Living with Diabetes is a growing concern for doctors and patients of all ages, as the number of Americans suffering with Diabetes continue to rise. It’s a disease that affects a long list of the body’s various organs, including our eyes. As Diabetes progresses, visual impairments can occur as a result of Diabetic Retinopathy, which becomes more of a concern as the disease advances over time. Diabetic Retinopathy can severely reduce or completely diminish one’s vision, and doctors are racing towards a fix as the number of patients with Diabetic Retinopathy continue to grow.
Doctors are making rapid advances in understanding and treating Diabetes, and it’s always been emphasized that a strong, healthy diet is vital in curbing the negative health effects that Diabetes can cause, particularly low vision, as the ocular system thrives on nutrition. But are there other things that can be done to help block Diabetic Retinopathy? Will Diabetes increase the odds of other low vision diseases as well (like Glaucoma or Macular Degeneration)? Find out more about Diabetes, including six vital steps in preventing low vision.
Currently, over 4 million Americans are suffering from Glaucoma. This low vision disease, a leading cause of blindness which typically affects older people, is referred to as “the sneak thief of sight”; it’s early stages often go undetected. Early detection is paramount, as doctors and specialists can possibly restore lost vision, or maximize their remaining vision. Some believe that this disease is ultimately unavoidable, that is to say, all of us will someday begin to lose our eye sight… if we live long enough. Others claim there are indeed preventative measures one can take to safeguard themselves from this terrible disease. The fact remains: In order to prevent Glaucoma, we must understand how the disease manifests and progresses. For more information on Glaucoma prevention, read the full article here:
As our aging population increases, more adults and seniors are losing their vision to common diseases like macular degeneration or glaucoma. In the search for a cure, it’s become obvious that a nutritious diet can go a long way in preventing low vision. U.S. Dietary Guidelines are expected to change in an effort to promote the correlation between healthy eating and healthy eyes. Every five years, there is a nationwide reevaluation of what can be done to ensure a healthy America, and the next publication, conducted by the Department of Health and Human Services, is due at the end of this year. Find out new nutritional information optometrists will be sharing with patients in an on-going effort to prevent macular degeneration, glaucoma, and other causes of low vision.
To read more about this topic you can visit the link below.
Positive results from a Phase II advanced dry macular degeneration study has opened doors to a Phase III clinical trial involving more than 900 patients in 20 countries. The study will run for two years.
The drug Lampalizumab “slowed progression of dry, aged related macular degeneration in patients with advanced disease, shrinking the area of geographic atrophy (GA) by 20.4%” according to the Phase II MAHALO study results. The principal investigator, Carl Regillo, MD, from the Wills Eye Hospital in Philadelphia, Pennsylvania states, “MAHALO is the first study to demonstrate a positive treatment effect with a complement inhibitor in geographic atrophy.” The main purpose of the Phase III trial will be the same – to see if the drug can promote a change in the GA area. Evaluations to monitor these changes will be by retinal imaging.
Eligibility and Intervention
The drug will be given by intravitreal injection. However, not every participant will be given the drug. The study is a randomized, double-blind, placebo controlled study. This means that some patients will get the drug and others will get a placebo or sham. Neither the participant nor the retinal doctor will know which patients are receiving the drug or the placebo until the end of the study.
Eligible candidates for the Phase III study must be 50 years or older and have evidence of Geographic Atrophy (GA) caused by macular degeneration with no choroidal neovascularization (wet AMD) in both eyes.
Inhibiting the Complement Pathway
Lampalizumab works by inhibiting the complement pathway. Ophthalmologist Phil Rosenfeld of Bascom Palmer Eye Institute in Miami, explains complement activation this way, “The complement pathway is responsible for preventing infection. When the pathway gets activated by bacteria, viruses, and foreign tissue, it destroys the invading organisms and transplanted organs. During the activation process, normal tissue can get damaged. In AMD, it is believed that people with AMD carry mutations in their DNA that cause the complement system to become over-activated and the pathway accidentally destroys normal tissue.
“Lampalizumab has the potential to represent a significant breakthrough for this disease and could provide real hope for GA patients,” said Sandra Horning, Roche’s chief medical officer. “It is the only ophthalmic drug in clinical development that specifically targets complement factor D.”
Leslie Degner, RN, BSN
In a recent blog by ophthalmologist and low vision specialist, Lylas Mogk, MD., she reports that “about 30% of people with vision loss experience Charles Bonnet Syndrome (CBS) for a year or two, in which they see clear, colorful images of people, animals, flowers or buildings, for example, that aren’t really there. The person seeing these is usually aware that the images are not real, as they may be superimposed on their living room wall or appear in the sky.”
