Diana Shechtman OD FAAO
Although most people have an annual physical or dental exam, often times the annual eye exam is overlooked. Eyesight plays a critical role in our day-to-day lives. The ability to see certainly affects and interferes with the world around us. Good quality vision is taken for granted until it begins to deteriorate. Visual impairment leads to a decrease in our ability to perform activities of daily living, including driving, computer use and reading. 1,2 Visual impairment is one of the most common disabilities, affecting 314 million people worldwide and3 the majority of visually impaired patients are adults over the age of 65. Common eye diseases like age-related macular degeneration, glaucoma, diabetic retinopathy and cataracts contribute to this. 4,5 Current and future research devoted to ocular disease will unquestionably provide better understanding of such diseases, viable treatment options and better visual outcome.
Eye care professional provide high quality eye care through the use of evidence based medicine enabling the advancement of eye care delivery and the development of new treatment options. In addition, eye care professionals provide good vision to their patients. Patients who experience vision loss attributed to eye related diseases are the ones that are at greatest need for proper visual enhancement. Moreover, uncorrected refractive error has been identified as a leading cause of visual impairment. 6
A routine eye exam is comprised of an overall health assessment of the eye and related structures, as well as the evaluation of vision, the visual system and vision processing. Various eye diseases, like age related macular degeneration, cataracts and glaucoma are insidious and hence, a routine eye exam may identify such conditions before problems ensue. Early diagnosis of ocular disease leads to prompt treatment intervention and better prognosis. Patients need to be cognizant of the importance of annual and routine eye exams. Appropriate and routine eye care reduces the impact of various ocular conditions.
One of the main goals of an eye care professional is to ensure the best corrective vision for the patient. In fact, that is what patients expect. 7 According to a recently published on-line survey conducted among 7 distinct countries (US, France, UK, Italy, Japan, Korea and China), it was determined that vision was by far the most crucial element to all patients.7 The NSIGHT (Needs, symptoms, incidence, global, eye health trends) study was conducted among 3,800 patients with visual corrective needs ranging in age from 15 to 65 years.3 The survey evaluated 40 different needs related to eye conditions, comfort, environment, convenience, health vision, personal performance and appearance. The study’s primary goal was to determine the ranking associated with patients needs when it came to choosing eye-related products. Among the 8 classifications in the study, the two most persuasive categories were vision followed by eye health, while personal performance and comfort rank at the lowest range of the spectrum.
Eye care professionals continue to restore and improve their patients’ sight. What they do everyday is fundamental and ultimately it is what is most important to the patient. So see your eye care professional today.
References
1. Haymes SA, Johnston AW, Heyes AD. Relationship between vision impairment and ability to perform activities of daily living. Ophthalmic and Physiological Optics 2002; 22: 79–173.
2. Lamoureux EL, Hassell JB, Keeffe JE. The determinants of participation in activities of daily living in people with impaired vision. AJO 137: 265-70.
3. Visual impairment and blindness. World Health organization. www.who.int/mediacentre/factsheets/fs282/en/ last accessed January 17, 2011.
4. Congdon N, O'Colmain B, Klaver CC, Klein R. et al. Causes and prevalence of visual impairment among adults in the United States. Archives of Ophthalmology 2004; 122:477-85.
5. Visual impairment and blindness. World Health organization. http://www.who.int/mediacentre/factsheets/fs282/en/ Last access Jan 16, 2011.
6. Congdon NG, Friedman DS, Lietman T. Important Causes of Visual Impairment in the World Today. JAMA 2003; 290: 2057-2060.
7. Mack CJ, Merchea MM, Thomas H. A global survey reveals vision needs of highest importance amongst a vision-corrected population. Poster presented at AAO 2010; San Francisco
Saturday, January 29, 2011
Friday, January 28, 2011
U-M device can predict diabetes through eyes
by: PATRICIA ANSTETT
A vision testing device developed by two University of Michigan researchers is showing promise in the detection of diabetes, both in its early and potentially blinding stages.
It also may help diagnose changes that occur in the eye as early as 10 years before a person is diagnosed with macular degeneration, the leading cause of blindness in the elderly.
Eventually, eye doctors may use the device to determine if vitamins and drug injections taken by patients with macular degeneration actually stop progression of the disease, said Dr. Victor Elner, professor of ophthalmology and visual sciences at U-M's Kellogg Eye Center.
Or it may help people at risk of diabetes, or diagnosed with it, to avoid complications by managing their disease with healthy diets and medicines, said Howard Petty, PhD, a U-M biophysicist and imaging expert and senior author of the study.
The device awaits further study and federal approval. Elner, Petty and a team of U-M scientists described their findings Monday in the July issue of Archives of Ophthalmology.
