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Macular Degeneration UPDATE Spring 2022

 

A newsletter devoted to the most current medical, social and psychological aspects of all visual diseases

 

A DIETARY APPROACH TO DRY EYE DISEASE MANAGEMENT

 

Help your patients to fuel their bodies with the correct nutrients, vitamins, minerals, and supplements.

Lisa Hornick, OD, FAAO and Kristyna Lensky Sipes, OD

 

Dry eye disease (DED) affects more than 16 million people in the United States.1 It is a chronic condition that requires continual care and treatment to minimize symptoms. When we educate patients about their DED diagnosis, it is important to start with one of the basics: nutrition.

What we put into our bodies can directly affect how we feel and how our bodies function, and our eyes are no exception. We are all familiar with providing DED patients with artificial tears and warm compresses, but in our practice we also make dietary recommendations as one of the first lines of treatment and a top priority in patient care.

For this article, we put together a list of foods, vitamins, and supplements that may ease patients’ DED symptoms and help keep their eyes healthy. Share these tips with your patients who have DED, along with the smoothie recipe (below), which can supply many of these elements all in one tasty drink.

 

OMEGA FATTY ACIDS

In the treatment of DED, omega-3 fatty acids are often at the top of our list. Along with supplements, we recommend that patients incorporate omega-3s into their everyday diets. Fish such as wild salmon, tuna, and sardines are high in omega-3s. Nuts and seeds such as walnuts, flax, chia, and hemp seeds are great options also.

Omega-3s have long been known for their antiinflammatory properties. They are activated in the tear film, and a metabolic deficiency in omega-3s can be a cause of chronic ocular surface inflammation.2 This chronic inflammation is a root cause of DED. A moderate daily dose of omega-3s can help reduce this inflammation, thus improving tear osmolarity and increasing tear stability.3 Omega-3s also increase the quality of meibomian gland oil, which helps improve the lipid layer in the tear film and prevents evaporative DED symptoms.4

Patients should be educated on the characteristics of high quality omega-3 supplements. The therapeutic dose recommended for DED is 2000 mg per day. Tell patients to look for a supplement that has high levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). EPA and DHA should make up 60% to 85% of the formulation. We recommend the triglyceride forms of these over the ethyl ester forms due to their superior bioavailability.5 Another important thing to look for in a supplement is the essential fatty acid gamma linolenic acid (GLA). EPA, DHA, and GLA are important because they are the precursors to the antiinflammatory components in fatty acids.6 GLA is key because it targets the inflammatory markers in the eye specifically.

 

VITAMIN D

More and more research is finding that vitamin D is crucial for a properly functioning tear film. Dietary sources of vitamin D include fortified milk, cheese, yogurt, salmon, sardines, and egg yolks. Of course, getting out in the sunshine is another great way to get vitamin D.

Vitamin D deficiency has been linked to impaired tear film function.7 Vitamin D most likely protects the eye by helping decrease inflammation on the surface and improving tear secretions.7,8 About 40% of US adults are vitamin D deficient, so this is something to keep in mind when we evaluate patients with symptoms of DED.9

 

VITAMIN C

Vitamin C is well known for its role in fighting the common cold and maintaining a healthy immune system, but its benefits for combating DED are equally important. Vitamin C is found in citrus such as oranges, lemons, and grapefruit and in other fruits such as bananas, apples, and blueberries. Vitamin C provides antioxidants that help reduce oxidative stress and can improve the ocular surface by improving tear breakup time and goblet cell density.10,11 Vitamin C also promotes healing by forming and maintaining connective tissue, including collagen in the cornea.12

 

VITAMIN E

Vitamin E also helps neutralize oxidation. Vitamin E boosts the immune system and protects the cells in our eyes from damage. It can be found in foods such as sunflower seeds, almonds, and peanuts. Vitamin E sourced from food may be more beneficial than vitamin E obtained through supplements.13

 

VITAMIN A

Vitamin A is another essential ingredient for combating DED. In fact, dry eyes can be one of the first symptoms of a vitamin A deficiency. Beta carotene in the diet converts to vitamin A. It is best absorbed through diet, so we recommend that patients do not take supplements of vitamin A but rather consume beta carotene in their everyday diets. Beta carotene is found in orange vegetables such as carrots and sweet potatoes. Green leafy vegetables such as spinach and kale are also great sources.

