scholarly journals A Randomized Study of Nutritional Supplementation in Patients with Unilateral Wet Age-Related Macular Degeneration

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1253
Author(s):  
Alfredo García-Layana ◽  
Sergio Recalde ◽  
Maria Hernandez ◽  
Maximino J. Abraldes ◽  
João Nascimento ◽  
...  

The purpose of this study is evaluate the efficacy and safety of medicinal products containing the original Age-Related Eye Disease group (AREDS) formulation at doses approved in Europe (EU, control group; n = 59) with a product that adds DHA, lutein, zeaxanthin, resveratrol and hydroxytyrosol to the formula (intervention group; n = 50). This was a multicenter, randomized, observer-blinded trial conducted in patients aged 50 years or older diagnosed with unilateral exudative Age related Macular Degeneration AMD. At month 12, the intervention did not have a significant differential effect on visual acuity compared with the control group, with an estimated treatment difference in Early Treatment Diabetic Retinopathy Study (ETDRS) of −1.63 (95% CI −0.83 to 4.09; p = 0.192). The intervention exhibited a significant and, in most cases, relevant effect in terms of a reduction in some inflammatory cytokines and a greater improvement in the fatty acid profile and serum lutein and zeaxantin concentration. In patients with unilateral wet AMD, the addition of lutein, zeaxanthin, resveratrol, hydroxytyrosol and DHA to the AREDS EU recommended doses in the short-term did not have a differential effect on visual acuity compared to a standard AREDS EU formula but, in addition to improving the fatty acid profile and increasing carotenoid serum levels, may provide a beneficial effect in improving the proinflammatory and proangiogenic profile of patients with AMD.

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Eva Rencová ◽  
Milan Bláha ◽  
Jan Studnička ◽  
Vladimír Bláha ◽  
Miriam Lánská ◽  
...  

Aim. To evaluate the long-term effect of rheohemapheresis (RHF) treatment of age-related macular degeneration (AMD) on photoreceptor IS/OS junction status.Methods. In our study, we followed 24 patients with dry AMD and drusenoid retinal pigment epithelium detachment (DPED) for a period of more than 2.5 years. Twelve patients (22 eyes) were treated by RHF and 12 controls (18 eyes) were randomized. The treated group underwent 8 RHF standardized procedures. We evaluated best-corrected visual acuity, IS/OS junction status (SD OCT), and macular function (multifocal electroretinography) at baseline and at 2.5-year follow-up.Results. RHF caused a decrease of whole-blood viscosity/plasma viscosity at about 15/12%. BCVA of treated patients increased insignificantlyP=0.187from median 74.0 letters (56.2 to 81.3 letters) to median 79.0 letters (57.3 to 83.4 letters), but it decreased significantly from 74.0 letters (25.2 to 82.6 letters) to 72.5 letters (23.4 to 83.1 letters) in the control groupP=0.041. The mfERG responses in the region of eccentricity between 1.8° and 7° were significantly higher in treated patientsP=0.04.Conclusions. RHF contributed to sparing of photoreceptor IS/OS junction integrity in the fovea, which is assumed to be a predictive factor for preservation of visual acuity.


2012 ◽  
Vol 93 (6) ◽  
pp. 994-996
Author(s):  
F R Saifullina ◽  
R Z Sharafieva ◽  
V I Pogorel’tsev ◽  
F M Fayzrahmanova ◽  
E A Abdulaeva