Elner and Petty, who developed the device, have filed for a patent and formed a company, OcuSciences Inc. of Ann Arbor. Elner said the team definitely plans to study whether vitamins taken by people at risk of macular degeneration help them avoid getting the disease.
The device is a camera linked to computer software that provides a numerical value, or score, that suggests the beginnings or progression of a disease. It measures the activity of a protein associated with abnormal cell changes associated with both diabetes and certain eye diseases. The team hopes to develop composite pictures of images taken of the retina.
The test takes a snapshot of the retina. It is quick, painless and inexpensive -- as little as $20 for each test, compared to as much as $120 or more for standard blood glucose testing for diabetes, Petty said. It also avoids the need to fast and have blood drawn three times for standard oral glucose tests, he said.
The team is focused on diabetes, Elner said, because in nine of 10 cases of diabetes, these abnormal changes occur. Diabetes also is a major U.S. public health problem. Some 24 million Americans are diagnosed with the disease and another 57 million have abnormal blood sugar levels that are considered pre-diabetic, according to the Centers for Disease Control and Prevention. About 4.1 million people 40 or older have diabetic retinopathy, a potentially blinding complication of the disease.
A vision testing device developed by two University of Michigan researchers is showing promise in the detection of diabetes, both in its early and potentially blinding stages.
It also may help diagnose changes that occur in the eye as early as 10 years before a person is diagnosed with macular degeneration, the leading cause of blindness in the elderly.
Eventually, eye doctors may use the device to determine if vitamins and drug injections taken by patients with macular degeneration actually stop progression of the disease, said Dr. Victor Elner, professor of ophthalmology and visual sciences at U-M's Kellogg Eye Center.
Or it may help people at risk of diabetes, or diagnosed with it, to avoid complications by managing their disease with healthy diets and medicines, said Howard Petty, PhD, a U-M biophysicist and imaging expert and senior author of the study.
The device awaits further study and federal approval. Elner, Petty and a team of U-M scientists described their findings Monday in the July issue of Archives of Ophthalmology.
Elner and Petty, who developed the device, have filed for a patent and formed a company, OcuSciences Inc. of Ann Arbor. Elner said the team definitely plans to study whether vitamins taken by people at risk of macular degeneration help them avoid getting the disease.
The device is a camera linked to computer software that provides a numerical value, or score, that suggests the beginnings or progression of a disease. It measures the activity of a protein associated with abnormal cell changes associated with both diabetes and certain eye diseases. The team hopes to develop composite pictures of images taken of the retina.
The test takes a snapshot of the retina. It is quick, painless and inexpensive -- as little as $20 for each test, compared to as much as $120 or more for standard blood glucose testing for diabetes, Petty said. It also avoids the need to fast and have blood drawn three times for standard oral glucose tests, he said.
The team is focused on diabetes, Elner said, because in nine of 10 cases of diabetes, these abnormal changes occur. Diabetes also is a major U.S. public health problem. Some 24 million Americans are diagnosed with the disease and another 57 million have abnormal blood sugar levels that are considered pre-diabetic, according to the Centers for Disease Control and Prevention. About 4.1 million people 40 or older have diabetic retinopathy, a potentially blinding complication of the disease.
Sunday, January 23, 2011
MACULAR DEGENERATION ASSOCIATION (MDA): ANNOUNCES UPCOMING WINTER SEMINAR
MACULAR DEGENERATION ASSOCIATION (MDA)
New Advances in the Treatment and Management of Macular Degeneration
Winter Seminar
February 7, 2011
Co-Sponsored by Winter Haven Hospital
January 18, 2011 (MMD Newswire) -- The Macular Degeneration Association will be hosting a seminar on Monday, February 7th, 2011 at Winter Haven Hospital's auditorium in Winter Haven, Florida from 12:00pm to 4:00pm to share information and provide macular patients and caregivers in Southern Florida an opportunity to learn about the latest information surrounding treatments, and drugs. There will also be a forum where patients and caregivers can exchange their questions and concerns with experts in the field of macular, as well as other patients.
This four hour program will feature guest lecturer, Dr. Michael Tolentino, a well known retina specialist from Winter Haven, Florida. "We are fortunate to have a distinguished doctor to speak to patients about macular degeneration," said Chairman, Lawrence Hoffheimer.
Program topics include:
New Advances in the Treatment and Management of Macular Degeneration
The Future of Age-related Macular Degeneration Treatments
This educational seminar is free of charge, space is limited, please call and reserve your place today. For more information please contact Donna Auger at dauger@maculardegenerationassociation.org or by phone at (727)478-4708
About the Macular Degeneration Association (MDA)
The Macular Degeneration Association is a nonprofit health organization providing Age-related macular degeneration research, information, and advocacy. The mission of the organization is to cure macular degeneration and to improve the lives of all people affected by the disease. To fulfill this mission, MDA will fund research, publish scientific findings, provide funding for information and other services to people with macular degeneration, their families, health care professionals, and the public. The foundation also expects to be actively involved in advocating for scientific research and for the rights of the people with macular degeneration. The money raised by the Macular Degeneration Association funds research, information programs, education, advocacy, and awareness efforts that will support the over 9.1 million people with macular degeneration in communities across America. For more information about the foundation please log onto www.maculardegenerationassociation.org. Thank you for your support.
