In summary, those with AMD have a higher risk for COVID-19 infection and severe disease. This increased risk has a genetic basis.

What is macular degeneration?

Age-related macular degeneration (AMD) is an eye condition that can worsen over time. AMD is the leading cause of severe, permanent vision loss in older individuals.

The macula wears down in AMD. The retina is the nerve tissue — at the back of the eye — that senses light.

AMD occurs when the small central portion of your retina, the macula, wears down. The retina is the nerve tissue that senses light and is at the back of your eye.

Below are fundus photographs of the right eye (top image) and left eye (bottom image), seen from the front so that the left in each image is to the person’s right. The gaze is on the camera, so the macula is in the center of the image in each picture. The optic disc is towards the nose.

Because AMD occurs with increasing age, it is often called age-related macular degeneration. While AMD doesn’t usually cause blindness, it might cause severe visual loss.

Another macular degeneration form (Stargardt disease or juvenile macular degeneration) affects children and young adults.

COVID-19 and macular degeneration

Scientists have discovered a genetic link between COVID-19 infection and age-related macular degeneration.

COVID-19 and AMD are associated with variations in the PDGFB gene. This gene has a role in new blood vessel formation (and is linked to abnormal blood vessel changes that occur with age-related macular degeneration).

Researchers analyzed genetic data from over 16,000 individuals with age-related macular degeneration, more than 50,000 people with COVID, and control groups. Here is Boston Univerity researcher Lindsay Farrer, Ph.D., chief of biomedical genetics, speaking in a news release:

“Our analysis lends credence to previously reported clinical studies that found those with AMD have a higher risk for COVID-19 infection and severe disease, and that this increased risk may have a genetic basis.”

Prior research showed that those with AMD have a 1.25 times increased risk of respiratory failure or death due to COVID, which is higher than other well-known risk factors such as type 2 diabetes (21 percent) or obesity (13 percent), according to the current researchers.

Reducing your AMD risk

I want to end with something actionable. How can you reduce your risk of getting age-related macular degeneration? The US Centers for Disease Control offers some tips:

• Tell your eye doctor about your family history.
• Get regular eye exams.
• Don’t smoke.
• Have a good cholesterol level

The Age-Related Disease Studies found that getting certain vitamins and minerals every day may slow the progression of the disease from the early or middle stages to the later stages. Specifically, combinations of the following vitamins can reduce the risk of late AMD by one quarter (25 percent):

• Vitamin C
• Vitamin E
• Beta-carotene
• Zinc
• Copper

Green, leafy vegetables contain large amounts of many of these vitamins. For those with AMD progression to later stages, therapeutic interventions may include laser treatment or injections.

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Age-related macular degeneration (AMD), or macular degeneration, is a common eye disorder. AMD results from the macula’s deterioration, a small area in the middle of the retina at the back of the eye.

Historically, clinical trials showed that supplements could slow the progression of age-related macular degeneration. Now comes a new study confirming this observation, albeit with a newer supplementation formulation.

We begin with macular degeneration basics before turning to positive new results.

What is age-related macular degeneration?

Macular degeneration is a common eye disorder. Deterioration of the macula, a small spot in the back of the eye, is the cause.

Macular degeneration can result in central vision loss; you may have trouble seeing what is in front of you as you look forward. At the end of this short video, you will see the visual field of someone with age-related macular degeneration:

As you can see, macular degeneration doesn’t affect your peripheral vision.

Macular degeneration is common: Approximately 11 million Americans have the disease. Age-related macular degeneration is the leading cause of visual loss.

There are two types of macular degeneration:

• Dry macular degeneration (affects 85 to 90 percent of those with macular degeneration). Occurs because of small yellow deposits (drusen) that develop under the macula.
• Wet macular degeneration results from abnormal blood vessels developing under the retina and macula.