Aim. To assess the antioxidant capacity in patients with the «dry» form of age-related macular degeneration before and after combined treatment with polarized polychromatic non-coherent light and dynamic electromyostimulation. Methods. Two groups of patients with the «dry» form of age-related macular degeneration were examined. 40 patients (80 eyes) from the main group were treated using combined treatment and 39 patients (78 eyes) in the group of control who were treated conventionally. The integral blood antioxidant capacity was measured by galvanometry. Results. Blood antioxidant capacity in healthy subjects is 26.0 kC/l. In patients of the main group blood antioxidant capacity before the treatment was equal to 22.81±0.27 kC/l, compared to 22.17±0.20 kC/l in control group (total mean value 22.49±0.27 kC/l). There was a relevant elevation of the blood antioxidant capacity at the late stages after the treatment - up to 12 months, compared to only 2 months in the control group. Visual acuity in patients of the main group before the treatment was 0.87±0.02, after the treatment was finished - 0.96±0,01 (p 0.001), 2 months after the treatment - 0.95±0.01 (p 0.001), 6 months after the treatment - 0.96±0.01 (p 0.001), 12 months after the treatment - 0.95±0.01 (p 0.001). Visual acuity in patients of the control group before the treatment was 0.91±0.02, after the treatment was finished - 0.95±0.02 (p 0.05), 2 months after the treatment - 0.94±0.02 (p 0.05), 6 months after the treatment - 0.92±0.02 (p 0.05). 12 months after the treatment the visual acuity deteriorated compared to the treatment start and was measured as 0.89±0.02. Conclusion. There is a decrease of blood antioxidant capacity (22.49±0.27 kC/l) in patients with the «dry» form of age-related macular degeneration; a relevant increase of blood antioxidant capacity and visual acuity can be observed up to 12 months after the treatment with polarized polychromatic non-coherent light and dynamic electromyostimulation.


Author(s):  
George W. Rozakis ◽  
Brian A. Bakke

The objective of the Hormones, Oxidative stress, Methylation, Inflammation and Gene expression (HOMING) trial was to assess the efficacy of personalized bio identical hormone, dietary supplement and nutritional care plans on dry and wet Age-related Macular Degeneration (AMD) outcomes.  We evaluated 220 Age-related Macular Degeneration (AMD) patients that followed a personalized clinical care plan for up to 9 months.   The care plans consisted of bio identical hormones, dietary supplements and nutrition recommendations with the objective to improve lab and clinical measurements linked to oxidative stress, inflammation and gene expression.  Serum concentrations of CRP, HbA1c and homocysteine responded favorably to the HOMING protocol with full program compliance. Sixty percent (42/70) of wet AMD patients reported improvement in visual acuity and/or a reduction in the frequency of anti-VEGF injections during the study period.  Forty eight percent (44/92) of dry AMD patients reported improvement in visual acuity during the study period.  Nine percent (4/45) patients reported improvement in visual acuity in the dry AMD control group and no (0/13) wet AMD patients in the control group reported improvement.  Six percent (4/70) of wet AMD patients reported that their vision declined and/or that their F frequency increased during the study period.  Five percent (4/92) of dry AMD patients reported that their vision was worse.  Keywords:  Bio identical Hormones, Oxidative stress, Methylation, Inflammation, Gene Expression, Nutrition and AMD.


2014 ◽  
Vol 7 (4) ◽  
pp. 27-32
Author(s):  
Yuriy Sergeyevich Astakhov ◽  
Nikita Yur’yevich Dal’ ◽  
Natal’ya Viktorovna Chistyakova

Many patients with wet age-related macular degeneration (AMD) also have a cataract in the same eye. Because there is a theoretical risk of progression of the degenerative processes in the macular area after surgical lens removal, this raises some ethical, clinical and economical questions for ophthalmologists. The purpose of the study was to compare the course of wet AMD in eyes with incipient cataract and the course in eyes after surgical cataract removal. Materials and methods: 135 eyes with wet AMD, 48 eyes - treated group - were subjects to phacoemulsification during the study, 87 eyes - control group - with incipient cataract without indications for surgery. Regular visits every 1.5 months during 2 years of follow-up with visual acuity testing, central retinal thickness analysis by optical coherence tomography (OCT). Anti-VEGF injections were performed according to a PRN regimen. Results: there was no statistically significant difference in visual acuity, central retinal thickness, intravitreal injection frequency between both groups during the study period. Conclusions: No influence of phacoemulsification on the wet AMD course was found.


