AMD: the most effective dietary supplements

Age-related macular degeneration, more commonly called AMD, is an eye disease that causes a progressive loss of central vision. Affecting mainly people over 50 years old, AMD can, in its advanced form, lead to partial or even total blindness. AMD results from deterioration of the macula, the central part of the retina. This area, rich in photoreceptors (cones and rods), is essential for sharp, precise vision, necessary for reading, recognizing faces, and seeing details. With age, the cells of the macula become vulnerable to attacks by free radicals, notably due to the accumulation of a pigment called lipofuscin. This pigment contains a toxic compound, A2E, which, when exposed to blue light, generates free radicals that destroy retinal cells.

The Two Types of AMD

Atrophic (dry) AMD This form accounts for about 85 to 90% of cases. It progresses slowly and causes a gradual deterioration of vision. Yellow lipid deposits, called "drusen", appear in the retina and progressively damage the cells. This form occurs in three stages: Early stage where a few drusen are present without a significant impact on vision. Intermediate stage: vision becomes blurred, requiring more light to read. Advanced stage: cell destruction spreads, making reading and recognizing faces difficult. Exudative (wet) AMD This is the most severe form, which progresses rapidly and can lead to partial blindness. It is characterized by the formation of new blood vessels under the retina, which can bleed or leak, causing scarring and sudden vision loss. This form requires urgent care.

Symptoms and Diagnosis of AMD

The symptoms of AMD include blurred central vision, difficulty recognizing faces, and perceiving straight lines as wavy (metamorphopsia). In advanced stages, dark or empty areas, called "scotomas", may appear in the center of the visual field. To diagnose AMD, the following examinations are performed: • Visual acuity measurement: assessment of the ability to see near and far. • Fundus examination: looking for drusen or areas of atrophy. • Angiography: used to identify neovascularization and any fluid leakage. • Amsler grid test: detects distortions of central vision.

Risk Factors for AMD

Several factors can increase the risk of AMD, including: • Age: the risk increases significantly after 50 years. • Sex: women appear to be more affected than men. • Genetic predisposition. • Exposure to blue light and sunlight, which can cause oxidative damage to the retina. • Smoking: it multiplies the risk of developing AMD by five. • Overweight and obesity: particularly with abdominal fat accumulation, associated with the exudative form. • Inflammation and high homocysteine levels, which are linked to an increased risk.

Prevention

Prevention of AMD relies on adopting good habits: • Protect the eyes from the sun with glasses equipped with UV filters. • Stop smoking, as smoking is a major risk factor. • Follow a diet rich in antioxidants: studies have shown that a high intake of vitamins C and E, zinc, as well as lutein and zeaxanthin, protects the macula and slows the progression of AMD. Lutein and zeaxanthin help maintain macular pigment density. Treatment options vary depending on the type of AMD: • Dry AMD: There is no curative treatment, but visual aids and visual rehabilitation programs can improve quality of life. • Wet AMD: Anti-VEGF injections (vascular endothelial growth factor inhibitors) are the main therapeutic approach. They block the growth of new blood vessels and can stabilize, or even improve, vision in some cases. Studies such as AREDS and AREDS2 have also confirmed that nutritional supplements can slow the progression of AMD. In AREDS2, replacing beta-carotene with lutein and zeaxanthin showed increased effectiveness, notably in smokers for whom beta-carotene posed risks. Additionally, some nutrients are beneficial for the prevention of AMD: • Vitamins C and E: powerful antioxidants that protect eye cells from free radicals. • Zinc: essential for maintaining retinal health. • Omega-3s: their anti-inflammatory properties and role in cell structure make them allies for eye health. AMD is a degenerative disease that can greatly impact quality of life. By identifying early signs and adopting the effective preventive measures mentioned, it is possible to slow its progression.