New Advances in the Treatment and Management of Macular Degeneration
Winter Seminar
February 7, 2011
Co-Sponsored by Winter Haven Hospital
January 18, 2011 (MMD Newswire) -- The Macular Degeneration Association will be hosting a seminar on Monday, February 7th, 2011 at Winter Haven Hospital's auditorium in Winter Haven, Florida from 12:00pm to 4:00pm to share information and provide macular patients and caregivers in Southern Florida an opportunity to learn about the latest information surrounding treatments, and drugs. There will also be a forum where patients and caregivers can exchange their questions and concerns with experts in the field of macular, as well as other patients.
This four hour program will feature guest lecturer, Dr. Michael Tolentino, a well known retina specialist from Winter Haven, Florida. "We are fortunate to have a distinguished doctor to speak to patients about macular degeneration," said Chairman, Lawrence Hoffheimer.
Program topics include:
New Advances in the Treatment and Management of Macular Degeneration
The Future of Age-related Macular Degeneration Treatments
This educational seminar is free of charge, space is limited, please call and reserve your place today. For more information please contact Donna Auger at dauger@maculardegenerationassociation.org or by phone at (727)478-4708
About the Macular Degeneration Association (MDA)
The Macular Degeneration Association is a nonprofit health organization providing Age-related macular degeneration research, information, and advocacy. The mission of the organization is to cure macular degeneration and to improve the lives of all people affected by the disease. To fulfill this mission, MDA will fund research, publish scientific findings, provide funding for information and other services to people with macular degeneration, their families, health care professionals, and the public. The foundation also expects to be actively involved in advocating for scientific research and for the rights of the people with macular degeneration. The money raised by the Macular Degeneration Association funds research, information programs, education, advocacy, and awareness efforts that will support the over 9.1 million people with macular degeneration in communities across America. For more information about the foundation please log onto www.maculardegenerationassociation.org. Thank you for your support.
Saturday, January 15, 2011
Age-Related Eye Disease Declining in U.S.
by: (HealthDay News)
The rate of age-related macular degeneration, a major cause of vision loss in the United States, has decreased in the last 15 years, a new study finds.
Researchers analyzed data from 7,081 people, aged 40 and older, who took part in the 2005 to 2008 National Health and Nutrition Examination Survey (NHANES). The participants were assessed for signs of age-related macular degeneration (AMD), and about 6.5 percent were found to have the disease.
The 1988 to 1994 NHANES found that the rate of AMD among Americans aged 40 and older was 9.4 percent, according to the study published in the January issue of the Archives of Ophthalmology.
This finding has important implications for public health, said Dr. Ronald Klein, of the University of Wisconsin School of Medicine and Public Health, and colleagues.
The most recent data also showed that blacks aged 60 and older had a lower rate of AMD than whites in the same age group, and that the rate of late (more advanced) AMD among all the participants was 0.8 percent.
"These [new] estimates are consistent with a decreasing incidence of AMD reported in another population-based study and have important public health implications," the researchers wrote in a journal news release.
"The decreasing prevalence of AMD may reflect recent change in the frequency of smoking and other exposures such as diet, physical activity and blood pressure associated with AMD," they suggested. "It remains to be seen whether public health programs designed to increase awareness of the relationships of these exposures to AMD in patients at risk and their physicians and eye care providers will continue to result in further decline of the prevalence of AMD in the United States.
The rate of age-related macular degeneration, a major cause of vision loss in the United States, has decreased in the last 15 years, a new study finds.
Researchers analyzed data from 7,081 people, aged 40 and older, who took part in the 2005 to 2008 National Health and Nutrition Examination Survey (NHANES). The participants were assessed for signs of age-related macular degeneration (AMD), and about 6.5 percent were found to have the disease.
The 1988 to 1994 NHANES found that the rate of AMD among Americans aged 40 and older was 9.4 percent, according to the study published in the January issue of the Archives of Ophthalmology.
This finding has important implications for public health, said Dr. Ronald Klein, of the University of Wisconsin School of Medicine and Public Health, and colleagues.
The most recent data also showed that blacks aged 60 and older had a lower rate of AMD than whites in the same age group, and that the rate of late (more advanced) AMD among all the participants was 0.8 percent.
"These [new] estimates are consistent with a decreasing incidence of AMD reported in another population-based study and have important public health implications," the researchers wrote in a journal news release.
