Balanced diet is key to good eye health

AGE-RELATED macular degeneration (ARMD) is the leading cause of visual impairment and is associated with significant reduction in quality of life.

The macula is the central part of the retina responsible for central, fine and colour vision. In elderly patients, ARMD results in poor central vision, which limits the ability to recognise faces and read small letters and has a significant impact on functional independence.

There are two types of ARMD – the dry type, which is more common and has no treatment available on the market to stop its progression, and the wet type, which can be treated via anti-vascular endothelial growth factor (anti-VEGF) therapy and laser treatments.

ARMD is a multifactorial disease. However, the precise pathogenesis of ARMD is unknown, although oxidative stress is highly implicated. Smoking is related to late ARMD.

Lutein and zeaxanthin are pigments concentrated in the macula and help protect the macular region by scavenging free oxygen radicals and filtering damaging blue light. These pigments are not able to be synthesised naturally by humans but can be found in leafy green vegetables.

Leading a healthy lifestyle and having a balanced diet is the ideal way to get the nutrition we need. A regular intake of vitamins and essential fatty acids is generally adequate to cater for the needs of healthy individuals.

However, in patients with risk factors for developing ARMD, randomised clinical trials have shown the benefits of lutein and zeaxanthin in reducing the risks of progression to advanced ARMD. In the Age-Related Eye Disease Study 2 lutein and zeaxanthin supplements have been found to be safe and beneficial. Dietary supplements can potentially delay the onset and slow the progression of ARMD.

Another clinical study called LUTEGA has found that supplementation with 10mg of lutein, 1mg of zeaxanthin and Omega-3 (100mg of DHA/30mg of EPA) seems to increase macular pigment optical density in ARMD patients, conferring some stability to vision.

With the wealth of information available on the Internet, nutritional advice to patients must be balanced. Patients with ARMD and at risk of developing ARMD are advised to consume green leafy vegetables and eat fatty fish twice a week.

If further supplementation is required, there are commercial preparations, which are manufactured in accordance with published clinical trials.

With these measures, we may see a healthier ageing population and lower incidence of ARMD. –

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The writer is a vitreo-retina and cornea surgeon at International Specialist Eye Centre. For more information, call 03-2284 8989 or email enquiries@isec.my