We talk to Prof. dr hab.n.med. Andrzej Stankiewicz from the Age-related Macular Degeneration Association, Head of the Mavit Ophthalmology Clinic and the Eye Clinic.
What is AMD (Age-related Macular Degeneration) and what are the symptoms associated with it?
Prof. Andrzej Stankiewicz: AMD is an age-related degenerative disease of the central part of the retina of unknown etiology. This disease affects both people over 45 years of age. That is, they are still fully active but mature people, although it most often affects people over 60 and 70, and even later. It is a progressive disease, it comes in two forms: sudden wet, wet, which can literally lead to the so-called legal blindness, i.e. a situation in which the patient is unable to function independently. The second form is milder, dry, which takes years, but can also seriously damage eyesight, or even go into a wet form.
How common is AMD, and who is most at risk of developing it?
The likelihood of AMD increases with age. According to various world population studies, especially carried out in Western countries, in people over 80 years of age. over 40 percent already has this condition.
That’s a lot. Yet our society is aging. However, in people over 40 years of age the ratio is below 1%, but then increases again later. Unfortunately, women are more often ill. It is believed to be related to the period of hormonal changes and also because the genetic factor is more pronounced in women. If someone in the family is ill, especially on the female line, it can be said that the probability that I, my children, my siblings will get sick is very high. It is a genetic factor. In addition to genetics, environmental factors also influence. Among them, the most dangerous from the point of view of developing AMD are smoking, improper nutrition, factors related to personal predisposition, most often with light blue irises. Also, people working in high sunlight or at heights are in a higher risk group. Naturally, our white race is relatively most vulnerable to this disease. A high risk of falling ill is also generated by systemic diseases, but also by our lifestyle. How we eat, how we deal with stress, whether we are physically active has a huge impact on the risk of developing diseases such as hypertension and diabetes, which are also partially conducive to the development of AMD. So the definition of the population at high risk of developing AMD is complex. So in the case of AMD, we come back to the concept: it is not the eye that suffers, the whole organism suffers, and in the eye it becomes more prominent.
Can AMD be prevented?
Yes. First, it is important to know if there is someone with AMD in the family. From an early age, we should take care of our diet (limit the excess of fats and carbohydrates). However, if we have it in our genes, we cannot avoid getting sick. However, we should strive for it to occur as late as possible. It is different when the disease occurs at the age of 50-60, and it is different when it comes to the age of 80. May it be mild. We have to take care of the so-called balanced body balance. Recent studies in the United States have shown that, especially for our zone, the deficiency of vitamin D and other micronutrients promotes the development of AMD many times more often. This must be taken care of early. There is also a method of cleaning the retina, at a certain age. The creator of this method put forward the thesis that at a certain age, preventively clean the retina of deposits that favor the development of AMD. Of course, this is a very bold hypothesis, it is just coming in, there is no full agreement on it, because it is, however, some interference in the structure of the eye tissue. Research is also important. Let’s test ourselves at least once a year and be aware of the risks.
Let us consult a physician of the appropriate specialty (we should turn to a retinologist). Let’s do genetic research. From this study we will find out whether we have a threat or not. When we are 40 or even less, let’s be aware of the possibility of getting sick and adjust our lifestyle and diet so that at 80 we can still see well.
What are the treatment options for patients with AMD?
The therapeutic options for dry AMD are very limited. Supplementation is available, but it is very important that patients’ specific product choices are backed up by research and that they choose safe products. If a worse, exudative form develops, it is possible to inhibit the intra-ocular administration of certain preparations. Such substances that, unfortunately, have to be used for the rest of their lives. It is effective somewhere in the range of 70-80%. And such a therapeutic option is able to stop or inhibit the form of the disease.
More and more modern preparations are available on the market, designed for patients with the dry form of AMD. How do they stand out and to what extent can they be helpful for patients?
Honest supplements, i.e. those that meet all the criteria in accordance with the guidelines of multi-center foreign research, can bring the result. They affect the level of macular nutrition. However, in addition to supplementation, we must not forget about the most important, i.e. proper, balanced nutrition that provides the right ingredients to our body.
What are lutein and zeaxanthin and how do they affect the level of normal vision?
These are macular pigments, more precisely a dye derived from vitamin A. A dye that makes the very precise cone cells located there feel perfectly in this environment and work properly. There are studies available in which the effect of zeaxanthin and lutein is documented, while supplements must contain lutein and zeaxanthin in a 5: 1 ratio, there should also be adequate micronutrients, for example vitamin D. Lutein must interact with everything, including unsaturated omega 3 and 6 acids.
What we need to focus on is medicine not from the point of view of treating the effects, but prophylactic, preventive, delaying the development of this disease. The medicine of the XNUMXst century should move towards prophylaxis in order to prevent such terrible diseases as AMD.
The entire publication is available here.