Studies have shown that vitamin A can be a successful therapy for DED.14-16 Vitamin A increases cell turnover, and this includes corneal epithelial cells. Patients with DED often have signs such as superficial punctate keratitis, caused by loss or damage of the corneal epithelial cells. One study found that vitamin A therapy reduced the number of apoptotic corneal epithelial cells by a factor of 10 compared to a control group.15

 

HYDRATION

In order to produce tears, it is important that the body be properly hydrated. It is important to drink water and other healthful fluids. Some drinks containing antioxidants will not only aid in hydration but will also help prevent oxidation. Green tea contains powerful antioxidants called catechins. Catechins have strong antiinflammatory properties that help protect the eye against oxidative stress and may improve tear breakup time.16 Water, of course, is the best for promoting hydration. We recommend drinking at least 64 oz of water per day to maintain optimal hydration.

 

THE TAKEAWAY

Food is fuel, and supplying our bodies with the correct nutrients, vitamins, minerals, and supplements can help us lead healthier lives and decrease the risks of chronic conditions including DED. It is essential that we educate patients about the importance of proper nutrition as a cornerstone to their treatment plans.

DED is chronic, and lifestyle changes including dietary changes are crucial in managing symptoms and decreasing the severity of the disease. Encouraging patients to incorporate dietary changes such as staying hydrated and increasing consumption of omega-3s; vitamins A, C, D, and E; and the antioxidants in green tea and other foods and beverages, will benefit not only their eyes but all aspects of their health.

 

  1. Farrand KF, Fridman M, Stillman IÖ, Schaumberg DA. Prevalence of diagnosed dry eye disease in the United States among adults aged 18 years and older. Am J Ophthalmol. 2017;182:90-98.
  2. Walter SD, Gronert K, McClellan AL, Levitt RC, Sarantopoulos KD, Galor A. Omega-3 tear film lipids correlate with clinical measures of dry eye. Invest Ophthalmol Vis Sci. 2016;57(6):2472-2478.
  3. Deinema LA, Vingrys AJ, Wong CY, Jackson DC, Chinnery HR, Downie LE. A randomized, double-masked, placebo-controlled clinical trial of two forms of omega-3 supplements for treating dry eye disease. Ophthalmology. 2017;124(1):43-52.
  4. Liu Y, Kam WR, Sullivan DA. Influence of omega 3 and 6 fatty acids on human meibomian gland epithelial cells. Cornea. 2016;35(8):1122-1126.
  5. Dyerberg J, Madsen P, Møller JM, Aardestrup I, Schmidt EB. Bioavailability of marine n-3 fatty acid formulations. Prostaglandins Leukot Essent Fatty Acids. 2010;83(3):137-141.
  6. Barnett M. Off the menu: a nutritional approach to dry eye. Paper presented at: SECO 20/20, March 4-8, 2020.
  7. Yildirim P, Garip Y, Karci AA, Guler T. Dry eye in vitamin D deficiency: more than an incidental association. Int J Rheum Dis. 2016;19(1):49-54.
  8. Bae SH, Shin YJ, Kim HK, Hyon JY, Wee WR, Park SG. Vitamin D supplementation for patients with dry eye syndrome refractory to conventional treatment. Sci Rep. 2016;6:33083.
  9. Peponis V, Papathanasiou M, Kapranou A, et al. Protective role of oral antioxidant supplementation in ocular surface of diabetic patients. Br J Ophthalmol. 2002;86(12):1369-1373.
  10. Huang JY, Yeh PT, Hou YC. A randomized, double-blind, placebo-controlled study of oral antioxidant supplement therapy in patients with dry eye syndrome. Clin Ophthalmol. 2016;10:813-820.
  11. Richer S. Keeping nutrition to the letter. Review of Optometry. 2018; supplement: 6-10.
  12. Ohigashi H, Hashimoto D, Hayase E, et al. Ocular instillation of vitamin A-coupled liposomes containing HSP47 siRNA ameliorates dry eye syndrome in chronic GVHD.Blood Adv. 2019;3(7):1003-1010.
  13. Capogna, Laurie . The Complete Eye Health and Nutrition Guide: Eyefoods, Robert Rose, Inc. 2019. p. 79.
  14. Zhang W, Li W, Zhang C, et al. Effects of vitamin A on expressions of apoptosis genes bax and Bcl-2 in epithelial cells of corneal tissues induced by benzalkonium chloride in mice with dry eye. Med Sci Monit. 2019;25:4583-4589.
  15. Sommer A. Effects of vitamin A deficiency on the ocular surface. Ophthalmology. 1983;90(6):592-600.
  16. Nejabat M, Reza SA, Zadmehr M, Yasemi M, Sobhani Z. Efficacy of green tea extract for treatment of dry eye and meibomian gland dysfunction; a double-blind randomized controlled clinical trial study. J Clin Diagn Res. 2017;11(2):NC05-NC08.

