scholarly journals Eating for Eye Health: Engaging patients with dry age-related macular degeneration in community cookery to support lifestyle change and positive health

2019 ◽  
Vol 3 (2) ◽  
pp. 129-141 ◽  
Author(s):  
Rose M. Gilbert ◽  
Ann Rawlings ◽  
Michael S. Dixon ◽  
Ana Rita Gonçalves de Pinho ◽  
Tadhg Caffrey

There are limited treatment options available upon diagnosis of dry age-related macular degeneration (AMD), a leading cause of blindness in older people, which progressively threatens central vision and quality of life. Community engagement has the potential to support 'positive health' of individuals with untreatable eye conditions. Eating for Eye Health is an award-winning public-engagement project that aims to raise awareness of research suggesting that nutrition might help protect against progression of AMD and to encourage patients to cook and eat antioxidant-rich food in a community environment. The project engaged patients who had a diagnosis of dry AMD through a focus group and a community cookery day organized in partnership with the healthy food outlet, Pod, and the Manor Gardens Community Kitchen Project, Islington, London. A focus group highlighted participants' potential barriers to engagement with research about lifestyle modification and identified that a co-designed community cookery project could help to address unmet needs for support. Individuals with dry AMD reported increased levels of confidence in cooking skills after participating in the community cookery day. The combination of these methods within the context of AMD highlights how a focus on patient needs and expectations can establish and grow mutually beneficial relationships. There is potential for Eating for Eye Health, or similar community kitchen approaches, to be implemented within the community setting through NHS 'social prescribing' initiatives. In conclusion, Eating for Eye Health is unique in its combination of elements of community consultative and collaborative forms of engagement. These methods could be adopted as part of Sustainability and Transformation Plans (STPs) in local health policy development in the community.

Proceedings ◽  
2020 ◽  
Vol 70 (1) ◽  
pp. 84
Author(s):  
Rimjhim Agarwal ◽  
Hung T. Hong ◽  
Alice Hayward ◽  
Stephen Harper ◽  
Neena Mitter ◽  
...  

Age-related macular degeneration (AMD) is the leading cause of blindness in developed countries, such as Australia. Lutein and zeaxanthin are the only two carotenoids found in the macular region of the eye. Studies have shown that an intake of 10 mg and 2 mg per day of lutein and zeaxanthin, respectively, can reduce the rate of progression of AMD. The supply of these carotenoids can only be met through dietary sources or supplements, as these compounds cannot be synthesised by humans. Although lutein is relatively abundant in dietary sources, zeaxanthin has limited sources. In this study, eight orange and three red capsicum varieties were analysed for their carotenoid profiles by UHPLC-DAD-APCI-MS. It was observed that the principal carotenoid for seven of the orange varieties was zeaxanthin, and capsanthin for the three red varieties. One orange variety, which had a darker orange hue, had capsanthin and violaxanthin as its principal carotenoids instead of zeaxanthin. Zeaxanthin concentration (the principal carotenoid) in the seven orange varieties varied from 2.6 ± 0.5 mg/100 g to 25.27 ± 9.4 mg/100 FW, suggesting that as little as 7 g of the high-zeaxanthin line could meet the recommended daily dietary intake of 2 mg/person/day.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alessandro Arrigo ◽  
Emanuela Aragona ◽  
Ottavia Battaglia ◽  
Andrea Saladino ◽  
Alessia Amato ◽  
...  

