Questions & Answers

Vitamin A in high doses can be toxic to the liver. Vitamin A has only been proven to have benefit for typical retinitis pigmentosa (a condition not related to age-related macular degeneration). Due to its potential toxic effects in high doses, vitamin A supplementation for macular degeneration is not recommended.

The main concern with stopping the Lucentis injections is that if abnormal blood vessels continue to grow, they could cause bleeding, fluid leakage, and result in decreased vision. While Lucentis has been shown to improve vision in patients with wet macular degeneration, the ultimate goal in most patients is to preserve and stabilize the current level of vision. Some patients respond so well to Lucentis after a few injections that their eyes remain stable after stopping injections. Other patients have recurrent leakage (active choroidal neovascularization) after stopping, and need maintenance injections at steady intervals. It is important to realize that not all patients respond the same and therefore should not be treated the same. Your husband's ophthalmologist would have the best understanding of his individual case, and would be able to make the best recommendation as to whether or not to continue with injections.

Zinc has been proven to be one of the most important components of the AREDS vitamins, which decrease the rate of progression from dry AMD to wet AMD by about 25% over 6 years. Although zinc in high doses may cause problems, it is generally recommended to continue supplementation at the AREDS* dose (80mg of zinc oxide daily) if you have dry AMD with high risk characteristics. The current AREDS2 study includes an assessment of whether or not a reduced dosage of zinc is as effective as the current AREDS dose is in reducing the risk of progression to wet AMD. The results of this study are still pending, but your physician should be able to keep you updated on this information and provide you with treatment recommendations based on your specific medical history.

*AREDS is the acronym for the Age-Related Eye Disease Study

1IU of beta carotene = 0.6 micrograms of beta carotene. Using this conversion, 15 milligrams of beta carotene = 25,000 IU of beta carotene.

There is a phenomenon known as Charles Bonnet syndrome, in which people with severe visual loss can have complex, highly detailed visual hallucinations. It occurs in people with macular degeneration, advanced cataracts, glaucoma, and other optic neuropathies. The theory is that the brain is attempting to compensate for the loss of visual stimuli by creating these hallucinations. It is important to reassure your grandfather that people who experience these hallucinations are mentally healthy and do not have a psychiatric disease. Sometimes the hallucinations will spontaneously resolve within a year or two. There is no known treatment for Charles Bonnet syndrome.

After conducting an exhaustive search of the research literature, including the PubMed database at the National Institutes of Health, I found no published reports of studies researching a possible link between celiac disease and macular degeneration. However, you are exactly right: celiac disease can result in malnutrition, and it is known that having low levels of carotenoids and antioxidant vitamins in the body may increase the risk for developing macular degeneration. Talking with your doctor and/or a nutritionist about dietary suggestions would be very helpful considering your specific medical conditions.

Lyrica has been reported to cause blurry vision and/or double vision in patients. The mechanism of this side effect is unknown.

It is difficult to make a diagnosis without examining your mother. Symptoms of macular degeneration vary from patient to patient. Your mother's ophthalmologist should be able to tell you which condition she has, and what the available treatment options are. If she has a macular hole, surgery is sometimes an option. Rheopheresis and stem cell treatments are not typically used as established clinical therapies at this time.