Lisa Hornick, OD, FAAO — Optometrist, Stanford Ranch Optometry, Rocklin, California — lmhornick1@gmail.com; Instagram @drlisahornick

Kristyna Lensky Sipes, OD — Owner and Optometrist,

Stanford Ranch Optometry, Rocklin, California

drlenskysipes@stanfordranchoptometry.com; Instagram @kristynasipes

 

Chairman’s Column | Spring Edition 2022

 

Greetings friends,

The Macular Degeneration Association is proud to welcome Dr. A. Paul Chous and Dr. Mile Brujic to the Optometric Medical Advisory Board. Dr. Paul Chous is an optometrist with a private practice specializing in diabetes eye care and education in Tacoma, WA. He attended Brown, UC Irvine and UC Berkeley. Dr. Chous writes and lectures on diabetes, nutrition and AMD in the US and internationally, and is thrilled to be on the MDA advisory board. Dr. Brujic graduated from the New England College of Optometry in 2002. He practices full scope optometry with an emphasis on ocular disease management of the anterior segment, contact lenses and glaucoma. Dr. Brujic is on the editorial board for a number of optometric publications. He has published over 200 articles and has given over 1,000 lectures, both nationally and internationally on contemporary topics in eye care. With the addition of these outstanding doctors, they bring a world of knowledge and round out our Optometric Medical Advisory Board.

 

Sincerely,

Lawrence Hoffheimer

MDA Chairman of the Board

 

Eye Foods – The Complete Eye

Health & Nutrition Guide

 

This book is for everyone who wants to learn more about eye health and the prevention of eye disease. This book draws from 20 years of the authors optometric practice, then integrated it with the most up-to-date scientific research and has developed a list of the best foods for helping us maintain healthy eyes and vision and prevent certain eye diseases, such as age-related macular degeneration, cataracts and dry eye syndrome.

Visit https://macularhopeorg/shop/eye-foodsthe-

complete-eye-health-nutrition-guide to get your copy today.

 

RETINA HEALTH FOR LIFE

PODCAST

Welcome to ASRS’s Retina Health for Life from the President’s Corner podcast. Join

host Dr. Timothy Murray, former President of the Foundation of the American Society of Retina Specialists, as he brings you inspiring conversations about making healthy vision possible. Dr. Murray interviews expert retina specialists and patients to bring you vital information on how to safeguard your retina health for life. You can watch these episodes on YouTube. by visiting MacularHope.org, click on the “Retina Health for Life Podcast” and then on YouTube.

 

An Ounce of Prevention….

By: Mile Brujic, OD

 

We’ve all heard this famous saying and know how it ends, but there is no more important condition that this applies to than macular degeneration. The macula is the small portion at the back of the eye that everything that we see focuses on. A healthy macula allows us to see a nice clear image. Macular degeneration, as its name implies, is a degeneration of the macula. This can cause a slow deterioration in the quality of vision.

The good news is that there are things that you can immediately start doing to decrease your risk of developing macular degeneration. The first is do not smoke. This is a major risk factor for the development of macular degeneration. The second is to make sure that you wear appropriate ultraviolet (UV) protection over your eyes when you go outside. This is easily accomplished through wearing quality sunglasses. Additionally, you may want to consider wearing a hat with a brim on it to block additional UV rays. The third is to increase your dietary intake of Lutein and Zeaxanthin. These are micronutrients that help protect the macula. These micronutrients are found naturally in kale, collards, spinach, orange paprika peppers and corn.

