Questions & Answers

There is a large amount of research being conducted to develop new therapeutic strategies for treating macular degeneration. In fact, some researchers are exploring the possible use of retinal transplants to create function in the macula. Preliminary results from these studies appear to be promising. While one cannot predict definitively the likelihood that the unaffected eye will also develop macular degeneration, the fact that one eye is affected increases the risk that the problem will also occur in the other eye.

After searching the National Institute of Health's PubMed database and other available sources, I found no scientific evidence supporting a correlation between macular degeneration and excessive sleep. Also, I did not find any relationship between excessive sleepiness and the AREDS vitamin formulation prescribed for the disease. If you are experiencing excessive sleepiness and feel that it may be related to the use of these vitamins, you should see your physician. Alternately, the excessive sleepiness could be related to some other underlying issue that you may not be aware of, so a visit to your doctor to discuss this is highly recommended in either case.

Stress or tension has not been clearly linked to bleeding from choroidal neovascularization (the formation of abnormal blood vessels that occurs with wet macular degeneration). The intravitreal injection that your friend is receiving every 4 months is likely an anti-VEGF medication that causes regression of these abnormal blood vessels. It is possible that your friend needs injections more frequently than every 4 months in order to prevent further bleeding.

The retina (the part of the eye affected by macular degeneration) is a very complex tissue. Though a number of studies have explored the possibility of retinal cell transplants being performed with promising results, at present this is not a standard procedure. To read about all of the macular degeneration clinical trials, please visit the following page on the National Eye Institute’s website: http://www.nei.nih.gov/neitrials/

Much of the work on the use of stem cells as a treatment for macular degeneration and other degenerative diseases of the retina have been conducted using animal models. Though preliminary results of these studies appear to be promising, one cannot speculate on whether or not similar procedures will be successful in the future for human patients. The time frame for translating these experimental procedures into routine clinical procedures is uncertain. Experimental research project using stem cells and rheopheresis are not only being targeted for the wet form of the disease. In fact, rheopheresis is an investigational treatment for dry macular degeneration.

Although the answer to your question has not been directly studied, vitamins in moderation are unlikely to be harmful. For example, you probably already take in the above quantities of vitamins E and C from your normal diet. Some vitamins, however, (e.g., vitamin A) can actually cause toxicity in if large amounts are taken. It is recommended that patients discuss supplementation with their doctor(s) to ensure that there is no conflict with any other prescribed medications or conditions they may have.

Macular degeneration comes in two general forms: wet and dry. The wet form of the disease is characterized by the growth of abnormal blood vessels in the eye, which are much more fragile than normal blood vessels and therefore are prone to leaking and/or hemorrhaging. This would likely explain the bleeding that your mother’s doctor is referring to. There are a number of new treatments aimed at preventing and/or stopping the damaging effects of bleeding characteristic of wet macular degeneration. Your mother’s doctor can let you know if she is a good candidate for these treatment options.

That is an excellent question. The effects of smoking are secondary to nicotine in the bloodstream. Nicotine has been shown to induce an increase in the size and severity of choroidal neovascularization (the formation of abnormal blood vessels in wet macular degeneration) in an experimental model. The eye contains nicotinic receptors that are theoretically stimulated by nicotine from any source. Therefore, even ex-smokers who have stopped smoking by using nicotine supplementation (nicotine gum or patch) are theoretically at risk.