Dark green leafy vegetables Spinach Kale Turnips Collard greens Fish Eating fatty fish such as salmon. lutein and zeaxanthin) – may delay or reduce the severity of AMD.There is growing evidence that by improving your diet.

but not the other eye. Advanced AMD is defined as either a breakdown of light-sensitive cells and supporting tissue in the central retinal area (advanced dry form). or the development of abnormal and fragile blood vessels under the retina (wet form) that can leak fluid or bleed. because highdose zinc is associated with copper deficiency.) While most patients in the study experienced no serious side effects from the doses of zinc and antioxidants used. Foods to Avoid A high-fat. Either of these forms of advanced AMD can cause vision loss. 2. as cupric oxide (copper should be taken with zinc. high-cholesterol diet can lead to fatty plaque deposits in the macular vessels. Even just a handful of nuts at two or three times a week can reduce your risk of AMD. which can hamper blood flow and increase the risk of AMD. as zinc oxide Copper 2 mg. Intermediate AMD in one or both eyes. Skip foods and processed baked goods with high-fat content. The doses used in the study were: • • • • • Vitamin C 500 mg Vitamin E 400 IU Beta-carotene 15 mg (approximately 25. A diet low in fat promotes good eye health.000 IU) Zinc 80 mg. These people are defined as having either: 1. Vitamins and Supplements The National Eye Institute’s Age-Related Eye Disease Study (AREDS) found that taking a specific high-dose formulation of antioxidants and zinc significantly reduces the risk of advanced AMD and its associated vision loss. Intermediate AMD is defined as the presence of either many medium-sized drusen or one or more large drusen. but also copper which can play a role in preventing age-related eye diseases.Nuts Nuts not only contain Omega-3 fatty acids. People who should consider taking the combination of antioxidants plus zinc include those who are at high risk for developing advanced AMD. In addition recent research has indicated that those consuming red meat (10 times a week or more) were at 47% higher risk for macular degeneration. Advanced AMD in one eye. a few taking zinc alone had urinary tract problems that . Ask you doctor if taking this special formulation is right for you and where you can obtain the specific formula in your country. Slowing AMD’s progression from the intermediate stage to the advanced stage will save the vision of many people.

Smokers and former smokers should not take beta-carotene. Some patients taking large doses of antioxidants experienced some yellowing of the skin. • • • • Hold the Amsler Grid at eye level at a comfortable reading distance. as studies have shown a link between beta-carotene use and lung cancer among smokers. Again. and focus on the center dot. broken or distorted lines or blurred or missing areas of vision. Exercise. Control your body weight. Studies have shown that exercise can reduce risk of AMD and slow the progression of the disease as well. Additional Recommended Preventative Measures No Smoking! Various studies show a correlation between smoking and AMD. consult with your eye care professional and follow his or her dosage recommendations carefully. If you notice any of the potential signs of AMD like wavy. especially in strong light. . Cover one eye at a time. you should contact your eye care provider immediately. Check Your Eyesight The Amsler Grid is a chart that may be helpful in revealing signs of wet age-related macular degeneration (AMD). wear them during the test. blood pressure and cholesterol levels. Some supplements may interfere with each other or other medications. The long-term effects of taking large doses of these supplements are still unknown.required hospitalization. Some studies suggest that people who smoke may be three to four times more likely to have AMD. If you wear any type of reading lenses. Protect your eyes! There is some evidence that light exposure may be associated with a higher risk of developing AMD. Wear sunglasses. before embarking on a vitamin supplement program. it is not a substitute for regularly scheduled eye exams. The chart looks like a piece of paper with dark lines that form a square grid with one dot in the middle. however.

Remember that the Amsler Grid is not a substitute for regularly scheduled eye exams.FIG 2. distorted lines This is how the Grid might look to someone with AMD. . An Amsler Grid with wavy.

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