Here are some risk factors for age-related macular degeneration:

• A diet rich in saturated fat (for example, meat, cheese, and butter) raises risk. On the other hand, fruits, vegetables, and nuts can reduce risk.
• Being overweight may be a risk factor
• Cigarettes
• Age over 50 years
• A family history of age-related macular degeneration.
• High blood pressure
• Heart disease
• High blood pressure or high cholesterol
• Race. Whites have the highest risk, followed by Chinese and Hispanic people and African-Americans with the least risk. Whites are also more likely to go blind from age-related macular degeneration than African-Americans.
• Ultraviolet ray exposure (for example, from sunlight)

Age-related macular degeneration treatment

Unfortunately, treatment for age-related macular degeneration cannot restore vision. On the other hand, intervention may slow vision loss.

Dry AMD

There is no good treatment for dry age-related macular degeneration. However, management tools include choosing larger print books (larger screen font sizes), using a magnifying device, or optimizing lighting.

Wet AMD

There are management strategies that may slow the rate of progression of age-related macular degeneration. I won’t go into too much detail here, but refer you to this Medicalnewstoday reference:Age-related macular degeneration (AMD): Symptoms and treatmentMacular degeneration affects the retina, a layer at the back of the eyeball. This layer contains light-sensitive cells…www.medicalnewstoday.com.

Macular degeneration risk reduction

While prevention is not assured, you may lower your macular degeneration risk by eating well, getting physical activity, not smoking, and getting regular eye tasks.

You may also lower your risk of age-related macular degeneration by wearing sunglasses that block ultraviolet (UV) rays to protect your eyes.

Some research points to increasing omega3 polyunsaturated fatty acids, especially docosahexaenoic acid and eicosapentaenoic acid, possibly dropping the risk of an early subtype of age-related macular degeneration.

Let’s look at new evidence suggesting that dietary supplements can lower the risk of macular degeneration progression.

Supplements and age-related macular degeneration

According to the Age-Related Eye Disease Studies (AREDS and AREDS2), supplements can slow the progression of age-related macular degeneration.

The AREDS2 formulation provided an additional one-quarter (26 percent) drop in the risk of age-related macular degeneration while not increasing lung cancer risk.

The AREDS1 supplement included beta-carotene. After scientists discovered an association between beta-carotene and lung cancer risk, the AREDS2 formulation substituted the antioxidants lutein and zeaxanthin for beta-carotene.

The original AREDS study showed that a dietary supplement formulation (500 mg vitamin C, 400 international units vitamin E, 2 mg copper, 80 mg zinc, and 15 mg beta-carotene) slowed AMD progression from moderate to late disease.

Alas, two concurrent studies also revealed that those who smoked and took beta-carotene had a significantly higher risk of lung cancer than expected.

For the AREDS2 clinical trial, researchers compared the beta-carotene formulation to one with the antioxidants lutein (10 milligrams) and zeaxanthin (2 milligrams) instead. Only those who never smoked (or had quit) could use the beta-carotene formulation.

Here are the results of the five-year AREDS2 study:

The AREDS2 formulation provided an additional one-quarter (26 percent) drop in the risk of age-related macular degeneration while not increasing lung cancer risk.

After the five-year study ended, researchers offered all participants the AREDS2 formulation.

Symptoms

Let’s end with some symptoms of macular degeneration. Dry macular degeneration symptoms usually develop gradually and without pain. Symptoms may include:

• Visual distortions (for example, straight lines appearing bent)
• Diminished central vision in one or both eyes
• The need for brighter light when reading or doing close-up work
• Increased challenges adapting to low light, for example, when entering a dimly lit restaurant
• Increased blurriness of printed words
• Decreased brightness or intensity of colors
• Challenges recognizing faces
• A well-defined blurry spot or a blind spot in your visual field

Let’s end with some risk-reduction tips from the good folks at WebMD:

• Check your vision daily by looking at an Amsler grid — a pattern of straight lines like a checkerboard. It can help you spot changes in your vision.
• Don’t smoke, eat a balanced diet with leafy green vegetables, and protect your eyes with sunglasses that block harmful ultraviolet (UV) rays.
• Supplements with antioxidants plus zinc may lower your risk of age-related macular degeneration.
• If you’re over 65, your vision exams should include testing for age-related macular degeneration.

Healthline adds two more:

• Maintain a healthy-for-you weight
• Exercise consistently, as much as you can

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