Make sure that you see your eye care professional on a yearly basis. They will help provide you with the most customized strategies to help optimize your macular health. Making sure you partner with your eye doctor will optimize your chance of maintaing your macular health.

 

 

READING GLASSES FOR MACULAR DEGENERATION AND LOW VISION

By Dr. W. Jarrod Long, OD, FIALVS

 

As a low vision optometrist for 25 years and one of the first Fellows of the International Academy of Low Vision Specialists, I can tell you with certainty that most of my low vision patients have macular degeneration. I can also state that, along with driving, reading is at the top of my macular degeneration patients’ list of goals. Today we’ll cover my approach to hands-free reading.

First, the measurements.

While high-contrast, “eye-chart” vision is important to measure, when it comes to reading it is equally important to measure reading speed with varied sizes of text, contrast, and lighting. Due to the size, position, and severity of the particular area(s) of degeneration, reading ability is often poorly correlated with “single letter/number” visual acuity measurements. What’s more, because the two eyes can compete for dominance, we need to determine if it’s better with just one eye, the other eye, or both together. It can be frustrating for a patient with a poorer-seeing, previously dominant, eye to try to read. They will often be caught closing one eye while reading.

With these measurements and observations documented, my next discussion with the macular degeneration patient usually follows one of two scripts. If they can read large print fluently with regular glasses, but slow down and, ultimately, cannot read the small print goal, then I explain that I will make the small print look like the larger print with stronger, possibly specialized, reading glasses and they will be thrilled to read fluently, hands-free again!

Unfortunately, the other discussion I sometimes need to have with a patient is clarifying that they do not read fluently at any size no matter how much I magnify, clarify, or enhance the print. Again, it goes back to the nature of macular degeneration and the unique characteristics of their vision loss. On the bright side, these patients can be helped with reading glasses for smaller print. However, I feel that it is helpful if they understand the nature of their vision loss and that it will take practice and more time to learn to use the best areas of their macula in order to steadily improve their enjoyment of reading.

So, for more information on the reading glasses that I prescribe for those with macular degeneration please see the accompanying chart. While quite thorough, this chart is not intended to be comprehensive. It reflects my particular prescribing preferences honed over the past several years.

For an even more detailed explanation of the glasses listed on the chart you can take a look at my video here: https://youtu.be/0jvjR-A6ZJ0. Keep in mind that it is quite technical and is primarily intended for low vision and other eye care professionals.

One final note about macular degeneration patient success or failure with low vision reading glasses…proper lighting and working distance are of utmost importance and cannot be stressed enough!

 

We are pleased to announce the retina and optometric practices awarded the distinction of

AMD Centers of Excellence!

 

Allisonville Eye Care (Fishers, IN)

Brown Retina Institute (San Antonio, TX)

Carolina Eye Associates, P.A. (North & South Carolina)

Central Optometry (London, Ontario)

Dr. Dorothy L. Hitchmoth, PLLC (New London, NH)

Eye Associates of Boca Raton, P.A. (Boca Raton, FL)

Eye Care Plus, LLP (Amarillo, TX)

Eyes on Sheppard (North York, Ontario)

Grin Eye Care (Leawood, KS)

Integrative Vision (Shrewbury, NJ)

Island Retina (Shirley, NY)

Joseph R. Podhorzer, MD, PLLC (Brooklyn, NY)

Lipski Eye Center, PC (Lewisburg, PA)

Low Vision Doctors of Ohio (Columbus, OH)

Low Vision Optometry of Southern California

(Mission Viejo, CA)

Low Vision Specialists of Maryland & Virginia

(Timonium, MD)

Marshall EyeCare Physicians, PC (Holmdel, NJ)

Memorial Vision, PA (Houston, TX)

Mississippi Retina Associates (Jackson, MS)

Ophthalmic Physicians Inc. (Mentor, OH)

Ophthalmology Associates PSC (Louisville, KY)

Orange County Retina (Santa Ana, CA)