Such was the experience of my father-in-law who has wet macular degeneration (AMD). He would see mothers and children in bright color clothes riding bikes on the side of the road while he was in the car or sitting in his yard. At first these visual hallucinations alarmed him and he spoke to his primary care doctor and explained that he was seeing these visions. Unaware of Charles Bonnet Syndrome, she ordered a brain CT scan for him. On the weekend before the test, he told me about his symptoms. When I explained that these strange sightings were not uncommon in those with macular degeneration or other vision loss, he felt great relief. Dr. Mogk goes on to explain, “ It’s important to know that these are not pathological hallucinations; they are just your eyes playing tricks on you, similar to phantom pain, for example, when someone feels like an amputated finger is itching but it can’t be because it’s not there.”
In a recent survey of general practitioners (GPs) by the Macular Society it was reported that 58% of those that responded were aware of the link between macular degeneration and visual hallucination. And an estimated 20% of GPs learned about CBS from their patients. Such was the case with my father-in-law. I instructed him to have a conversation with his GP about CBS and his symptoms before he had the CT scan in case she wanted to cancel the test.
Thankfully my father-in-law told his doctor about his “sightings” and found great relief knowing that his hallucinations were not from some other serious disorder. However, that’s not the case for many other patients who suffer in silence afraid of what these abnormal visions might mean.
Dr Waqaar Shah, of the Royal College of General Practitioners and the UK Vision Strategy Eye Health Clinical Priority Project, commented, “Patients will rarely volunteer this symptom for fear of being judged as having a mental health condition so it is important GPs raise awareness amongst patients so that they can receive appropriate support. “
Learn more about this syndrome so that you can discuss it with someone you know with vision loss or maybe even your GP:
Charles Bonnet Syndrome
Leslie Degner, RN, BSN
There has been lots of activity in the research world using embryonic and adult stem cells to treat not only macular degeneration, but other eye diseases as well, such as Stargardts macular dystrophy, optic nerve disease and glaucoma. These early Phase I clinical trials enroll very small numbers of patients, leaving the rest of the world to watch and wait.
But perhaps there are other ways to replace damaged cells with healthy stem cells produced by your own body. Damon P. Miller II, M.D. board-certified medical doctor, fellowship-trained radiologist and certified by the American Naturopathic Certification, has written a book called Stem Cells Heal Your Eyes: Prevent and Help: Macular Degeneration, Retinitis Pigmentosa, Stargardt, Retinal Dystrophy, and Retinopathy. Dr. Miller does not practice traditional medicine but rather uses natural, drugless therapies to treat chronic medical conditions. He has devoted a significant part of his practice to the treatment of eye disorders.
Dr. Miller worked with Grace Halloran, PhD to put together several eye health therapies now called the Better Eye Health Program, that seek to prevent vision loss from eye diseases such as retinitis pigmentosa (RP) and macular degeneration. Dr. Halloran was diagnosed with RP and macular degeneration at the age of 25. When her son was born he also inherited the defective gene for RP. After many visits to academic medical centers she received the same answer from all of them – there is nothing we can do for your son’s vision. Not to be deterred she determined that she must take responsibility to find or pave her own way to prevent this eye disease from taking her and her son’s vision. She was able to restore much of her own vision and her son’s vision remained healthy and normal through a variety of different therapies along with diet and nutrition. Dr. Miller writes, “Dr. Halloran’s therapies were helping people support their own adult stem cells to regenerate damaged eye tissue.” You can read Grace’s story in her autobiography, Amazing Grace, Autobiography of a Survivor.
Unlike a single injection into the eye, the stimulation of one’s own stem cell production involves many different therapies and approaches. Also unlike today’s healthcare which treats a single part of the body, such as the eye or the retina, these therapies work to improve systems of the body such as increasing circulation, providing nourishment and oxygen, and reducing chronic inflammation. According to Dr. Miller, “when an individual incorporates certain disciplines into their lifestyle, vision can be improved and degeneration can be slowed or stopped.” Here are some of the therapies he uses:
Dr. Miller explains, “Adult stem cells allow the body to repair damaged tissue previously thought irreparable including eye tissue.” Find out more about his book and the Better Eye Health Program here:
Leslie Degner, RN, BSN
Ocata Therapeutics, formerly known as Advanced Cell Technology, is conducting a study for the treatment of dry macular degeneration (AMD) at several sites in the United States. The company concentrates their efforts in a new field of treatment, called regenerative medicine. “At the very core of our regenerative ophthalmology efforts is the notion that we can change the course of degenerative eye disease by identifying which cell types are compromised or lost due to disease, and replacing those missing cells with the same cell generated from a stem cell source.” Instead of treating symptoms their goal is to rejuvenate, replace and even regenerate damaged retinal tissue.
