Sunlight triggers oxidative damage in the eye that, in turn, can cause ARMD.82 Animals that were given antioxidants, which protect tissues against oxidative damage, have had a lower risk of developing this vision problem.83 People with high blood levels of antioxidants also have a lower risk.84 Those with the highest levels of the antioxidants selenium, vitamin C, and vitamin E may have a 70% lower risk of developing ARMD.85 People who eat diets that are rich in beta-carotene, another antioxidant, also appear to be at a lower risk for developing ARMD.86 As such, many people who want to lower their risk for macular degeneration take antioxidants. Reasonable adult levels include 200 mcg of selenium, 1,000 mg of vitamin C, 400 IU of vitamin E, and 25,000 IU of natural beta-carotene per day. The carotenoids lutein and zeax-anthin are antioxidants much like beta-carotene. These carotenoids, which are found in high concentrations in spinach and kale, concentrate in the part of the retina where ARMD strikes. The macula acquires its yellow appearance from the accumulation of carotenoid pigments. Lutein is found in higher concentrations outside of the fovea while zeaxanthin concentrates closer to the fovea.86 Research has shown that carotenoids act to protect the retina from damage caused by sunlight.87 People who eat spinach and kale have a lower risk of developing ARMD, although blood levels of lutein have not been correlated with a risk of macular degeneration.88 Two important enzymes needed for vision in the retina require zinc (an outstanding ally in free-radical defense). Double-blinded research, using 80 mg of zinc versus placebo for two years, found that zinc prevented 42% of vision loss in subjects with ARMD.89 Additional research did not, however, confirm the data generated from this earlier study.90 Active bioflavonoid compounds (anthocyanosides) in bilberry act as antioxidants in the retina. This makes the herb a potential preventive measure against macular degeneration.91 Bilberry has also been shown to strengthen capillaries and reduce hemorrhaging in the retina.92 Many people take 240- 480 mg per day of bilberry extract in capsules or tablets standardized to 25% anthocyanosides. Additional research has shown promise for the antioxidant effects of gingko for preventing or treating macular disorders.93 Promising preliminary research points toward the profound effect that vitamin and nutrient antioxidants have on macular function. Once again, the future of therapies relies strongly on preventive medical measures. Counseling patients regarding reducing exposure to oxidative damaging environments and activities, increasing antioxidant-rich food sources, and increasing activities that influence blood flow to the eye, will be the most potent therapeutics. However, in circumstances when treatment is needed, sound scientific support is becoming available tojustify treatment with nutrients and botanicals including carotenoids, vitamins C and E, zinc, selenium, and ginkgo.
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