2021 ◽  
Vol 57 (1) ◽  
pp. 34
Author(s):  
Indriani Kartika Dewi ◽  
Moestidjab Moestidjab ◽  
Titut Harnanik

This study was to compare the effectiveness of hyperbaric oxygen therapy (HBOT) on contrast and macular light sensitivity improvement in dry type age-related macular degeneration (AMD) patients. The subjects were eyes that had been diagnosed with dry type AMD which met inclusion criteria. The subjects were divided into two groups. The first group was given antioxidants and HBOT. The second group was given only antioxidants. Contrast and macular light sensitivity test were done using MARS contrast sensitivity chart and Humphrey Field Analyzer-3 for three times, pre-therapy, day-1 and 14 post- therapy. This study found that 25 eyes were included for analysis, 14 subjects in first group, and 11 subjects in second group. Statistical analysis results showed that there were significant increase on contrast sensitivity in intervention group between one-day post-therapy with pre-therapy, P = 0.003 (P <0.05), and between 14-days post-therapy with pre-therapy, P = 0,015 (P <0.05). From pre- and post-analysis, there were no significant difference found on contrast sensitivity in control group and macular light sensitivity in intervention group. In control group, there were significant increase on superotemporal, superonasal, and inferonasal area between one-day post-therapy and pra-therapy with P = 0.004, P = 0.013 and P = 0.008 (P <0.05), respectively, and there was significant decrease on inferonasal area between 14-days post-therapy and one-day post-therapy, P = 0.003 (P <0.05). In conclusion, patients with AMD who were subjected to HBOT achieved improvement in contrast sensitivity in cases considered as having low prognosis. HBOT should be considered as promising intervention for AMD management adjuvant and further research are needed to find optimal dosage.


2016 ◽  
Vol 10 ◽  
Author(s):  
Abbas Riazi ◽  
Yunes Panahi ◽  
Ali Agha Alishiri ◽  
Mohammad Ahmad Hosseini ◽  
Ali Akbar Karimi Zarchi ◽  
...  

The aim was to evaluate the impact of saffron supplementation on visual function in patients with dry age-related macular degeneration (ARMD). Fifty-four participants, 23 male and 31 female, with dry ARMD were assigned to one of the following two groups. The treatment group (n=29) consumed 50 mg saffron daily during a 3- month period, while 25 subjects served as the control group. Visual acuity, contrast sensitivity, and retinal thickness were measured at the beginning and at the end of the study. Quality of life was evaluated using the Melbourne Low Vision Index (MLVI) before and after treatment. Significant increases in visual acuity and contrast sensitivity were found in the saffron group but not in the control group. Changes in macular thickness were not statistically different between the two groups. Short-term consumption of saffron may slow down the progression of disease and improve visual function, especially contrast sensitivity, in patients with dry ARMD.


2014 ◽  
Vol 7 (4) ◽  
pp. 13-21
Author(s):  
Yuriy Sergeyevich Astakhov ◽  
Gassan Basharovich Shaar ◽  
Nikita Yur’yevich Dal’

Purpose. To study the effects of vitrectomy on the course of wet age-related macular degeneration (AMD). Materials and methods. 99 patients (99 eyes) with wet AMD associated with vitreo-macular adhesion or posterior hyaloid traction were included in the study. During the first 6 months, all patients received anti-VEGF treatment according to a PRN regimen. Then, they were divided into two groups: in 45 patients vitrectomy was performed and 54 patients did not receive surgical treatment. The follow-up period duration was one year. Results. At the beginning of the study, visual acuity was 0.27 ± 0.17 in the control group, and 0.17 ± 0.15 in the treatment group. Most prominent differences in visual acuity between the two groups were observed during the first 6 months (visual acuity in the treatment group before surgery was 0.12 ± 0.1) (p < 0.01 and p < 0.001), at the same time during the following 6 follow-up months, this difference decreased (p < 0.05 and p < 0.01). 1 year from the study start, visual acuity in the control group was 0.24 ± 0.17, and 0.17 ± 0.13 in the treatment one. Conclusions. Vitrectomy surgery in patients with wet AMD in association with vitreo-macular adhesion or posterior hyaloid traction does not exacerbate the disease course, stabilizes visual functions and improves the quality of life.


