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Dr Sharma Diagnostics



Macular Degeneration

(Excerpt from ‘Live Longer, Live Younger’)

The macula is found at the centre of the retina at the back of the eye. It is a conglomeration of rods and cones – the nervous system’s receptors for light – and is responsible for fine vision.

Macular (the ‘r’ is conventionally added when describing disease of this area of the eye) degeneration is mostly an age related condition (AMD) where the macula area is damaged, usually by decreased blood supply through the ageing of arteries, arteriosclerosis, diabetes or high blood pressure.

There are two defined types, Dry AMD and Wet AMD,

Dry AMD is the most common form and occurs in about 90 percent of those with the condition. Yellow material called Drusen products form, although why is not fully explained, in the retina. The likely explanation is reduced blood flow allowing free radical (oxidative) damage to occur or a lack of oxygen and nutrients causes changes

Wet AMD is associated with the development of abnormal blood vessels behind the retina and under the macula and develops after the dry form in 10% of people with the condition. These new blood vessels form probably in an attempt to increase failing blood flow but tend to be fragile and leak blood. This causes the macula to swell and pressurises the nerves causing irreparable damage.

Dry AMD may have very few symptoms in the early stages but as the disease progresses blurred vision is the most common symptom of dry as well as things may not appearing to be as bright as they used to be. More light is needed for reading or fine, delicate finger manoeuvres. Later on peripheral vision is utilised – people start turning their heads to look at things from a side angle.


Treatment options

  • Injections. In wet MD, abnormally high levels of a compound known as vascular endothelial growth factor (VEGF) is found in the eyes. This substance promotes the growth of new abnormal blood vessels. Anti-VEGF injection therapy blocks this. Frequent and repeated injections, even monthly may be needed.

  • Laser Therapy with or without Photodynamic therapy. A drug called Verteporfin is injected into a vein in your arm. The drug travels to new, abnormal blood vessels and these are highlighted in your eye. A laser beam is then shone into your eye which activates this drug and destroys the new blood vessels in the hope of slowing the rate of vision loss. The procedure takes about 20 minutes. It is extremely important to have any visual deterioration examined by a specialist as soon as it is noticed. Do not delay, an earlier diagnosis leads to earlier treatment.

Naturopathic Options

Nutritional

Aim at low fat, low sugar diet full of vegetables to provide antioxidant benefit and encouragement of improved blood vasculature.Cherries, Blueberry or billberry contain anthocyanidins (Klin Monbl Augenheilkd. 2009 Apr;226(4):216-9. Epub 2009 Apr 21)


Supplemental

These are often found in combinations. Use citrate or food state form to avoid pharmaceutical products if at all possible.


Vitamins

Vitamin A and beta carotene
Vitamin C
Vitamin E


Minerals

Selenium (200µg daily),
Zinc (10mg three times a day)


Amino Acid

Taurine


Other nutrients

Lutein
Zeaxanthin
Anthocyanadins
Ginkgo biloba
  • A special mention should be made of Melatonin. Both forms of AMD seem to benefit from Melatonin and it appears more effective than current injection treatments which are the gold standard. (Annals of the New York Academy of Sciences, Volume1057;384-392, December 2005).
  • http://onlinelibrary.wiley.com/doi/10.1196/


MELATONIN

Specially trained, medically qualified practitioners can offer intravenous infusions of some of the above nutrients possibly at frequent dosages. No long term or large studies have been published but many, many centres offer this and it is one of those conditions that I prescribe IV treatment for sooner than later.

Scientific papers and references on AMD can be read on line here http://vitasearch.dyndns.info/search?sort=date%3AD%3AL%3Ad1

I recommend a selection of supplements to be taken orally each day. I also give some of these by IV infusions initially on a weekly basis for 6 – 10 weeks depending on the benefits perceived and on ophthalmic opinion through examination.

Here is a brief summary from a USA based I specialist centre discussing the various intravenous therapies available. http://www.healingtheeye.com/iv-therapies.html




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