"The decreasing prevalence of AMD may reflect recent change in the frequency of smoking and other exposures such as diet, physical activity and blood pressure associated with AMD," they suggested. "It remains to be seen whether public health programs designed to increase awareness of the relationships of these exposures to AMD in patients at risk and their physicians and eye care providers will continue to result in further decline of the prevalence of AMD in the United States.
Sunday, January 9, 2011
Alkeus Pharmaceuticals Licenses Novel Ophthalmologic Therapies from Columbia University with Applications in Dry-AMD and Stargardt's Disease
Source: Columbia Technology Ventures
Alkeus Pharmaceuticals and Columbia University announced today that they have entered into a license agreement for a set of potential therapies for the treatment of dry age-related macular degeneration (dry-AMD), Stargardt disease, and other degenerative diseases of the eye. Left untreated, these conditions often lead to impaired vision and even blindness.
Dr. Ilyas Washington, inventor of the technology and the Michael Jaharis Assistant Professor in the Department of Ophthalmology at Columbia University Medical Center, has found in preclinical testing that the compounds can reduce accumulation of certain toxic pigments in the eye. These pigments, which accumulate with age, are thought to be partially responsible for the vision loss associated with dry-AMD and Stargardt disease. Other conditions that can lead to impaired vision and are also associated with the accumulation of vitamin A aggregates may also be addressed, including Best’s disease and certain forms of retinitis pigmentosa and of cone rod dystrophy.
“We have developed a modified vitamin A with the hope of halting vision loss or even restoring ocular function,” Dr. Washington says. “Humans have evolved to make use of natural micronutrients or vitamins that regulate a wide variety of physiological functions. By altering the chemical structure of these vitamins, we can potentially regulate or enhance the biological processes that they control.”
Dr. Leonide Saad, Chief Executive Officer of Alkeus, explained, “These vitamin A aggregates accumulate in dry-AMD and, to an even faster extent, in Stargardt disease due to a genetic defect that exacerbates this process. Ilyas has elegantly shown, in a mouse model of Stargardt, that slightly changing vitamin A significantly reduces the rate of formation of these aggregates, eventually preserving visual function.
“While these results are at the preclinical stage, the way vitamin A interacts with the human body is very well understood and gives us confidence of the low risk and the high potential to tackle these serious ocular diseases,” said Dr. Saad.
Other therapeutic compositions have been evaluated to reduce the accumulation of these vitamin A aggregates employing more invasive techniques, but the compounds developed by Dr. Washington rely on a novel and innocuous mechanism of action that strengthens the specific chemical bonds that have to be broken in order to form these aggregates.
“The problem with other approaches is that they affect the way vitamin A is processed in the eye, which often results in visual side effects such as slowed dark adaptation, hallucinations and night blindness,” commented Dr. Saad.
“We are very pleased to be working with Alkeus for the continued development of these therapies. In Alkeus, we believe we have found the best partner to efficiently and effectively drive commercialization of these therapies,” said Donna See, who oversees portfolio strategy and marketing for Columbia Technology Ventures, the technology transfer office of Columbia University. “As yet, there is no therapy to address impaired vision resulting from dry-AMD, a condition which affects millions of people around the world. Perhaps even more urgent is a therapy for the children who are affected by Stargardt. We look forward to hopefully one day being able to offer a way to help these patients and their families.”
About dry age-related macular degeneration: Dry-AMD is the number one cause of blindness in the western world with several million Americans living with poor vision and at a high risk of turning blind. With the aging population, the number of patients with AMD is expected to double by 2020. Although dry-AMD symptoms progress more slowly than the wet form of the disease, dry-AMD represents nearly 90% of all the AMD cases in the United States, and remains without any treatment, contrary to wet-AMD which can be treated with periodic ocular injections.
About Stargardt disease: Stargardt disease is the most common form of inherited juvenile macular degeneration. It is a rare disease with a prevalence of one in 10,000 persons, or an estimated 30,000 people in the United States. Patients with Stargardt often start losing vision during their teenage years and will in most cases turn blind before becoming adults. As for dry-AMD, there is no treatment or cure.
About Columbia Technology Ventures
A leading academic and research university, Columbia University continually seeks to advance the frontiers of knowledge and to foster a campus community deeply engaged in understanding and addressing the complex global issues of our time. Columbia University's technology transfer office, Columbia Technology Ventures, manages Columbia's intellectual property portfolio and serves as the university's gateway for companies and entrepreneurs seeking novel technology solutions. Our core mission is to facilitate the transfer of inventions from academic research to outside organizations for the benefit of society on a local, national and global basis. For more information on Columbia Technology Ventures, please visit www.techventures.columbia.edu.
