Macular Degeneration
By Alice R. Laule, MD
To discuss this further, we should talk about the different forms of macular
degeneration. The term “dry” refers to a variety of forms of macular
degeneration where the vision receptor cells (cones and rods) drop out and die,
or at least cease to function well, resulting in a loss of vision. The “wet”
form of macular degeneration is a much more devastating form in which abnormal
blood vessels break through an elastic membrane at the base of the retina, and
actually begin to grow beneath the receptor cells, blocking their function. The
abnormal, new blood vessels are fragile and tend to leak fluid or actually
break and bleed, either of which event causes scar tissue to form that
permanently destroys the central retina. The macula is a small area, about the
size of a pencil eraser, which contains a dense concentration of color vision cells,
and is the only part of the eye that is wired for 20/20 vision. When the macula
is destroyed, it takes a hole out of the center of the vision. Reading vision
is gone, although the peripheral vision remains.
What I had learned, thanks to Dr. Jonathon Wright, was that dry macular
degeneration responds to nutritional supplements sometimes. Dr. Wright is not
an ophthalmologist, and as I used his techniques for both oral and intravenous
supplementation, I was able to refine his information. I discovered that a
particular form of dry macular degeneration responds the best. This is the most
common form, where the macula has dark and light mottling of its pigmentation,
but no huge white areas, and no large, waxy structures called drusen. Tiny
drusen may be present, and the treatments will still help. I’ve not done a
formal study of these patients, but over a period of a year kept track of the
results informally, discovering that after a series of eight intravenous
treatments, following with oral supplements, over half, nearly 70%, of the
patients got gains in vision of at least 2 lines on the eye chart. Some of
these gains were dramatic, almost beyond belief. One lady with best correct
vision of 20/200 (legally blind) was restored to 20/40 vision and able to
read the newspaper again in one eye. Only one eye responded well — the other
eye gained only to about 20/80. Nonetheless, for a disease that is well known
for being progressive, never spontaneously improving, these were quite dramatic
results.
About 4 years ago, I did a literature search on lutein, and discovered not a
single human study indicating that supplemental lutein was of any value. All
the positive data showing benefits in preventing macular degeneration from
lutein and zeaxanthin were dietary studies. There was one dog study showing a
reduction in cataract formation with supplemental lutein. (Presumably dogs are
not very good at eating their greens and needed supplements.) I have not
updated my literature search, but still there is a lesson here, that it is more
important ALWAYS to get our nutrition from food sources when possible. I still
do not recommend taking oral lutein, but rather suggest that people eat their
colorful fruits and vegetables to get the entire group of 600+ carotenoids the
natural way. New information, however, may cause me to change my mind about
supplements.
Unpublished research publicized as a poster presentation at a meeting in 2003
has come to my attention. This research explored the fact that meso-zeaxanthin,
which we are supposed to make by converting from lutein in the retina, is
missing in some people. Perhaps some of us lack an enzyme to make the
conversion. A post-mortem study suggests absence of any one of the three
pigments is associated with thinning of the macula. Meso-zeaxanthin is now
available in supplemental form. When researchers gave this to people with
age-related macular degeneration, the supplemented individuals had increased
macular thickness readings by an method called OCT. As far as I am aware, Life
Extension is the only place that has supplemental meso-zeaxanthin available, in
a mixture with the long-underpublicized zeaxathin, and the familiar lutein.
Data indicate a 43% reduction in macular degeneration in people with a high
level of these carotenoids in their plasma. My suggestion now would be for
those with a family history of macular degeneration to consider supplements.
For the rest of us, I still think eating our green and orange vegetables is
best.
I would like to make one more point. In all my years — 1992 to present— of
treating macular degeneration with nutrition, with the high success rate that I
previously mentioned, never once have I seen a smoker get any improvement in
vision. Let me repeat that — never once have I seen a smoker respond at
all to nutritional treatments for their macular degeneration. The
link between smoking and macular degeneration has been known since the 1970’s.
I now simply refuse to implement the intravenous part of the treatment for a
smoker. It is a waste of their money. This is the most definitive and stunning
evidence I have of the ill effects smoking has on the human body. There are
plenty of reasons to quit smoking, but I find this to be one of the most
compelling.
Alice
R. Laule, M.D.