Pacific Eye Surgery Center (Honolulu, HI)

Palmetto Retina Center, LLC (West Columbia, SC)

Paul Vision Institute (Wilmington, NC)

Professional Eye Care Center (Niles, IL)

Rancho Mirage Eye Care + Optometry (Rancho Mirage, CA)

Retina Associates of Orange County (Laguna Hills, CA)

Retina Associates of Western NY, P.C. (Rochester, NY)

Retina Consultants of Southern Colorado, P.C. (Colorado Springs, CO)

Retinal Consultants of San Antonio (San Antonio, TX)

Rouse Family Eye Care (Sunrise, FL)

Sight Improvement Center, Inc. (New York, NY)

Southern Montana Optometric Center (Laurel, MT)

The Eye Associates (Bradenton, FL)

The Macula Center (Clearwater, FL)

The Retina Center (St. Louis, MO)

The VitreoRetinal Eye Center (Biloxi, MS)

Toronto Integrated Eye Care (Etobicoke, Ontario)

True Vision Eyecare (Acworth, GA)

Upper Richmond Optometry (Arva, ON)

Vision Center of Lake Norman (Mooresville, NC)

*AMD Center of Excellence® is a

registered trademark of MacuLogix, Inc.

 

OPEN YOUR EYES

PODCAST

 

Open Your Eyes podcast series follows

Dr. Kerry Gelb and his featured speakers into the future of eye health.

By visiting MacularHope.org you can watch the release of this feature-length documentary exploring how optometrists can now see almost 300 diseases in the human eye.

 

NUTRITIONAL SUPPLEMENTS FOR GLAUCOMA

Lisa Hornick, OD, FAAO

Kristyna Lensky Sipes, OD

 

Dietary recommendations for when your patients ask, “What else can I do?”

 

AT A GLANCE

  • Some dietary supplements, used as adjuncts to traditional therapy, may help lower the risk of developing glaucoma and potentially slow disease progression.
  • Ginkgo biloba is one of the most promising supplements for glaucoma treatment. It is known to have antioxidant properties, help increase blood flow, stabilize mitochondria, and protect neurons from damage.
  • Providing our patients with information and guidance about nutritional supplements can help them navigate the many options available.

Glaucoma is one of the leading causes of irreversible blindness worldwide.1 It is commonly treated with prescription eye drops and surgical procedures. Often, our patients ask if there is anything else they can do to prevent or reduce the chance of the disease progressing.

Research shows that some dietary supplements may help lower the risk of developing glaucoma and potentially slow disease progression.2 Dietary supplements are meant to be used as adjuncts to traditional therapy, including prescription eye drops and surgical interventions. We always ask our patients to speak with their primary care physicians before adding any supplements to their diet, as there may be contradictions for those who are taking blood thinners or other systemic medications.

 

MECHANISMS OF GLAUCOMA

Before suggesting dietary supplements to a patient with glaucoma, it is important to understand the pathogenesis of the disease. We know that elevated IOP, whether from decreased aqueous outflow or from an imbalance in aqueous production, is related to retinal ganglion cell (RGC) death,3,4 a hallmark feature of glaucoma. Elevated IOP also causes mechanical stress and strain on the optic nerve.3 Other causes of optic nerve damage and risk factors for glaucomatous RGC death include vascular dysregulation leading to impaired microcirculation, decreased ocular blood flow and perfusion, mitochondrial dysfunction, and oxidative stress.3-6

The supplement options suggested below and the Table on page 48 have properties that are being investigated for their potential to lower IOP by increasing aqueous outflow, decreasing oxidative stress; shielding the optic nerve from damage and RGC death through neuroprotective effects; increasing ocular blood flow; and/or mitigating mitochondrial dysfunction.

