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ANTIOXIDANTS & AMD

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

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  1. ANTIOXIDANTS & AMD Dr AJAY I DUDANI ZEN EYE CENTRE MUMBAI

  2. 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.

  3. 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

  4. ANTIOXIDANTS • Vitamin C watersoluble antioxidant • Vitamin E -tocopherol ( lipid soluble antoxidant ) • Carotenoids  &  - carotene, Lutein / zeaxanthin (- quenches singlet O) Zinc

  5. 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

  6. 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

  7. INDICATIONS OF AREDS • Extensive intermediate size drusen • 1 large drusen • geographic atrophy in 1 or both eyes • 1 eye lost in AMD

  8. CI FOR ANTIOXIDANTS • Smoking • Dementia

  9. Macular pigment • Lutein • Zeaxanthin • protects macula- filtering blue light, scavenging free radicals

  10. 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.

  11. Micro-nutrient supplementation • Higher intake of both Lutein and Zeaxanthin & Omega 3 LCPUFAs are Associated with decreased risk of wet ARMD and Geographic Atrophy

  12. 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%

  13. DIET • Egg yolk,maize, kiwi, red grapes, pumpkin, spinach(palak), cucumber, peas, orange juice

  14. AMD • Reactive oxygen • OH , singlet oxygen • lipid deoxidation of cell wall & DNA • O & Blue light  Macular oxidation

  15. THANK YOU

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