WHAT IS AMD?

Macular degeneration is a progressive eye condition affecting as many as 15 million Americans and millions more around the world. The disease attacks the macula of the eye, where our sharpest central vision occurs. Although it rarely results in complete blindness, it robs the individual of all but the outermost, peripheral vision, leaving only dim images or black holes at the center of vision.

There are several forms of macular degeneration, but the fastest growing form is age-related macular degeneration (AMD). AMD is the number one cause of severe vision loss and legal blindness in adults over 60 in the U.S. As our population ages, and the "baby boomers" advance into their 60's and 70's, we will see a virtual epidemic of AMD. Perhaps 14%-24% of the U.S. population aged 65-74 years and 35% of people aged 75 years or more have the disease.

Although it never causes total blindness by itself, age-related macular degeneration robs those affected of their sharp central vision and can dim contrast sensitivity and color perception. It destroys the clear, "straight ahead" central vision necessary for reading, driving, identifying faces, watching television, doing fine detailed work, safely navigating stairs and performing other daily tasks we take for granted. Peripheral vision may not be affected, and it is possible to see "out of the corner of your eye". Vision Rehabilitation and assistive devices can help people use their remaining vision effectively. The impact of developing AMD can be devastating to those who were independent and active prior to the onset of this impairment. Their visual world gradually diminishes into a vague blur, making ordinary daily activities challenging.

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There are two types of AMD - "wet" or neovascular and "dry" or atrophic. There is no cure for AMD, but new treatments are available for the wet form of the disease. There is no treatment for the dry form, but training and special devices can promote independence and a return to favorite activities.

How Did I Get It?

Risk Factors

In medicine today you will hear a lot about risk factors. Studies in large populations show that statistically a person's chance of developing a disease is increased by risk factors. Although the cause of age-related macular degeneration is unknown, a number of factors appear to contribute to the development of the disease. Some of them are outside of your control, like family history. Others are related to lifestyle and you can change them.

What Can I Do About It?

You have control over some of the known risk factors for macular degeneration. If you have macular degeneration, a family history of AMD, or are in the "macular generation" (age 60 or above), you should be particularly attentive to these. However, it is most effective to take these steps well before you are at risk. Healthy habits, started young, will provide the most benefits.

Smoking increases your risk of developing macular degeneration two to 5 times! Tobacco appears to interfere with the absorption of lute in, an important antioxidant that protects the retina. Smokers are likely to have low levels of lutein and they are at greater risk of developing macular degeneration than nonsmokers. So, if you've been trying to quit smoking, here's another good reason to stop!

The eye is a highly vascular organ and it has a rich supply of blood vessels. In fact, the rate of blood exchange in the eye is the highest in the body. The link between high blood pressure and AMD has been the subject of much research.

The only way to know if you have high blood pressure is to have your doctor check for it. There are no symptoms, which is why it is called "the silent killer". If you have high blood pressure, it can be controlled by following your doctor's instructions. This may involve changes in diet and/or medication

Ultraviolet light and blue light can damage your retina and may increase your chances of developing macular degeneration. They can also speed up its development. Therefore, it is extremely important to protect your eyes when you are out of doors.

Wear a hat or visor whenever you are outside, even on overcast days. Ultraviolet light passes through cloud cover and is just as dangerous as direct sunlight.

Look for sunglasses that screen 99-100% of ultraviolet A and B rays. Recent research points to blue light (the short wavelengths of the light spectrum) as an even more damaging factor. To be on the safe side, try to find glasses that guard against both ultraviolet rays and bluelight. A certain percentage of sunglasses are mislabeled, so always buy sunglasses from a reputable dealer. Your optician can check your glasses to measure the UV protection.

Most glasses allow some direct sunlight to enter from the top and sides of the frame. There are sunglasses designed specifically for macular degeneration that include side panels and a ridge at the top of the glasses so that all light is filtered. The most helpful colors for blocking out blue light are red, orange, yellow and amber. Because glare is often a problem for people with AMD, choose this protection carefully. You can also have your regular glasses treated with ultraviolet protection - a clear coating that will not interfere with your sight.