One of their current studies is for the treatment of dry AMD. It is a Phase I/II study “to Determine the Safety and Tolerability of Sub-retinal Transplantation of Human Embryonic Stem Cell Derived Retinal Pigmented Epithelial (MA09-hRPE) Cells in Patients With Advanced Dry AMD.” Patients receive the stem cells via a single injection into the eye. There will be 5 cohorts or groups of patients – each group receiving a different amount of MA09-hRPE cells transplanted
Three AMD patients will receive 50,000 MA09-hRPE cells transplanted
Three AMD patients will receive 100,000 MA09-hRPE cells transplanted
Four Better Vision AMD patients will receive 100,000 MA09-hRPE cells transplanted
Three AMD patients will receive 150,000 MA09-hRPE cells transplanted
Three AMD patients will receive 200,000 MA09-hRPE cells transplanted
The first group of patients will be followed for 6 weeks and evaluated by an independent Data Safety and Monitoring Board before proceeding with the next group of patients. Patients will remain in the study for 12 months.
At the time of this writing, February 2015, they are recruiting a small number of participants. This is a partial list of the criteria one must meet to be eligible.
Male or Female adults 55 years or older
Be in reasonably good health with the expectation of living at least 4 years after treatment
Diagnosed with advanced dry AMD
Have clinical signs of Geographic Atrophy
Cannot have wet AMD in the treated eye
Jules Stein Eye Institute, UCLA School of Medicine in Los Angeles, CA
Bascom Palmer Eye Institute in Miami, FL
Wills Eye Institute in Philadelphia, PA
Mass Eye and Ear in Boston, MA
The injected cells used in this clinical trial are the same cells they are intended to replace. Once injected, they will seek out the areas of degeneration and according to Ocata, “replace the missing native cells and regenerative the structure of the eye and restore its function.” Study results when published will report on the safety of the procedure, the success of the engraftments, and any vision changes. For more detailed info on this type of research visit:
Leslie Degner, RN, BSN
The iolAMD is a breakthrough in the treatment of macular degeneration. Patients are reporting that once the new lenses are implanted they are able to see faces, enjoy colors, drive and read again. These telescopic lenses work differently than other macular degeneration implants in several ways. It is available to a wider range of patients with vision problems, there is no need for low vision rehab after they are implanted, and the procedure is less invasive, without even any need for stitches.
Unlike other macular degeneration implants that are just for those with advanced AMD, the iolAMD can, according to the iolAMD website, “help patients with early, intermediate and end stage dry AMD and established wet forms of AMD. iolAMD can also help patients with other forms of macular disease including diabetic maculopathy, macular holes, myopic degeneration, diabetic retinopathy and hereditary retinal diseases such as Stargardt’s and Best’s.”
Patients are first seen in a doctor’s office with a simulation test to determine whether or not they would benefit from the implants. If there is vision improvement with the office test, it is highly likely that the lenses would also offer improved vision.
Two tiny lenses are implanted through a minimally invasive procedure, using a micro-incision – much like a cataract operation – but even less invasive. The incision is only 3 mm compared to 8-11 mm for other implants. Because the incision is so small, no stitches or sutures are needed. The procedure is done in 5” to 10” under a local anaesthetic. The smaller incision means quicker healing and less surgical risk. The natural lens is removed and two iolAMD lenses are actually “injected” into the eye. Unlike other telescopic lens implants, each eye receives a lens. The two lenses actually work together in two ways:
It takes about 1-2 months for the eyes and brain to adjust to the new way of seeing. These optic lenses were developed by eye surgeon Dr Bobby Qureshi and optical physicist Professor Pablo Artal. The unique characteristics of the lenses means there is little to no distortion and significant improved vision.