About Alkeus Pharmaceuticals
Alkeus is a clinical development biopharmaceutical company focused on developing new treatments for blindness and other serious ophthalmic conditions. Its lead compound, ALK-001, specifically addresses the excessive accumulation of toxic debris in the eyes of patients with dry age-related macular degeneration and Stargardt’s disease.
Alkeus Pharmaceuticals and Columbia University announced today that they have entered into a license agreement for a set of potential therapies for the treatment of dry age-related macular degeneration (dry-AMD), Stargardt disease, and other degenerative diseases of the eye. Left untreated, these conditions often lead to impaired vision and even blindness.
Dr. Ilyas Washington, inventor of the technology and the Michael Jaharis Assistant Professor in the Department of Ophthalmology at Columbia University Medical Center, has found in preclinical testing that the compounds can reduce accumulation of certain toxic pigments in the eye. These pigments, which accumulate with age, are thought to be partially responsible for the vision loss associated with dry-AMD and Stargardt disease. Other conditions that can lead to impaired vision and are also associated with the accumulation of vitamin A aggregates may also be addressed, including Best’s disease and certain forms of retinitis pigmentosa and of cone rod dystrophy.
“We have developed a modified vitamin A with the hope of halting vision loss or even restoring ocular function,” Dr. Washington says. “Humans have evolved to make use of natural micronutrients or vitamins that regulate a wide variety of physiological functions. By altering the chemical structure of these vitamins, we can potentially regulate or enhance the biological processes that they control.”
Dr. Leonide Saad, Chief Executive Officer of Alkeus, explained, “These vitamin A aggregates accumulate in dry-AMD and, to an even faster extent, in Stargardt disease due to a genetic defect that exacerbates this process. Ilyas has elegantly shown, in a mouse model of Stargardt, that slightly changing vitamin A significantly reduces the rate of formation of these aggregates, eventually preserving visual function.
“While these results are at the preclinical stage, the way vitamin A interacts with the human body is very well understood and gives us confidence of the low risk and the high potential to tackle these serious ocular diseases,” said Dr. Saad.
Other therapeutic compositions have been evaluated to reduce the accumulation of these vitamin A aggregates employing more invasive techniques, but the compounds developed by Dr. Washington rely on a novel and innocuous mechanism of action that strengthens the specific chemical bonds that have to be broken in order to form these aggregates.
“The problem with other approaches is that they affect the way vitamin A is processed in the eye, which often results in visual side effects such as slowed dark adaptation, hallucinations and night blindness,” commented Dr. Saad.
“We are very pleased to be working with Alkeus for the continued development of these therapies. In Alkeus, we believe we have found the best partner to efficiently and effectively drive commercialization of these therapies,” said Donna See, who oversees portfolio strategy and marketing for Columbia Technology Ventures, the technology transfer office of Columbia University. “As yet, there is no therapy to address impaired vision resulting from dry-AMD, a condition which affects millions of people around the world. Perhaps even more urgent is a therapy for the children who are affected by Stargardt. We look forward to hopefully one day being able to offer a way to help these patients and their families.”
About dry age-related macular degeneration: Dry-AMD is the number one cause of blindness in the western world with several million Americans living with poor vision and at a high risk of turning blind. With the aging population, the number of patients with AMD is expected to double by 2020. Although dry-AMD symptoms progress more slowly than the wet form of the disease, dry-AMD represents nearly 90% of all the AMD cases in the United States, and remains without any treatment, contrary to wet-AMD which can be treated with periodic ocular injections.
About Stargardt disease: Stargardt disease is the most common form of inherited juvenile macular degeneration. It is a rare disease with a prevalence of one in 10,000 persons, or an estimated 30,000 people in the United States. Patients with Stargardt often start losing vision during their teenage years and will in most cases turn blind before becoming adults. As for dry-AMD, there is no treatment or cure.
About Columbia Technology Ventures
A leading academic and research university, Columbia University continually seeks to advance the frontiers of knowledge and to foster a campus community deeply engaged in understanding and addressing the complex global issues of our time. Columbia University's technology transfer office, Columbia Technology Ventures, manages Columbia's intellectual property portfolio and serves as the university's gateway for companies and entrepreneurs seeking novel technology solutions. Our core mission is to facilitate the transfer of inventions from academic research to outside organizations for the benefit of society on a local, national and global basis. For more information on Columbia Technology Ventures, please visit www.techventures.columbia.edu.
About Alkeus Pharmaceuticals
Alkeus is a clinical development biopharmaceutical company focused on developing new treatments for blindness and other serious ophthalmic conditions. Its lead compound, ALK-001, specifically addresses the excessive accumulation of toxic debris in the eyes of patients with dry age-related macular degeneration and Stargardt’s disease.