AbstractOuter retinal tubulations (ORT) are a relatively new finding characterizing outer retinal atrophy. The main aim of the present study was to describe ORT development in advanced age-related macular degeneration (AMD) and to assess its relationship with disease’s severity. Patients with advanced AMD characterized either by macular neovascularization or geographic atrophy, showing signs of outer retinal disruption or retinal pigment epithelium atrophy on structural optical coherence tomography (OCT) at the inclusion examination were prospectively recruited. All the patients underwent complete ophthalmologic evaluation, structural OCT scans and fundus autofluorescence imaging. The planned follow-up was of 3-years. Main outcome measures were ORT prevalence, mechanism of ORT formation, mean time needed for complete ORT formation, best-corrected visual acuity (BCVA), definitely decreased autofluorescence (DDAF) area, questionably decreased autofluorescence (QDAF) area, retinal layer thickness, foveal sparing, number of intravitreal injections. We also assessed the possible role of external limiting membrane (ELM) and Müller cells in ORT pathogenesis. Seventy eyes (70 patients) were included; 43 showed dry AMD evolving to geographic atrophy, while 27 displayed the features of wet AMD. Baseline BCVA was 0.5 ± 0.5 LogMAR, decreasing to 0.9 ± 0.5 LogMAR at the 3-year follow-up (p < 0.01). We detected completely formed ORT in 26/70 eyes (37%), subdivided as follows: 20 eyes (77%) wet AMD and 6 eyes (23%) dry AMD (p < 0.01). ORT took 18 ± 8 months (range 3–35 months) to develop fully. We described the steps leading to ORT development, characterized by progressive involvement of, and damage to the photoreceptors, the ELM and the RPE. Eyes displaying ORT were associated with a smaller QDAF area, less retinal layers damage and lower rate of foveal sparing than eyes free of ORT (p < 0.01). We also described pigment accumulations simulating ORT, which were detected in 16/70 eyes (23%), associated with a greater loss of foveal sparing, increased DDAF area and smaller QDAF area at the 3-year follow-up (p < 0.01). In conclusion, this study provided a description of the steps leading to ORT development in AMD. ELM and Müller cells showed a role in ORT pathogenesis. Furthermore, we described a subtype of pigment hypertrophy mimicking ORT, evaluating its clinical utility.


Biology ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 622
Author(s):  
Iswariyaraja Sridevi Gurubaran ◽  
Hanna Heloterä ◽  
Stephen Marry ◽  
Ali Koskela ◽  
Juha M. T. Hyttinen ◽  
...  

Aging-associated chronic oxidative stress and inflammation are known to be involved in various diseases, e.g., age-related macular degeneration (AMD). Previously, we reported the presence of dry AMD-like signs, such as elevated oxidative stress, dysfunctional mitophagy and the accumulation of detrimental oxidized materials in the retinal pigment epithelial (RPE) cells of nuclear factor erythroid 2-related factor 2, and a peroxisome proliferator-activated receptor gamma coactivator 1-alpha (NFE2L2/PGC1α) double knockout (dKO) mouse model. Here, we investigated the dynamics of inflammatory markers in one-year-old NFE2L2/PGC1α dKO mice. Immunohistochemical analysis revealed an increase in levels of Toll-like receptors 3 and 9, while those of NOD-like receptor 3 were decreased in NFE2L2/PGC1α dKO retinal specimens as compared to wild type animals. Further analysis showed a trend towards an increase in complement component C5a independent of component C3, observed to be tightly regulated by complement factor H. Interestingly, we found that thrombin, a serine protease enzyme, was involved in enhancing the terminal pathway producing C5a, independent of C3. We also detected an increase in primary acute phase C-reactive protein and receptor for advanced glycation end products in NFE2L2/PGC1α dKO retina. Our main data show C5 and thrombin upregulation together with decreased C3 levels in this dry AMD-like model. In general, the retina strives to mount an orchestrated inflammatory response while attempting to maintain tissue homeostasis and resolve inflammation.


2021 ◽  
Vol 10 (10) ◽  
pp. 2072
Author(s):  
Phoebe Lin ◽  
Scott M. McClintic ◽  
Urooba Nadeem ◽  
Dimitra Skondra

Blindness from age-related macular degeneration (AMD) is an escalating problem, yet AMD pathogenesis is incompletely understood and treatments are limited. The intestinal microbiota is highly influential in ocular and extraocular diseases with inflammatory components, such as AMD. This article reviews data supporting the role of the intestinal microbiota in AMD pathogenesis. Multiple groups have found an intestinal dysbiosis in advanced AMD. There is growing evidence that environmental factors associated with AMD progression potentially work through the intestinal microbiota. A high-fat diet in apo-E-/- mice exacerbated wet and dry AMD features, presumably through changes in the intestinal microbiome, though other independent mechanisms related to lipid metabolism are also likely at play. AREDS supplementation reversed some adverse intestinal microbial changes in AMD patients. Part of the mechanism of intestinal microbial effects on retinal disease progression is via microbiota-induced microglial activation. The microbiota are at the intersection of genetics and AMD. Higher genetic risk was associated with lower intestinal bacterial diversity in AMD. Microbiota-induced metabolite production and gene expression occur in pathways important in AMD pathogenesis. These studies suggest a crucial link between the intestinal microbiota and AMD pathogenesis, thus providing a novel potential therapeutic target. Thus, the need for large longitudinal studies in patients and germ-free or gnotobiotic animal models has never been more pressing.