 

SUPPLEMENT OPTIONS

Vitamins and Minerals

Vitamin C is a strong antioxidant that has the potential to protect the optic nerve against oxidative stress.7 One study noted that vitamin C levels were significantly lower in patients with normal tension glaucoma (NTG) than in healthy control patients.8 However, evidence on whether receiving vitamin C supplements is protective against glaucoma is mixed. Another study showed that vitamin C given intravenously lowered IOP by 20%, but that over a period of 10 to 12 hours, IOP returned to baseline.9 Vitamin C appears to have a significant osmotic effect, similar to mannitol, but intravenous supplements are not practical.9 Further studies showed that vitamin C taken orally had no effect on IOP.9

Magnesium may help patients with glaucoma by improving ocular blood flow.10 It also has a neuroprotective effect by inhibiting the release of glutamate, a compound that can induce oxidative stress and cause damage to the optic nerve.10 One study showed that patients with glaucoma taking a supplement that included magnesium—along with homotaurine, carnosine, forskolin, folic acid, and vitamins B1, B2, and B6—demonstrated a statistically significant reduction in IOP, as well as improved light and contrast sensitivity.11

Another supplement for the treatment of glaucoma that has recently gained interest is vitamin B3, also known as niacin, and one of its derivatives, niacinamide. Low niacin intake has been linked to an increased risk for NTG and primary open-angle glaucoma (POAG).12,13 There is particular interest in the coenzyme nicotinamide adenine dinucleotide (NAD+), which comes from niacinamide. A recent paper concluded that certain crucial deficits in glaucoma can be linked to a deficit in NAD+ and resulting mitochondrial dysfunction.14 A recent large, collaborative preclinical study spanning seven countries used rodent models to simulate glaucoma and found that nicotinamide had neuroprotective effects, suggesting that this supplement is worth testing in human clinical trials.15

Omegas 3 and 6

The essential fatty acids (FAs) omega3 and omega6 may help decrease IOP by increasing aqueous outflow.16 A study evaluating the blood composition of FAs in patients with POAG noted that these patients had reduced levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) compared with healthy individuals.17 An animal study suggested that a diet high in omega3 FAs was associated with lower IOP.16 Another study showed that an increase in oral omega3 consumption significantly increased aqueous outflow and lowered IOP in patients with NTG.18 The mechanism of this increased aqueous outflow is activity of prostaglandins, which are metabolites of omega3 FAs.19 Treating patients with glaucoma using prostaglandin analogs is a mainstay of current best practices.

 

Phenol Compounds

Ginkgo biloba is one of the most promising supplements for glaucoma treatment. It is known to have antioxidant properties, help increase blood flow, stabilize mitochondria, and protect neurons from damage.20 The major components identified in ginkgo biloba are known as flavonoids, which are polyphenol compounds found in plants that have both neuroprotective and antioxidant properties.21 A meta-analysis on the effect of flavonoids in patients with glaucoma and ocular hypertension (OHT) showed that flavonoids appeared to play a part in slowing the progression of visual field loss.21 A randomized, double blind, placebo-controlled crossover study showed that oral supplementation with antioxidants, including ginkgo biloba, produced increases in biomarkers of ocular blood flow in patients with open-angle glaucoma.22 Another study showed that taking ginkgo biloba supplements appeared to improve existing visual field damage in some patients with NTG.23 A different study involving patients with NTG showed that ginkgo biloba may also have desirable effects on ocular blood flow.24

Mirtogenol (Horphag/Indena) is a dietary supplement that works similarly to gingko biloba. It is a combination of two phenolic extracts taken from bilberry and French maritime pine bark.25 Previous studies have demonstrated that Mirtogenol can be helpful in treating glaucoma by improving ocular blood flow and lowering IOP. In one study, Mirtogenol lowered IOP in patients with OHT who did not yet show signs of glaucoma.26 Another study noted that Mirtogenol, when used in combination with the prostaglandin analog latanoprost ophthalmic solution 0.005% (Xalatan, Viatris), had a synergistic effect; patients who received both latanoprost and Mirtogenol had significantly lower IOP and improved retinal blood flow compared with patients who took latanoprost alone.25

Resveratrol is a plant polyphenol. Clinical studies have shown that resveratrol has strong antioxidant and antiinflammatory properties, as well as neuroprotective and anti-aging effects.27 It may also improve mitochondrial dysfunction.23 In a literature review, one study demonstrated resveratrol’s antioxidative and antiapoptotic roles in the trabecular meshwork cells by noting a decrease in inflammatory markers and cellular senescence markers consistently observed in patients with POAG.27 Another study showed that treatment with resveratrol considerably slowed the apoptotic process, helping to maintain normal mitochondrial membrane potential and enhancing cell survival.27

 

AN EXCITING FUTURE

Dietary supplements are gaining popularity in health care. Providing our patients with information about which supplements to take can help them navigate the abundance of options out there. This list is not exhaustive, and there are many other supplements that show promise in helping to slow the onset and progression of glaucoma. Although there are limited data on nutritional supplements for glaucoma, this is an exciting area of study with a lot of future potential.