Sunday, January 2, 2011
Obesity and Macular Degeneration
Self-Help Series ® 2011 Alexander
Larry J Alexander, OD FAAO
larryalexander@tx.rr.com
Introduction
The self-help series is designed to give doctors and patients some guidelines to help minimize the risk of vision-threatening eye diseases. While directed specifically at age-related macular degeneration (ARMD), these guidelines are also applicable to other eye and systemic disorders. All of us should be developing Therapeutic Lifestyle Changes (TLC).
Does Your Weight Affect Macular Degeneration?
Unfortunately the world is plagued by both starvation and by excesses. In the developed countries we all probably eat more than necessary and the things we eat are often inappropriate to sustain proper health. Obesity is a chronic disease that potentiates the development of all kinds of symptoms including macular degeneration.
Diet and weight definitely influence the development of macular degeneration. One very interesting study related that excessive consumption of corn bread was significantly related to vision loss in ARMD. 1 This relationship was the result of high dietary glycemic indices often related to excessive consumption of carbohydrates. 2-3 Glycemic index is a measure of your spike in blood sugar after consuming any food. A follow-up article in this series will discuss how to minimize your glycemic index.
Evidence also exists that obesity was a risk factor for visually significant ARM in men, in particular for dry ARM. 4 Further studies point to the fact that in women, early age-related maculopathy was significantly associated with both body mass index and waist-to-hip ratio, but more so waist-to-hip ratio. 5 One seemingly contrary report suggested that recent studies indicate that obesity is a probable risk factor for progression of ARMD, but there is no significant relation with the presence of ARMD. 6 Evidence exists that visceral obesity also contributes to the overall aging process by facilitating inflammation 7 that is likewise linked to macular degeneration. A very profound study found that middle-aged persons who had a 3% or greater reduction in Waist-Hip-Ratio over time were less likely to have ARMD, particularly among those who were initially obese. 8 More evidence has been presented that smoking, cardiovascular risk factors, use of calcium channel blockers, diabetes, and obesity are risk factors for late AMD in women. 9-11 Additional work has found that macular pigment (lutein and zeaxanthin) which helps protect the eye from developing macular degeneration is also lower in persons with excessive abdominal obesity and large waist circumference. 12-13 Further work emphasized that overall obesity and abdominal obesity increased the risk for progression to advanced ARMD, and more physical activity tended to decrease the risk. 14
Recommended Action to Help Yourself
In view of the overwhelming evidence we should all watch our weight and get as close as we can to the recommendations of our general physicians. Not only does weight affect our general health but excesses can likewise increase our risk for progression of macular degeneration. You can go to the national heart, lung and blood website http://www.nhlbisupport.com/bmi/ to calculate your body mass index to determine your personal weight situation.
References:
1. Holcomb CA. Consumption of carotenoid-rich foods and central vision loss: a matched case-controlled study in Kansas. J Nutr Elder 2004;24(1):1-18.
2. Chiu CJ, Milton RC, Klein R, Gensler G, Taylor A. Dietary carbohydrate and the progression of age-related macular degeneration: a prospective study from the Age-Related Eye Disease Study. Am J Clin Nutr 2007;86(4):1210-8.
3. Chiu CJ, Milton RC, Klein R, Gensler G, Taylor A. Association between dietary glycemic index and age-related macular degeneration in nondiabetic participants in the Age-Related Eye Disease Study. Am J Clin Nutr 2007;86(1):180-8.
4. Schaumberg DA, Christen WG, Hankinson SE, Glynn RJ. Body mass index and the incidence of visually significant age-related maculopathy in men.
Arch Ophthalmol. 2001 Sep;119(9):1259-65.
5. Klein BE, Klein R, Lee KE, Jensen SC. Measures of obesity and age-related eye diseases. Ophthalmic Epidemiol. 2001 Sep;8(4):251-62.
6. Moeini M, Masoudpour H, Ghanbari H. A study of the relation between body mass index and the incidence of age related macular degeneration. Br J Ophthalmol. 2005 Aug;89(8):964-6.
7. Ishida S. [Lifestyle-related diseases and anti-aging ophthalmology: suppression of retinal and choroidal pathologies by inhibiting renin-angiotensin system and inflammation] Nippon Ganka Gakkai Zasshi. 2009 Mar;113(3):403-22; discussion 423.
8. Peeters A, Magliano DJ, Stevens J, Duncan BB, Klein R, Wong TY. Changes in abdominal obesity and age-related macular degeneration: the Atherosclerosis Risk in Communities Study. Arch Ophthalmol. 2008 Nov;126(11):1554-60.
9. Klein R, Deng Y, Klein BE, Hyman L, Seddon J, Frank RN, Wallace RB, Hendrix SL, Kuppermann BD, Langer RD, Kuller L, Brunner R, Johnson KC, Thomas AM, Haan M. Cardiovascular disease, its risk factors and treatment, and age-related macular degeneration: Women's Health Initiative Sight Exam ancillary study. Am J Ophthalmol. 2007 Mar;143(3):473-83.
