Does High-Dose Supplementation with Vitamins C and E, Beta Carotene, and Zinc Slow the Progression of Age-Related Macular Degeneration and Vision Loss?

2020 ◽  
pp. 219-224
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
Macular Degeneration ◽  
Vision Loss ◽  
Beta Carotene ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
High Dose ◽  
Age Related ◽  
Intermediate Size ◽  
Zinc Supplements ◽  
Disease Study

The Age-Related Eye Disease Study (AREDS) was a randomized, double-masked, clinical trial with two components, an age-related macular degeneration (AMD) trial and a cataract trial. This paper reports the results of the AMD trial, which was designed to determine the effect of high-dose vitamins C and E, beta carotene, and zinc supplements on the progression of AMD and vision loss. Based on the study findings, the authors recommended that individuals fifty-five years of age and older with extensive intermediate size drusen, at least one large druse, noncentral geographic atrophy in one or both eyes, or advanced AMD or vision loss due to AMD in one eye, and without contraindications such as smoking, should consider taking a supplement of antioxidants (consisting of vitamin C and E and beta carotene) plus zinc.

Non-Nutritional Medical Treatments in Dry-Form (Non-Neovascular) Age-Related Macular Degeneration

2017 ◽  
pp. 145-148
Keyword(s):  
Macular Degeneration ◽  
Vision Loss ◽  
The Elderly ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Medical Treatments ◽  
Age Related ◽  
Dry Amd ◽  
Disease Study ◽  
Developed World

Age-related macular degeneration (AMD) is the major cause of blindness for the elderly population in the developed world. Although vision loss is mainly due to the neovascular form, dry AMD remains a challenge for ophthalmologists because of the lack of effective therapies. The Age-Related Eye Disease Study (AREDS) demonstrated the protective effect of dietary supplementation of antioxidants to slow down the progression of dry AMD. On the other hand, there has been no proven drug treatment for dry AMD to date. This review is aimed to discuss recent non-nutritional treatments for dry AMD and geographic atrophy.

scholarly journals Ophthalmic artery angioplasty for age-related macular degeneration

2022 ◽  
pp. neurintsurg-2021-018222
Author(s):  
Ivan Lylyk ◽  
Carlos Bleise ◽  
Pedro N Lylyk ◽  
Nicolas Perez ◽  
Javier Lundquist ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Late Stage ◽  
Ophthalmic Artery ◽  
Vision Loss ◽  
Retinal Pigment ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Patient Reports ◽  
Age Related ◽  
Clinically Significant

BackgroundThere is considerable overlap of contributors to cardiovascular disease and the development of age-related macular degeneration (AMD). Compromised ocular microcirculation due to aging and vascular disease contribute to retinal dysfunction and vision loss. Decreased choroidal perfusion is evident in eyes with dry AMD and is thought to play a role in retinal pigment epithelial dysfunction, the rate of development of geographic atrophy, and the development of neovascularization. The aim of the study was to demonstrate that AMD is correlated with a compromised blood flow in the ocular pathway and show OA angioplasty as a potential treatment of late-stage AMD.MethodsBased on the potential for the ophthalmic artery (OA) to be an anatomical target for the treatment of AMD as outlined above, five patients were found to be eligible for compassionate use treatment, presenting clinically significant late-stage AMD with profound vision loss in one or both eyes, and are included in this retrospective study.ResultsOA narrowing, or significant calcium burden at the ophthalmic segment of the internal carotid artery compromising the origin of the OA was confirmed in all cases. Subsequent OA cannulation was achieved in all patients with some difficulty. Subjective patient reports indicated that all patients perceived a benefit following the procedure; however, improved postoperative visual acuity did not confirm that perceived benefit for one of the patients.ConclusionsFeasibility and safety of the OA angioplasty were demonstrated, and a benefit perceived in five patients with profound vision loss and a desire to achieve improved quality of life. A clinical trial with controlled schedule, imaging, and methodologies is needed to confirm these results.

High-Dose Supplementation with Vitamins C and E and Beta Carotene for Age-Related Cataract and Vision Loss

2020 ◽  
pp. 39-44
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
Visual Acuity ◽  
Vision Loss ◽  
Beta Carotene ◽  
High Dose ◽  
Age Related ◽  
History Of ◽  
Visual Acuity Loss ◽  
Lens Opacities ◽  
Antioxidant Characteristics ◽  
Disease Study

The Age-Related Eye Disease Study (AREDS) was a multicenter study of the natural history of age-related cataract and macular degeneration (AMD) in a relatively well-nourished older adult cohort that comprised two clinical trials sharing one pool of participants. The study was designed to determine whether a high-dose antioxidant formulation affected the development and progression of age-related lens opacities and visual acuity loss. The cataract trial showed that use of a high-dose formulation of vitamins having antioxidant characteristics (vitamin C, vitamin E, and beta carotene) had no apparent effect on the 7-year risk of development or progression of age-related lens opacities or visual acuity loss.

scholarly journals Genetic risk factors for late age-related macular degeneration in India