 

The authors would like to extend a special thank you to Zac Denning for his help in providing research sources for this article.

  1. Physicians Committee for Responsible Medicine. Nutrition guide for clinicians: glaucoma. nutritionguide.pcrm.org/nutritionguide. Updated December 15, 2020. Accessed October 18, 2021.
  2. Ramdas WD, Wolfs RCW, Jong JCK, et al. Nutrient intake and risk of open-angle glaucoma: the Rotterdam Study. Eur J Epidemiol. 2012;27(5):385-393.
  3. Weinrab RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA. 2014;311(18):1901-1911.
  4. Heiting G. All About Vision. Ocular hypertension: 5 causes of high eye pressure. www.allaboutvision.com/conditions/hypertension.htm. Published March 2019. Updated September 2021. Accessed October 18, 2021.
  5. Owaifeer AMA, Taisan AAA. The role of diet in glaucoma: a review of the current evidence. Ophthalmol Ther. 2018;7(1):19-31.
  6. Kong GYX, Bergen NJV, Trounce IA, Crowston JG. Mitochondrial dysfunction and glaucoma. J Glaucoma. 2009;18(2):93-100.
  7. Glaucoma Research Foundation. Glaucoma and nutrition: why what you eat matters. www.glaucoma.org/news/blog. Published June 16, 2021. Accessed October 18, 2021.
  8. Yuki K, Murat D, Kimura I, Ohtake Y, Tsubota K. Reduced-serum vitamin C and increased uric acid levels in normal-tension glaucoma. Graefes Arch Clin Exp Ophthalmol. 2010;248(2):243-248.
  9. Gamell LS. Supplements and glaucoma: advising your patients. Review of Ophthalmology. www.reviewofophthalmology.com/article/supplements-and-glaucoma-advising-your-patients. Published February 9, 2018. Accessed October 18, 2021.
  10. Ekici F, Korkmaz S, Karaca EE, et al. The role of magnesium in the pathogenesis and treatment of glaucoma. Int Sch Res Notices.
  11. Rolle T, Dallorto L, Rossatto S, Curto D, Nuzzi R. Assessing the performance of daily intake of a homotaurine, carnosine, forskolin, vitamin B2, vitamin B6, and magnesium based food supplement for the maintenance of visual function in patients with primary open angle glaucoma. J Ophthalmol. 2020;2020:7879436.
  12. Jung KI, Kim YC, Park CK. Dietary niacin and open-angle glaucoma: the Korean National Health and Nutrition Examination Survey. Nutrients. 2018;10(4):387.
  13. Nzoughet JK, Chao de la Barca JM, Guehlouz K, et al. Nicotinamide deficiency in primary open-angle glaucoma. Invest Ophthalmol Vis Sci. 2019;60(7):2509-2514.
  14. Cimaglia G, Votruba M, Morgan JE, André H, Williams PA. Potential therapeutic benefit of NAD+ supplementation for glaucoma and age-related macular degeneration. Nutrients. 2020;12(9):2871.
  15. Tribble JR, Otmani A, Sun S. Nicotinamide provides neuroprotection in glaucoma by protecting against mitochondrial and metabolic dysfunction. Redox Biol. 2021;43:101988.
  16. Pasquale LR, Kang JH. Lifestyle, nutrition and glaucoma. J Glaucoma. 2009;18(6):423-428.
  17. Ren H, Magulike N, Ghebremeskel K, Crawford M. Primary open-angle glaucoma patients have reduced levels of blood docosahexaenoic and eicosapentaenoic acids. Prostaglandins Leukot Essent Fatty Acids. 2006;74(3):157-163.
  18. Downie LE, Vingrys AJ. Oral omega-3 supplementation lowers intraocular pressure in normotensive adults. Transl Vis Sci Technol. 2018;7(3):1.
  19. Huang W, Fan Q, Zhang X. Cod liver oil: a potential protective supplement for human glaucoma. Int J Ophthalmol. 2011;4(6):648-651.
  20. Cybulska-Heinrich AK, Mozaffarieh M, Flammer J. Ginkgo biloba: An adjuvant therapy for progressive normal and high tension glaucoma. Mol Vis. 2012;18:390-402.
  21. Patel S, Mathan JJ, Vaghefi E, Braakhuis AJ. The effect of flavonoids on visual function in patients with glaucoma or ocular hypertension: a systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol. 2015;253(11):1841-1850.
  22. Harris A, Gross J, Moore N, et al. The effects of antioxidants on ocular blood flow in patients with glaucoma. Acta Ophthalmol. 2018;96(2):e237-e241.
  23. Quaranta L, Bettelli S, Uva MG, Semeraro F, Turano R, Gandolfo E. Effect of Ginkgo biloba extract on preexisting visual field damage in normal tension glaucoma. Ophthalmology. 2003;110(2):359-362, discussion 362-364.
  24. Park JW, Kwon HJ, Chung WS, Kim CY, Seong GJ. Short-term effects of Ginkgo biloba extract on peripapillary retinal blood flow in normal tension glaucoma. Korean J Ophthalmol. 2011;25(5):323-328.
  25. Steigerwalt RD, Belcaro G, Morazzoni P, Bombardelli E, Burki C, Schönlau F. Mirtogenol potentiates latanoprost in lowering intraocular pressure and improves ocular blood flow in asymptomatic subjects. Clin Ophthalmol. 2010;4:471-476.
  26. Steigerwalt RD, Belcaro G, Morazzoni P, Bombardelli E, Burki C, Schönlau F. Effects of Mirtogenol on ocular blood flow and intraocular hypertension in asymptomatic subjects. Mol Vis. 2008;14:1288-1292.
  27. Abu-Amero KK, Kondkar AA, Chalam KV. Resveratrol and ophthalmic diseases. Nutrients. 2016;8(4):200.