The diet widely recommended as beneficial for cardiovascular good health - low in saturated fats, high in fruits and vegetables - also seems to help people suffering from AMD. A healthy lifestyle that includes regular cardiovascular exercise also contributes to both cardiac and eye health. One explanation: A healthy heart speeds the delivery of essential nutrients to the eyes and hastens the removal of waste products. Other studies have noted beneficial changes from a diet rich in dark green leafy vegetables such as spinach, kale, mustard and collard greens. Antioxidants are present in fruits and vegetables with bright color, including red grapes, peppers, corn, oranges, cantaloupe and mango.

Research and Experimental Treatments

Many treatment options for AMD are in the experimental stage. Some are in controlled clinical trials and are not yet available to the general public. Others, like TTT and radiation, are in clinical trials but are also available outside of the trials. Most treatments are appropriate only for "wet" macular degeneration, characterized by bleeding under the retina. Some others attempt to treat the "dry" form of the disease, in which protein deposits called drusen form in the retina. We will keep you advised on the progress of these protocols, presenting the pros and cons as they emerge.

Another major thrust of current research is towards understanding the mechanism of AMD and presenting opportunities for treatment. These include investigations on the role of nutrition, genetics, light exposure and other environmental issues. Genetics research holds great potential in finding the cause of macular degeneration and in creating future treatments. Anti-angiogenesis seeks to stop the bleeding before it occurs.

Yet other research looks for new ways to improve low vision rehabilitation, or to restore sight. Retinal "chips", implanted electrodes, miniature implanted telescopes are all part of this area.

Research on treatments starts in the laboratory where scientists work to identify the processes involved. These are called Pre-Clinical studies. Clinical trials begin with Phase I trials, which test a small number of people for safety and dose. Phase II involves several hundred subjects to test for effectiveness. Phase III expands the study to thousands of people in order to confirm effectiveness and monitor safety and side effects. After the drug or treatment has been approved by the Food and Drug Administration (FDA) and made available for public use, studies continue to track side effects and success.

In the clinical trials, large numbers of patients participate in a study. To be of value, a new therapy must be proven both safe and effective by careful unbiased studies. To prevent bias, neither the patient nor those examining the patient must know who got the treatment and who were the untreated "control" subjects. These are called double masked studies and usually yield the most reliable results. The medication is coded and patients are selected at random. Once the study is concluded, the code is broken and everyone can tell who got the placebo and who got the real drug.

Some techniques cannot be studied this way because they involve machines or surgeries. So they are structured to insure that each patient is treated exactly the same. Many clinical studies are going on across the country.

AMD is a long term and unpredictable disease. It progresses differently in each individual. Therefore, studies may involve hundreds of patients followed for 3, 5 or even 10 years to determine if a new therapy is really effective. It is frustrating to wait for a cure or treatment, but only rigorous controls and continued follow-up can truly give us the answers we need.

Because of the number of people affected by macular degeneration, we hear about a lot of treatments that may or may not eventually be proven to help. Some experiments are performed by well-respected physicians with excellent credentials. They are being monitored by agencies such as the Food and Drug Administration (FDA) and the National Eye Institute to be sure the work is done in an unbiased, scientific manner.

Other experiments do not meet this rigorous standard and the results of the treatments are anecdotal. In other words, you only hear about the results from the people performing or receiving the treatment. Some of these may show promise; others would be considered "fringe" experiments or treatments and should be viewed cautiously. It doesn't mean that they won't end up being useful, just that there is no scientific data to support them.

It is just this kind of situation that has encouraged the emergence of useless and "magic" medicines and cures through the centuries. You should certainly stay informed of any activity toward a cure because we don't know where the answers will be found, but be alert to exaggerated claims and expensive therapies that sound too good to be true.

The hybrid marigolds are processed in our laboratory to provide the purest Lutein and Zeaxanthin as the major ingredients in our AMD/OPTICAPS formula.