10. Schaumberg DA, Hankinson SE, Guo Q, Rimm E, Hunter DJ. A prospective study of 2 major age-related macular degeneration susceptibility alleles and interactions with modifiable risk factors. Arch Ophthalmol. 2007 Jan;125(1):55-62.
11. Fraser-Bell S, Wu J, Klein R, Azen SP, Hooper C, Foong AW, Varma R. Cardiovascular risk factors and age-related macular degeneration: the Los Angeles Latino Eye Study. Am J Ophthalmol. 2008 Feb;145(2):308-16.
12. Mares JA, LaRowe TL, Snodderly DM, Moeller SM, Gruber MJ, Klein ML, Wooten BR, Johnson EJ, Chappell RJ; CAREDS Macular Pigment Study Group and Investigators. Predictors of optical density of lutein and zeaxanthin in retinas of older women in the Carotenoids in Age-Related Eye Disease Study, an ancillary study of the Women's Health Initiative. Am J Clin Nutr. 2006 Nov;84(5):1107-22.
13. Johnson EJ. Obesity, lutein metabolism, and age-related macular degeneration: a web of connections. Nutr Rev. 2005 Jan;63(1):9-15.
14. Seddon JM, Cote J, Davis N, Rosner B. Progression of age-related macular degeneration: association with body mass index, waist circumference, and waist-hip ratio. Arch Ophthalmol. 2003 Jun;121(6):785-92.
Larry J Alexander, OD FAAO
larryalexander@tx.rr.com
Introduction
The self-help series is designed to give doctors and patients some guidelines to help minimize the risk of vision-threatening eye diseases. While directed specifically at age-related macular degeneration (ARMD), these guidelines are also applicable to other eye and systemic disorders. All of us should be developing Therapeutic Lifestyle Changes (TLC).
Does Your Weight Affect Macular Degeneration?
Unfortunately the world is plagued by both starvation and by excesses. In the developed countries we all probably eat more than necessary and the things we eat are often inappropriate to sustain proper health. Obesity is a chronic disease that potentiates the development of all kinds of symptoms including macular degeneration.
Diet and weight definitely influence the development of macular degeneration. One very interesting study related that excessive consumption of corn bread was significantly related to vision loss in ARMD. 1 This relationship was the result of high dietary glycemic indices often related to excessive consumption of carbohydrates. 2-3 Glycemic index is a measure of your spike in blood sugar after consuming any food. A follow-up article in this series will discuss how to minimize your glycemic index.
Evidence also exists that obesity was a risk factor for visually significant ARM in men, in particular for dry ARM. 4 Further studies point to the fact that in women, early age-related maculopathy was significantly associated with both body mass index and waist-to-hip ratio, but more so waist-to-hip ratio. 5 One seemingly contrary report suggested that recent studies indicate that obesity is a probable risk factor for progression of ARMD, but there is no significant relation with the presence of ARMD. 6 Evidence exists that visceral obesity also contributes to the overall aging process by facilitating inflammation 7 that is likewise linked to macular degeneration. A very profound study found that middle-aged persons who had a 3% or greater reduction in Waist-Hip-Ratio over time were less likely to have ARMD, particularly among those who were initially obese. 8 More evidence has been presented that smoking, cardiovascular risk factors, use of calcium channel blockers, diabetes, and obesity are risk factors for late AMD in women. 9-11 Additional work has found that macular pigment (lutein and zeaxanthin) which helps protect the eye from developing macular degeneration is also lower in persons with excessive abdominal obesity and large waist circumference. 12-13 Further work emphasized that overall obesity and abdominal obesity increased the risk for progression to advanced ARMD, and more physical activity tended to decrease the risk. 14
Recommended Action to Help Yourself
In view of the overwhelming evidence we should all watch our weight and get as close as we can to the recommendations of our general physicians. Not only does weight affect our general health but excesses can likewise increase our risk for progression of macular degeneration. You can go to the national heart, lung and blood website http://www.nhlbisupport.com/bmi/ to calculate your body mass index to determine your personal weight situation.
References:
1. Holcomb CA. Consumption of carotenoid-rich foods and central vision loss: a matched case-controlled study in Kansas. J Nutr Elder 2004;24(1):1-18.
2. Chiu CJ, Milton RC, Klein R, Gensler G, Taylor A. Dietary carbohydrate and the progression of age-related macular degeneration: a prospective study from the Age-Related Eye Disease Study. Am J Clin Nutr 2007;86(4):1210-8.
3. Chiu CJ, Milton RC, Klein R, Gensler G, Taylor A. Association between dietary glycemic index and age-related macular degeneration in nondiabetic participants in the Age-Related Eye Disease Study. Am J Clin Nutr 2007;86(1):180-8.
