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Q: Can macular degeneration be caused caused by myopia?
Myopic degeneration is one of many disorders that can also cause damage to the macula. Extreme myopia (nearsightedness) often
results in stretching and thinning of the retina in the back of the eye. This usually happens because the back of the eye is larger than normal when the eye is very nearsighted. Marked thinning and stretching may
lead to break down of the macula, surrounding retina and its underlying tissue. This will cause a varying amount of blurred vision. There is no generally accepted treatment for myopic degeneration. Occasionally,
abnormal blood vessels may grow beneath the retina. These may be treated with laser in the same way that abnormal blood vessels (subretinal neovascularization) may be treated in age-related macular degeneration
(AMD), depending on their size and location. AMD is not more common in myopia.
Q: Is the use of vitamins related to macular degeneration?
Some ophthalmologists have suggested that vitamin/mineral therapy may prevent macular degeneration from getting worse. They do
not believe that vitamin/mineral treatment will improve vision. Since most people have a slowly progressive form of macular degeneration, it would be very helpful to have a treatment which could slow down or stop
the rate of vision loss. Zinc is a commonly recommended mineral and will be discussed in a separate question. The most frequently recommended vitamins include the anti-oxidants, beta carotene, vitamin C, vitamin E
and the mineral selenium. Several years ago there was a very interesting study that found a lower incidence of macular degeneration in people who included leafy green vegetables (i.e. spinach) in their regular diet.
It is very important to understand that no one has proven that vitamin/mineral therapy helps macular degeneration. All of the studies that have been done are preliminary.
Q: What is the role of zinc in treating macular degeneration?
A small preliminary study in the 1980s suggested that zinc might help slow down the progression of macular degeneration. Zinc is
present in relatively high levels in the retina and the elderly often have diets which are low in zinc. Unfortunately, there have been subsequent studies which have failed to show any benefit from zinc. Zinc and
other vitamin/mineral supplements are often recommended by ophthalmologists, but they have not yet been proven to be effective. The National Eye Institute is currently conducting a multi-centered study concerning
the possible benefits of vitamin/mineral treatment in macular degeneration and cataract. Unfortunately, that study will probably not reach a conclusion for several more years. In the meantime, I recommend that you
discuss vitamin/mineral supplements with your ophthalmologist. Please keep in mind that it can be harmful to take very high levels of certain vitamins and minerals.
Q: Is this a genetic disease? If there is a family history should I take some extra precautions? What are Macular Drusen Deposits?
There are probably many factors which affect the development of age-related macular degeneration, but heredity is certainly a
very strong one. There is no question that your risk of developing age-related macular degeneration (AMD) is much higher if other people in your family have it. Some ophthalmologists would recommend vitamin/mineral
supplementation in the hope that it might slow down progression of macular degeneration (see questions 2 and 3).
Macular drusen are small deposits of material which build up over many years beneath the retina in people with macular degeneration. They are
visible to the ophthalmologist when he or she examines your retina. They are often the first sign of AMD.
Q: Are there any new treatments for macular degeneration?
There are new treatments which are being investigated for use in macular degeneration. Most of these concern treatment of
subretinal new vessels which are already under the macula. In this position, laser treatment is not very effective because the laser itself will damage the macula as well as the abnormal blood vessels.
Investigations are being done with medication, radiation and surgery. The goal is to remove or cause regression of the new vessels without damaging the center of the macula itself. These treatments are not for
everyone with macular degeneration and successful results are preliminary.
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