 

PRESERVE & PROTECT YOUR VISION DONATE TODAY

 

Without ongoing contributions from generous donors like you, the Macular Degeneration Association would be

unable to fund Research and Education for the millions of people living with macular degeneration.

 

HOW TO GIVE

 

Phone, Mail or Online

Phone: Please call (941)893-4387 today to speak to one of our Donor Services Representatives.

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Please give serious consideration to the donation of stock and mutual fund shares as this offers numerous opportunities

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Wills, Bequests and Planned Gifts

Please give serious consideration to the designation of MDA in your Will, Charitable Trusts, Life Insurance, Appreciated

Securities and Real Estate as this offers preplanned giving opportunities that will serve the macular community for

years to come. Please call Lynne Henry (941)893-4389 at the Macular Degeneration Association, today, for personal

assistance in initiating this effort.

The following language has been reviewed and is deemed a legally acceptable form for including such a bequest in a will:

“I give and bequeath to the Macular Degeneration Association, 5969 Cattleridge Blvd. Suite # 100 Sarasota, FL 34232

for discretionary use in carrying out its aims and purposes, (the sum of $_____) or ( a sum equal to _______% of

the value of my gross estate at the time of my death under this will or any codicil hereto).”

The Macular Degeneration Association Federal ID number is 27-3025707

 

MEMORIAL AND HONOR GIVING

 

Honor a family member, friend or special event by donating to MDA. Pay tribute to someone you love whose life

has been impacted by macular degeneration. In lieu of flowers, please consider designating Macular Degeneration

Association as your charity of choice.

 

WORKPLACE GIVING

 

Launch a Giving Campaign

Please consider leading a team at work by encouraging your colleagues and staff to join together to help those

living with macular degeneration. Launch a workplace giving campaign today.

Ask about Matching Gifts

Many gracious employers double or even triple charitable donations made by individual employees. Some companies

will match gifts made by retirees and or their spouses. Contact your employer for matching gift eligibility

as this allows you to maximize your personal donation.

 

Thank you!

 

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