Where Is It Available
As of this writing the lenses are available in the United Kingdom, France, Italy and Germany. The U.S. is still waiting for FDA approval. To watch a video on how these optic lenses work visit:
Leslie Degner, RN, BSN
Vitamin D is a fat-soluble vitamin that benefits our bones, our mental health, our immune system, our heart health and yes, even our eyes. Vitamin D deficiency is more common in patients with wet macular degeneration than in those with dry age related AMD according to the September 2014 issue of the medical journal Retina. The research found that the vitamin D levels were lower and more prevalent in those with neovascular (wet) AMD. It may be due to the effects of vitamin D preventing angiogenesis – or new blood vessel formation. It also provides the benefit of being anti-inflammatory. Inflammation plays a key role in the development of AMD.
According to Michael Holick, Ph. D., M.D., the author of The Vitamin D Solution, those with wet AMD are not the only ones deficient in this vital nutrient. “The vitamin D deficiency and insufficiency that afflict at least half of the worlds population, and remain one of the most undiagnosed medical conditions, are real – and very serious.” He goes on to say that “Three out of every four Americans are deficient in vitamin D, up from one out of two twenty years ago.”
Health Consequences of Vitamin D Deficiency
Sarfraz Zaidi, M.D., the author of the Power of Vitamin D states that there is a relationship between vitamin D deficiency and bone pain, osteoporosis, immune disorders, heart disease, high blood pressure, depression and cancer.
Ask your doctor to do a 25-vitamin D test. It is a simple blood test that is sent off to the lab. Dr. Holick recommends levels to be in the range of 30 to 100 nanograms per milliliter of blood.
How to Increase Your Levels
You can increase your vitamin D levels in three ways.
Laura Jeffers, a registered dietitian at Cleveland Clinic salmon. “Salmon is a great source of Vitamin D and having 3 ounces, a couple of times per week, will help support your Vitamin D intake,” she said. Wild caught salmon has higher amounts of this vitamin than does farm raised. However, Dr. Holick informs his readers that “you can’t rely on diet to obtain it.”
Dr. Holick states, “I typically recommend taking 1,000 to 2,000 IU of vitamin D a day – that should be adequate along with a multi-vitamin that contains 400 IU of vitamin D.
3. Sun Exposure
Vitamin production is triggered when skin is exposed to ultraviolet light. Dr Holick’s preferred method is that sunlight be most people’s main source of vitamin D. Find out how to safely expose your skin to enhance your vitamin D production here:
Leslie Degner, RN, BSN
As someone who eats very healthy, including lots of fresh salads and vegetables, I discovered that all this good food could be better utilized with a healthy digestive system. Dr. Steven Lamm, MD, internist and faculty member at New York University School of Medicine, writes, “When the digestive system is working properly it serves as a barrier to bacteria, viruses and pathogens of all kinds.”
Diminishing Digestive Enzymes
There are some things we can do and other things we can’t avoid that adversely affect the production of pancreatic enzymes. They are:
1. Aging Children and young adults normally have good digestive health, but Dr. Susan Lark the author of Enzymes the Missing Link to Health, writes that “by the time most people reach their forties and fifties, the biochemical aging of the body begins to accelerate and the production of digestive enzymes diminishes. “ Some doctors suggests that by age 50 you may be making half the amount you did when you were younger.
2. Standard American diet Lack of fresh vegetables and fruits means a lower supply of digestive enzymes. Raw fruits and vegetables provide needed enzymes to digest our food. Once cooked, the enzymes are destroyed.
4. Alcohol overuse
Why You May Need Digestive Enzymes
1. Digestive enzyme production diminishes with age
2. Digestive processes become less efficient with age
3. Reduced motility – the ability of food to move through the digestive tract – occurs with aging
4. Stomach produces less hydrochloric acid with age which helps with protein digestion
Signs of Digestive Enzymes Deficiency
As people age they may find that foods they once enjoyed, they can no longer tolerate. Some digestive symptoms listed below may be a sign that you are deficient in your enzyme production:
How to Improve Your Digestive Health?
1. Take digestive enzymes to improve your health and immune system
2. Take these supplement just before a meal
3. Chew your food to increase your own natural production of enzymes
4. Eat raw foods such as pineapple, mango, kiwi, and papaya
Heated foods destroy enzymes while raw and organic foods contain the most enzymes.
A diet that includes enzyme rich foods and digestive enzyme supplements can help to support physical and mental energy by improving the absorption and assimilation of nutrients. Dr. Susan Lark ties the role of digestive enzymes with the inflammatory process. “The production of abundant pancreatic enzymes not only helps to hasten recovery from trauma, respiratory illnesses and exertion, but can be useful in the treatment of a number of inflammatory diseases ….”
Leslie Degner, RN, BSN