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AFBAmerican Foundation®
for the Blind

Expanding possibilities for people with vision loss

What Treatments Are Available for Dry Macular Degeneration?

By Lylas G. Mogk, M.D.

The dry (atrophic) type of AMD affects approximately 80-90% of individuals with AMD. Its cause is unknown, it tends to progress more slowly than the wet type, and there is not - as of yet - an approved treatment or cure; however, there are a number of clinical trials underway.

In dry age-related macular degeneration, small white or yellowish deposits, called drusen, form on the retina, beneath the macula, causing it to deteriorate or degenerate over time.

retina with yellow spots, which are drusen

Drusen are the hallmark of dry AMD. These small yellow deposits beneath the retina are a buildup of waste materials. They are made up of cholesterol, protein and fats. Typically, when drusen first form, they don't cause any vision loss. However, they are a risk factor for progressing to vision loss. When a person has more advanced dry macular degeneration, there are many more of these small yellowish deposits and they are larger.

The Macular Degeneration Partnership and Macular Degeneration Support provide the following recommendations for slowing down, or preventing the progression of, both dry and wet AMD:

Nutrition and Weight Control

Studies suggest that eating antioxidant-rich foods, such as fresh fruits and dark green leafy vegetables (kale, collard greens, and spinach, for example), may delay the onset or reduce the severity of dry AMD. These types of vegetables contain lutein, which may protect the macula from sun damage, just as it protects the leaves of these vegetables from sun damage.

Eating at least one serving of fatty fish per week may also delay the onset or reduce the severity of dry AMD. These types of fish are high in omega-3 fatty acids, which help decrease inflammation and promote eye health.

Avoid packaged foods as much as possible. It's important to keep a balance between omega-6 fatty acids and omega-3 fatty acids in our diets. Virtually every food in a package contains omega-6 fatty acids in the form of vegetable oil. We need to increase our intake of omega-3s and decrease our intake of omega-6s.

Avoid artificial fats. Low-fat foods are good options if they've achieved their low-fat status through a process that physically removes the fat. Skim milk and low fat cottage cheese are examples of these types of good low-fat foods.

A low-fat cookie or a no-fat cake, however, is a nutritional contradiction. Usually a low-fat or no-fat label on baked goods doesn't mean less fat was used in the production of the food, but that an artificial fat was used, usually partially hydrogenated vegetable oil. These types of fats are artificial ingredients made in a laboratory and our bodies can't metabolize them. So it's best to eat real cookies - just don't eat the whole dozen!

Incorporate exercise into your everyday life. Obesity may increase the risk for progression to advanced AMD.

Nutritional Supplements

In May 2013, The National Eye Institute concluded the Age-Related Eye Disease Study 2 (AREDS2), which tested several changes to the original AREDS formulation:

  • The primary goal of the AREDS2 study was to determine if (a) adding omega-3 fatty acids or (b) lutein and zeaxanthin (the anti-oxidants found in dark green leafy vegetables) to the original AREDS formulation would make it more effective for reducing the risk of advanced AMD and cataract.
  • The AREDS2 research group also substituted lutein and zeaxanthin for beta-carotene, which prior studies had associated with an increased risk of lung cancer in smokers.

The researchers concluded that while omega-3 fatty acids had no effect on the formulation, lutein and zeaxanthin together appeared to be a safe and effective alternative to beta-carotene. Therefore, the addition of lutein and zeaxanthin to, and the subtraction of beta carotene from, the AREDS supplement formula was recommended by AREDS2.

The AREDS2 formulation now includes:

  • 500 milligrams (mg) of vitamin C
  • 400 international units of vitamin E
  • 80 mg zinc as zinc oxide
  • 2 mg copper as cupric oxide (to avoid anemia with high zinc intake)
  • 10 mg lutein
  • 2 mg zeaxanthin

Be sure to talk with your doctor before adding any nutritional or vitamin supplements to your diet. If you don't have AMD and wish to take nutritional supplements, take a good multiple vitamin/mineral combination with additional lutein and omega-3 fatty acids. The AREDS formula is not recommended for persons who do not have macular degeneration because it contains a high dose of zinc.

Implantable Miniature Telescope

The U.S. Food and Drug Administration (FDA) has approved the Implantable Miniature Telescope (IMT) for end-stage AMD.

Blue Light

Avoid ultraviolet and blue light (light waves that make the sky, or any object, appear blue) as much as possible and wear sunglasses that block blue light. In commercial sunglasses, this is usually in the yellow-orange-amber tints. Read Artificial Lighting and the Blue Light Hazard from Prevent Blindness for more information.

Control Blood Pressure

In the AREDS trial, individuals with hypertension were 1.5 times more likely to have wet AMD than persons without hypertension.

Avoid smoking

If you do smoke, stop - and avoid secondhand smoke as well.

Have an Eye Examination

If you have not had an eye exam by an ophthalmologist in three or more years, you may qualify for help from the AMD Eye Care Program, offered through the American Academy of Ophthalmology. The program provides free eye exams for individuals who have not been diagnosed with AMD, are age 65 and older, are U.S. citizens or legal residents, and do not belong to an HMO or the Veterans' Administration (VA). Call the toll-free helpline at 1-866-324-EYES (3937) for more information.

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