2017 ◽  
Vol 102 (9) ◽  
pp. 1213-1217 ◽  
Author(s):  
Anand Rajendran ◽  
Pankaja Dhoble ◽  
Periasamy Sundaresan ◽  
Vijayan Saravanan ◽  
Praveen Vashist ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Population Based ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Nucleotide Polymorphisms ◽  
Limited Data ◽  
Genetic Determinants ◽  
Single Nucleotide ◽  
Age Related ◽  
Disease Study

Background/AimsThere are limited data from India on genetic variants influencing late age-related macular degeneration (AMD). We have previously reported associations from a population-based study in India (the India age-related eye disease study (INDEYE)) of early AMD and single nucleotide polymorphisms (SNPs) in ARMS2/HTRA1 and no association with CFH, C2 or CFB. Late AMD cases were too few for meaningful analyses. We aimed to investigate SNPs for late AMD through case enrichment and extend the loci for early AMD.MethodsFundus images of late AMD hospital cases were independently graded by the modified Wisconsin AMD grading scheme. In total 510 cases with late AMD (14 geographic atrophy and 496 neovascular AMD (nvAMD)), 1876 with early AMD and 1176 with no signs of AMD underwent genotyping for selected SNPs. We investigated genotype and per-allele additive associations (OR and 95% CIs) with nvAMD or early AMD. Bonferroni adjusted P values are presented.ResultsWe found associations with nvAMD for CFHY402H variant (rs1061170) (OR=1.99, 95% CI 1.67 to 2.37, P=10−6), ARMS2 (rs10490924) (OR=2.94, 95% CI 2.45 to 3.52, P=10−9), C2 (rs547154) (OR=0.67, 95% CI 0.53 to 0.85, P=0.01), ABCA1 (rs1883025) (OR=0.77, 95% CI 0.65 to 0.92, P=0.04) and an SNP near VEGFA (rs4711751) (OR=0.64, 95% CI 0.54 to 0.77, P=10−3). We found no associations of TLR3 (rs3775291), CFD (rs3826945), FRK (rs1999930) or LIPC (rs10468017) or APOE ε4 alleles with nvAMD or early AMD, nor between early AMD and rs1883025 or rs4711751.ConclusionsThe major genetic determinants of nvAMD risk in India are similar to those in other ancestries, while findings for early AMD suggest potential differences in the pathophysiology of AMD development.

scholarly journals New and Innovative Treatments for Neovascular Age-Related Macular Degeneration (nAMD)

2021 ◽  
Vol 10 (11) ◽  
pp. 2436
Author(s):  
Prem Patel ◽  
Veeral Sheth
Keyword(s):  
Macular Degeneration ◽  
Randomized Clinical Trials ◽  
Vision Loss ◽  
Standard Of Care ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Neovascular Amd ◽  
Current Standard ◽  
Combination Strategies ◽  
Age Related

Age-related macular degeneration (AMD) is one of the most common causes of vision loss. Advanced forms of AMD are seen in primarily two types—neovascular AMD (nAMD) with the presence of choroid neovascularization and non-neovascular AMD (nnAMD) with geographic atrophy. Neovascular AMD is characterized by choroidal neovascularization (CNV), which leads to a cascade of complications, including exudation, leakage, and ultimately fibrosis with photoreceptor loss. Inhibition of VEGF represents the current standard of care. However, there is a tremendous gap between the outcomes in randomized clinical trials and real-world settings. New agents for nAMD might offer the potential to improve treatment outcomes and reduce treatment of frequent intravitreal injections. We summarize all the newer molecules, their pivotal clinical trial results, and their unique mechanisms of action; these include longer-acting agents, combination strategies, sustained release, and genetic therapies.

scholarly journals Imaging and artificial intelligence for progression of age-related macular degeneration

2021 ◽  
pp. 153537022110315
Author(s):  
Kathleen Romond ◽  
Minhaj Alam ◽  
Sasha Kravets ◽  
Luis de Sisternes ◽  
Theodore Leng ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Machine Learning ◽  
Macular Degeneration ◽  
Vision Loss ◽  
External Validation ◽  
Geographic Atrophy ◽  
Age Related Macular Degeneration ◽  
Learning Approaches ◽  
Imaging Data ◽  
Age Related

Age-related macular degeneration (AMD) is a leading cause of severe vision loss. With our aging population, it may affect 288 million people globally by the year 2040. AMD progresses from an early and intermediate dry form to an advanced one, which manifests as choroidal neovascularization and geographic atrophy. Conversion to AMD-related exudation is known as progression to neovascular AMD, and presence of geographic atrophy is known as progression to advanced dry AMD. AMD progression predictions could enable timely monitoring, earlier detection and treatment, improving vision outcomes. Machine learning approaches, a subset of artificial intelligence applications, applied on imaging data are showing promising results in predicting progression. Extracted biomarkers, specifically from optical coherence tomography scans, are informative in predicting progression events. The purpose of this mini review is to provide an overview about current machine learning applications in artificial intelligence for predicting AMD progression, and describe the various methods, data-input types, and imaging modalities used to identify high-risk patients. With advances in computational capabilities, artificial intelligence applications are likely to transform patient care and management in AMD. External validation studies that improve generalizability to populations and devices, as well as evaluating systems in real-world clinical settings are needed to improve the clinical translations of artificial intelligence AMD applications.

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