4. Schaumberg DA, Christen WG, Hankinson SE, Glynn RJ. Body mass index and the incidence of visually significant age-related maculopathy in men.
Arch Ophthalmol. 2001 Sep;119(9):1259-65.
5. Klein BE, Klein R, Lee KE, Jensen SC. Measures of obesity and age-related eye diseases. Ophthalmic Epidemiol. 2001 Sep;8(4):251-62.
6. Moeini M, Masoudpour H, Ghanbari H. A study of the relation between body mass index and the incidence of age related macular degeneration. Br J Ophthalmol. 2005 Aug;89(8):964-6.
7. Ishida S. [Lifestyle-related diseases and anti-aging ophthalmology: suppression of retinal and choroidal pathologies by inhibiting renin-angiotensin system and inflammation] Nippon Ganka Gakkai Zasshi. 2009 Mar;113(3):403-22; discussion 423.
8. Peeters A, Magliano DJ, Stevens J, Duncan BB, Klein R, Wong TY. Changes in abdominal obesity and age-related macular degeneration: the Atherosclerosis Risk in Communities Study. Arch Ophthalmol. 2008 Nov;126(11):1554-60.
9. Klein R, Deng Y, Klein BE, Hyman L, Seddon J, Frank RN, Wallace RB, Hendrix SL, Kuppermann BD, Langer RD, Kuller L, Brunner R, Johnson KC, Thomas AM, Haan M. Cardiovascular disease, its risk factors and treatment, and age-related macular degeneration: Women's Health Initiative Sight Exam ancillary study. Am J Ophthalmol. 2007 Mar;143(3):473-83.
10. Schaumberg DA, Hankinson SE, Guo Q, Rimm E, Hunter DJ. A prospective study of 2 major age-related macular degeneration susceptibility alleles and interactions with modifiable risk factors. Arch Ophthalmol. 2007 Jan;125(1):55-62.
11. Fraser-Bell S, Wu J, Klein R, Azen SP, Hooper C, Foong AW, Varma R. Cardiovascular risk factors and age-related macular degeneration: the Los Angeles Latino Eye Study. Am J Ophthalmol. 2008 Feb;145(2):308-16.
12. Mares JA, LaRowe TL, Snodderly DM, Moeller SM, Gruber MJ, Klein ML, Wooten BR, Johnson EJ, Chappell RJ; CAREDS Macular Pigment Study Group and Investigators. Predictors of optical density of lutein and zeaxanthin in retinas of older women in the Carotenoids in Age-Related Eye Disease Study, an ancillary study of the Women's Health Initiative. Am J Clin Nutr. 2006 Nov;84(5):1107-22.
13. Johnson EJ. Obesity, lutein metabolism, and age-related macular degeneration: a web of connections. Nutr Rev. 2005 Jan;63(1):9-15.
14. Seddon JM, Cote J, Davis N, Rosner B. Progression of age-related macular degeneration: association with body mass index, waist circumference, and waist-hip ratio. Arch Ophthalmol. 2003 Jun;121(6):785-92.
Monday, December 27, 2010
Small Steps to Healthy Eyes
by:Reuters
People who lead an overall healthy life by exercising, eating right and not smoking, run a significantly lower risk of eye degeneration, a major cause of visual impairment in older adults, says a study.
Exercise and diet each reduced the risk, but both combined, along with a lack of smoking,caused the risk for age-related macular degeneration (AMD) to fall by more than 70%, says study author Julie Mares, at the University of Wisconsin in Madison. “Relatively small things could make a difference,” said Mares.
Macular degeneration can make it difficult or impossible to read or recognize faces. For the study, published in Archives of Ophthalmology, researchers reviewed information about diet, exercise and smoking from 1,313 women between the ages of 55 and 74.
The results showed that even 10 hours per week of light exercise, including housework, gardening and walking — or 8 hours of moderate exercise a week, lowered the risk of AMD since diet and exercise lower blood pressure, which can protect the eyes from degeneration
People who lead an overall healthy life by exercising, eating right and not smoking, run a significantly lower risk of eye degeneration, a major cause of visual impairment in older adults, says a study.
Exercise and diet each reduced the risk, but both combined, along with a lack of smoking,caused the risk for age-related macular degeneration (AMD) to fall by more than 70%, says study author Julie Mares, at the University of Wisconsin in Madison. “Relatively small things could make a difference,” said Mares.
Macular degeneration can make it difficult or impossible to read or recognize faces. For the study, published in Archives of Ophthalmology, researchers reviewed information about diet, exercise and smoking from 1,313 women between the ages of 55 and 74.
The results showed that even 10 hours per week of light exercise, including housework, gardening and walking — or 8 hours of moderate exercise a week, lowered the risk of AMD since diet and exercise lower blood pressure, which can protect the eyes from degeneration
Subscribe to:
Posts (Atom)