2019 ◽  
Vol 4 (1) ◽  
pp. e000273
Author(s):  
Irina Balikova ◽  
Laurence Postelmans ◽  
Brigitte Pasteels ◽  
Pascale Coquelet ◽  
Janet Catherine ◽  
...  

ObjectiveAge-related macular degeneration (ARMD) is a leading cause of visual impairment. Intravitreal injections of anti-vascular endothelial growth factor (VEGF) are the standard treatment for wet ARMD. There is however, variability in patient responses, suggesting patient-specific factors influencing drug efficacy. We tested whether single nucleotide polymorphisms (SNPs) in genes encoding VEGF pathway members contribute to therapy response.Methods and analysisA retrospective cohort of 281 European wet ARMD patients treated with anti-VEGF was genotyped for 138 tagging SNPs in the VEGF pathway. Per patient, we collected best corrected visual acuity at baseline, after three loading injections and at 12 months. We also registered the injection number and changes in retinal morphology after three loading injections (central foveal thickness (CFT), intraretinal cysts and serous neuroepithelium detachment). Changes in CFT after 3 months were our primary outcome measure. Association of SNPs to response was assessed by binomial logistic regression. Replication was attempted by associating visual acuity changes to genotypes in an independent Japanese cohort.ResultsAssociation with treatment response was detected for seven SNPs, including in FLT4 (rs55667289: OR=0.746, 95% CI 0.63 to 0.88, p=0.0005) and KDR (rs7691507: OR=1.056, 95% CI 1.02 to 1.10, p=0.005; and rs2305945: OR=0.963, 95% CI 0.93 to 1.00, p=0.0472). Only association with rs55667289 in FLT4 survived multiple testing correction. This SNP was unavailable for testing in the replication cohort. Of six SNPs tested for replication, one was significant although not after multiple testing correction.ConclusionIdentifying genetic variants that define treatment response can help to develop individualised therapeutic approaches for wet ARMD patients and may point towards new targets in non-responders.


Metabolites ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 183
Author(s):  
Kevin M Mendez ◽  
Janice Kim ◽  
Inês Laíns ◽  
Archana Nigalye ◽  
Raviv Katz ◽  
...  

The purpose of this study was to analyze the association between plasma metabolite levels and dark adaptation (DA) in age-related macular degeneration (AMD). This was a cross-sectional study including patients with AMD (early, intermediate, and late) and control subjects older than 50 years without any vitreoretinal disease. Fasting blood samples were collected and used for metabolomic profiling with ultra-performance liquid chromatography–mass spectrometry (LC-MS). Patients were also tested with the AdaptDx (MacuLogix, Middletown, PA, USA) DA extended protocol (20 min). Two measures of dark adaptation were calculated and used: rod-intercept time (RIT) and area under the dark adaptation curve (AUDAC). Associations between dark adaption and metabolite levels were tested using multilevel mixed-effects linear modelling, adjusting for age, gender, body mass index (BMI), smoking, race, AMD stage, and Age-Related Eye Disease Study (AREDS) formulation supplementation. We included a total of 71 subjects: 53 with AMD (13 early AMD, 31 intermediate AMD, and 9 late AMD) and 18 controls. Our results revealed that fatty acid-related lipids and amino acids related to glutamate and leucine, isoleucine and valine metabolism were associated with RIT (p < 0.01). Similar results were found when AUDAC was used as the outcome. Fatty acid-related lipids and amino acids are associated with DA, thus suggesting that oxidative stress and mitochondrial dysfunction likely play a role in AMD and visual impairment in this condition.


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