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ANTIOXIDANTS & AMD

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ANTIOXIDANTS & AMD. Dr AJAY I DUDANI ZEN EYE CENTRE MUMBAI . AREDS. AREDS demonstrated beneficial effects of high dose antioxident vitamin and mineral supplementation in decreasing the risk of advanced ARMD. R.C.T.=4757 participants 55-81 yrs. 11 centers.

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antioxidants amd

ANTIOXIDANTS & AMD

Dr AJAY I DUDANI

ZEN EYE CENTRE

MUMBAI

areds
AREDS
  • AREDS demonstrated beneficial effects of high dose antioxident vitamin and mineral supplementation in decreasing the risk of advanced ARMD.
  • R.C.T.=4757 participants 55-81 yrs. 11 centers.
ares stereoscopic color macular photos
ARES Stereoscopic Color Macular Photos.
  • Cat1 Few Small Drusen
  • Cat2 Extensive small Drusen or non extensive intermediate drusen
  • Cat3 Extensive intermediate drusen, one large drusen or non central Geographic atrophy.
  • Cat4 Unilateral Advanced AMD or Vision Loss worse than 20/32
antioxidants
ANTIOXIDANTS
  • Vitamin C watersoluble antioxidant
  • Vitamin E -tocopherol ( lipid soluble antoxidant )
  • Carotenoids  &  - carotene, Lutein / zeaxanthin (- quenches singlet O) Zinc
areds study age related eye disease study
AREDS studyAge Related Eye Disease Study.
  • Report no 8, Arch of Ophthalmology -Vit C 500 IU -Vit E 400 IU - carotene 15 mg -Zinc oxide 80 mg with 2mg of Cupric Oxide -Lutein + Zeaxanthin
areds6
AREDS
  • Antioxidants + Zinc effective in preventing progression of intermediate AMD to advanced AMD -25-30 % benefit
  • But no to early AMD - no apparent benefit
  • Vitamin C, E, ß-carotene
indications of areds
INDICATIONS OF AREDS
  • Extensive intermediate size drusen
  • 1 large drusen
  • geographic atrophy in 1 or both eyes
  • 1 eye lost in AMD
ci for antioxidants
CI FOR ANTIOXIDANTS
  • Smoking
  • Dementia
macular pigment
Macular pigment
  • Lutein
  • Zeaxanthin
  • protects macula- filtering blue light, scavenging free radicals
micro nutrient supplementation
Micro-nutrient supplementation
  • Macular Xanthophylls, leutin And Zeaxeatin –present in spinach,Collard greens & Kale.
  • 25% of total retinal carotenoids – in Rod outer Seg. To protect from oxidative damage from U.V. Light
  • Omega 3 long Chain PUFA -– is a major structural lipid in sensory Retina –Present in Fish
  • Is a part of docosahexanoic acid.- essential role in vision.
micro nutrient supplementation11
Micro-nutrient supplementation
  • Higher intake of both Lutein and Zeaxanthin & Omega 3 LCPUFAs are Associated with decreased risk of wet ARMD and Geographic Atrophy
new from areds
New From AREDS
  • AREDS DEATHS 11%
  • Mortality increase severity of Macular disease.
  • Zn- beneficial to decrease mortality
  • Vn worse than 20/40 = increase risk
  • AMD Cat4 Associated with CVS deaths.
  • Neoplasms 31%
slide13
DIET
  • Egg yolk,maize, kiwi, red grapes, pumpkin, spinach(palak), cucumber, peas, orange juice
slide14
AMD
  • Reactive oxygen
  • OH , singlet oxygen
  • lipid deoxidation of cell wall & DNA
  • O & Blue light  Macular oxidation
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