2020 ◽  
Vol 77 (5) ◽  
pp. 779-780 ◽  
Author(s):  
Anu Kauppinen

AbstractProlonged life expectancies contribute to the increasing prevalence of age-related macular degeneration (AMD) that is already the leading cause of severe vision loss among the elderly in developed countries. In dry AMD, the disease culminates into vast retinal atrophy, whereas the wet form is characterized by retinal edema and sudden vision loss due to neovascularization originating from the choroid beneath the Bruch’s membrane. There is no treatment for dry AMD and despite intravitreal injections of anti-vascular endothelial growth factor (VEGF) that suppress the neovessel formation, also wet AMD needs new therapies to prevent the disease progression and to serve patients lacking of positive response to current medicines. Knowledge on disease mechanisms is a prerequisite for the drug development, which is hindered by the multifactorial nature of AMD. Numerous distinguished publications have revealed AMD mechanisms at the cellular and molecular level and in this multi-author review, we take a bit broader look at the topic with some novel aspects.


Age-related macular degeneration (AMD) is a degenerative disorder of the central retina and represents the leading cause of severe visual impairment in the elderly population of industrialized societies. It is known that it currently exists between 30 and 50 million people around the world and is estimated that will have doubled by the end of the coming decade. Several large epidemiologic studies have evaluated the prevalence of non-neovascular or so-called dry AMD. There is some variation in the prevalence of non-neovascular AMD depending on the exact definition of AMD. All of them report a higher prevalence of early AMD and an increasing prevalence with age. It is seen most in Caucasians and least in people with Africans and it is not related to gender.


2019 ◽  
Vol 20 (20) ◽  
pp. 5049 ◽  
Author(s):  
Ibuki ◽  
Shoda ◽  
Miwa ◽  
Ishida ◽  
Tsubota ◽  
...  

Background: Age-related macular degeneration (AMD) is the leading cause of blindness and can be classified into two types called atrophic AMD (dry AMD) and neovascular AMD (wet AMD). Dry AMD is characterized by cellular degeneration of the retinal pigment epithelium, choriocapillaris, and photoreceptors. Wet AMD is characterized by the invasion of abnormal vessels from the choroid. Although anti-vascular endothelial growth factor (VEGF) therapy has a potent therapeutic effect against the disease, there is a possibility of chorio-retinal atrophy and adverse systemic events due to long-term robust VEGF antagonism. We focused on hypoxia-inducible factor (HIF) regulation of VEGF transcription, and report the suppressive effects of HIF inhibition against ocular phenotypes in animal models. Many of the known HIF inhibitors are categorized as anti-cancer drugs, and their systemic side effects are cause for concern in clinical use. In this study, we explored food ingredients that have HIF inhibitory effects and verified their effects in an animal model of AMD. Methods: Food ingredients were screened using a luciferase assay. C57BL6/J mice were administered the Garcinia cambogia extract (Garcinia extract) and hydroxycitric acid (HCA). Choroidal neovascularization (CNV) was induced by laser irradiation. Results: Garcinia extract and HCA showed inhibitory effects on HIF in the luciferase assay. The laser CNV model mice showed significant reduction of CNV volume by administering Garcinia extract and HCA. Conclusions: Garcinia extract and HCA showed therapeutic effects in a murine AMD model.


