MACULAR DEGENERATION TESTING AND EVALUATION

High levels of antioxidants and zinc significantly reduce the risk of advanced age-related macular degeneration (AMD) and its associated vision loss. These same nutrients had no significant effect on the development or progression of cataract. These findings from a nationwide clinical trial are reported in the October 2001 issue of Archives of Ophthalmology. The AREDS 1 formula is the first demonstrated treatment for people at high risk for developing advanced AMD.
The Areds2 study showed addition of lutein and zeaxanthin, DHA and EPA, or both to the AREDS formulation in primary analyses did not further reduce risk of progression to advanced AMD. However, because of potential increased incidence of lung cancer in former smokers, lutein and zeaxanthin could be an appropriate carotenoid substitute in the AREDS formulation.
Attention to diet eg particular fruit and vegetables eg being a good source of beta carotene (needed to create vitamin A )and antioxidants that also helps with the immune system as well as an array of medical approaches are required to limit potential vision loss.   A diet rich in antioxidants involves:

The correct intake of plant based foods, carrots,eggs,milk and yogurt ,whole grains, quinoa, whole lentils, oats, brown rice ,oysters,red bell pepper,sunflower seeds, lentils, kidney beans, chickpeas, green peas, sprouts sweet potatoes among others are all vital for eye health as they supply the antioxidant activity. 

Including the essential vitamins A,C,E omega-3,Zinc, Zeaxanthin,beta-carotene,lycopene,lutein,selenium.
Sources of  antioxidants can be found in vitamins A, C and E, Dark chocolate, the minerals selenium, zinc and copper, and can also be found in phytochemicals from plants, fruits and vegetables.  Too high doses of antioxidant supplements may work against your own antioxidants which are produced naturally rather than artificially.

Macutec once daily is an AREDS  2 formulation designed to reduce AMD implications from side effects of oxidative stress.

It is often recommended by your optometrist for those patients who prefer to take one capsule per day to reduce the risk of their dry age related macular degeneration progressing. AREDS-2 was an important five-year clinical study that demonstrated positive results for dietary lutein and zeaxanthin being a safe and effective alternative to beta-carotene.

It contains
Vitamin E  400 mg
Lutein 10 mg   Zeaxanthin 2 mg
Zinc (from Zinc Oxide) daily dose of 25 mg
Copper (as Cupric Oxide) 2 mg
Ascorbic acid (Vitamin C) 500 mg​
Omega-3 fatty acids – Eicosapentaenoic acid (EPA), and Docosahexaenoic acid (DHA). 
The DHA in fish oil is essential for normal retinal  functioning. 
Macutec Once Daily doesn’t contain beta-carotene with its ill effects or fish oil unlike other alternatives eg Lacritec.  Fish oil has a slight blood thinning effect so it is advised to consult your GP if you are taking blood thinning drugs such as warfarin.
Fish oil is an especially rich source of omega-3 fatty acids, which are also found in flaxseed, walnuts, and dark leafy greens. 
There are no known significant drug interactions with Macutec Once Daily
The human body is capable of producing all the fatty acids it needs, except for two: linoleic acid (LA), an omega-6 fatty acid, and alpha-linolenic acid (ALA), an omega-3 fatty acid both found in plant and seed oils.
Omega-3s have anti-inflammatory benefits and help prevent heart disease, whereas Omega-6s lower blood cholesterol and support the skin.
Modern food processing and storage can rob many foods of much of their nutrition. For some natural sources it is difficult to actually eat the quantities required. Examples include fish and spinach. Even food preparation can reduce the nutrition content.
 Macutec is based on a very large clinical trial which showed a significant benefit in slowing the progression of macular degeneration. The majority of the people who were on this trial and showed benefit were also eating healthily. 
Sometimes Resveratrol in red wine is thought to help reduce abnormal angiogenesis.

AMD patients need to wear tinted glasses because of photostress. There can be  many situations where the absorption is too dark or unsuitable ,requiring need for different filter values,sometimes more cheaply overcome by fitover shields of which we have in different densities. Photodynamic therapy (PDT) and the administration of compounds acting against vascular endothelial growth factor (anti-VEGF) are approved for the treatment of choroidal neovascularization (CNV) secondary to AMD. 

Periodic intravitreal (into the eye) injections are sometimes required.  Cell-penetrating peptide eye drops will drive the next generation of treatment for people with AMD rather than intraocular injections. Drugs that can activate proteins found in blood vessel cells are being developed to make the blood vessel more stable. Abnormal blood vessel growth and leakage are two primary factors in both age-related macular degeneration and diabetic retinopathy.

In the wet rather than the dry form of ARM anti vegf drugs some now plant based are normally administered by intravitreal injection rather than topical eye drops to reach the back part of the eye.

Photodynamic therapy uses laser light and light-sensitive dye to seal off the leaking areas. Free radicals, referred to as oxidants are unstable molecules in the body with unpaired electrons.

Oxidative stress plays a pivotal role in developing and accelerating retinal diseases including the leading cause of  blindness in Austrlia -age related macular degeneration (AMD) the part of the eye responsible for central vision, glaucoma, diabetic retinopathy (DR), and retinal vein occlusion (RVO). 

Risk factors for retinal vein occlusion  which can cause other problems like heart attacks and strokes. The main risk factors are:

Age (most retinal vein occlusions happen in people over 60)
High blood pressure
High blood lipid levels
Diabetes
Smoking
Overweight

If a retinal vein occlusion causes fragile, abnormal new blood vessels to grow in the eye the risk of beeding can be minimised  by using laser and/or intra-ocular drug injections.
If the central macula is affected and vision is reduced due to swelling of the central macula, treatment with anti-VEGF drugs may be used. Anti-VEGF drugs are administered as injections into the eye. The usual treatment regimen begins with monthly injections for three months. Then to maintain control of the disease, injections are typically continued on an indefinite basis, or until the swelling has resolved.

We also use digital retinal photography and employ tests to measure the effect on vision and if any distortion is present often involving an eye drop to dilate the pupil. 

We can enhance vision by glasses,loupes and electronic magnification and with timely referral for laser intervention,injections or surgery. 

Those with susceptible family history for ARM can consider predictive genetic testing, quit smoking, lower cholesterol, and be conscious of your environmental light exposure, and perhaps consider supplementation with antioxidants, such as lutein and zeaxanthin.

Blue light wavelengths  boost our concentration so can impact on sleep 
Blue light  can damage the retina so at risk groups  – family history of AMD, smokers, people who are obese,children can benefit by blue light filter especially when outside.