What's good for the heart also good for the eyes

AS RETINAL specialists with a keen interest in the management of age-related macular degeneration (AMD), we are excited with the new research findings suggesting a significantly higher risk of AMD among East Asians with a specific genetic mutation, as this is a step forward in the better understanding of AMD risk factors ("Good for the heart, bad for the eyes"; last Tuesday).

The article, however, alludes to providing nutritional supplementation with vitamin B among other vitamins for patients with early AMD. In fact, vitamin B has no beneficial role in the current management of AMD.

In a landmark multi-centre, randomised, controlled trial called the Age-Related Eye Disease Study (AREDS), taking a daily supplement containing vitamins A (beta carotene), C and E, as well as zinc and copper, reduces the risk of moderate AMD progressing to advanced AMD by 25 per cent over five years ("Vitamins can stop sight loss in the old"; Dec 12, 2001).

A recent follow-up study, AREDS 2, has further refined the original AREDS formulation with the finding that lutein and zeaxanthin are safe and effective alternatives to beta carotene, which has been associated with an increased risk of lung cancer in smokers ("Possible beta carotene risk for smokers"; Dec 22, 2001).

Of the current known risk factors for AMD, genetic factors - like other factors such as age, gender and ethnicity - are, at least for now, non-modifiable.

Of more importance are the potential benefits of altering modifiable lifestyle or environmental risk factors.

AMD and heart disease share many common risk factors, such as smoking, a diet low in green, leafy vegetables, fruits and fish, a high serum lipid level, high blood pressure, physical inactivity and obesity.

In terms of these shared risk factors, what is good for the heart, in general, is also good for the eyes.

Although AMD may not be totally preventable, the risk of developing this blinding eye disease can be potentially reduced by tackling the appropriate modifiable risk factors.

Ajeet Madhav Wagle (Dr)

Elaine Huang (Dr)

Au Eong Kah Guan (Dr)

Department of Ophthalmology and Visual Sciences

Khoo Teck Puat Hospital

This article was first published on March 03, 2015.
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