2021 ◽  
Vol 28 (1) ◽  
pp. 7
Author(s):  
Ho Hin Ma ◽  
Rasa Liutkevičienė

Ageing is a natural process that everyone experiences and nobody is an exception. With ageing, our body experiences physiological changes. In this article, the focus is made on the physiological changes of our eyes related to ageing and age-related macular degeneration (AMD), which is the most common cause of incurable visual impairment in developed countries. With ageing populations increasing in many countries, more and more patients will have AMD in a foreseeable future. In Eastern Europe, blindness due to AMD, currently, is approximately 20% and there has been an increasing trend depicted in the future. Generally, AMD can be divided into early stages and two forms in an advanced (late) stage. Advanced AMD form includes neovascular AMD (wet) and geographic atrophy (late dry), both of these are associated with substantial, progressive visual impairment. The pathogenesis of AMD is complex and, by far, not completely understood. Multiple factors have been studied, for example: environmental factor, genetic factor (complement factor H), lifestyle. It has been proved that they are linked to higher the risk of developing of AMD, however, the actual pathogenesis is not yet formulated. AMD progression can also be a culprit to certain biochemical events and molecular changes linked to inflammation and pathological angiogenesis. In nowadays, we do have diagnostic methods for both early and late forms of AMD as well as ways to prevent progression of early AMD and wet AMD. However, until now, there is still no treatment for dry AMD. This article is a brief review of AMD and may hopefully lead to some future directions in early diagnostic methods and treating dry AMD.


2019 ◽  
Vol 3 (2) ◽  
pp. 94-98
Author(s):  
Omar M. Ismail ◽  
Lauren Mason ◽  
John O. Mason

Purpose: The purpose of this article is to examine the efficacy of macular hole repair in eyes with coexisting dry age-related macular degeneration (AMD). Methods: A retrospective analysis was performed of charts of 25 patients (27 eyes) diagnosed with mild to moderate dry AMD who underwent macular hole repair via 25-gauge pars plana vitrectomy between 2014 and 2016. Data of interest included anatomic failure rates, complication rates, and best-corrected visual acuity (BCVA) preoperatively, and at 1 month, 3 months, 6 months, and 12 months postoperatively. When available, data at each patient’s most recent visit were also analyzed. Results: Macular hole repair resulted in a statistically significant ( P < .05) visual improvement postoperatively, with BCVA increasing from 20/141 preoperatively to 20/33 1 year postoperatively. Mean BCVA at most recent visit was 20/41. Mean duration of follow-up was 13 months (range, 1-39 months). One of 27 (3.7%) macular holes failed to close after vitrectomy. One of 27 eyes (3.7%) progressed from dry to wet AMD. Four of 27 additional eyes (18.5%) were noted to have worsening of their AMD on exam over the course of follow-up. Conclusions: Macular hole repair in patients with coexisting dry AMD leads to a significant improvement in visual performance and has a low risk of failure or complication.


2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Maobo Du ◽  
Shuo Shen ◽  
Lina Liang ◽  
Kai Xu ◽  
Aiping He ◽  
...  

Age-related macular degeneration (AMD) is the third largest eye disease. However, the eye has a variety of drug delivery barriers, which prevent the drug from reaching the lesions in the posterior segment of the eye, coupled with the pathogenesis of dry-AMD; these lead to the lack of effective treatment drugs for dry-AMD. Therefore, the developments of a suitable therapeutic drug and a novel ophthalmic preparation are of great significance for the treatment of dry-AMD. The purposes of this study were to construct a novel traditional Chinese medicine (Chuanqi Fang) anti-AMD microemulsion in situ gel for treating dry-AMD and investigate its characteristic, efficiency, irritation, and tissue distribution. In this study, the characteristic of the Chuanqi microemulsion in situ gel was measured by dynamic light scattering. The electroretinogram (ERG) indicators and the number of retinal pigment epithelial cells were measured to evaluate the therapeutic effect of the novel ophthalmic nanopreparations. Irritation was evaluated according to Technical Guideline Principles (ZGPT4-1). The analysis of tissue distribution was carried out with LC-MS. The research showed that the particle size of microemulsion was 38.56 ± 0.21 nm. The Chuanqi microemulsion in situ gel had certain roles in repairing retina damage of the dry-AMD animal model and showed no irritation. The tissue distribution study found that the microemulsion in situ gel could effectively deliver the drug to the posterior eye of the AMD model rat through the route of cornea-vitreous body-retina. In conclusion, this study provided a meaningful research strategy and research basis for the development of new dry-AMD therapeutic drugs.


Sign in / Sign up

Export Citation Format

Share Document