Kapur Punam ¹, Pathak Ashok ¹, Suri Manjula ²

Affiliations
1 Dept of Ophthalmology, Ram Manohar Lohia Hospital, New Delhi, IN
2 Dept of Physiology and Promotive Health, Institute of Home Economics, University of Delhi, New Delhi, IN

Abstract

Age Related Macular Degeneration (ARMD) is the leading cause of irreversible blindness in older adults which has no cure and limited therapeutic options. ARMD may become an increasing concern in the developing countries like India as a result of socio-economic and dietary changes that accompany the economic development1. Diet is potentially one of the most cost effective strategies to prevent the development of end stage condition of ARMD. This review describes the current literature on the role of quality of diet and nutritional supplementation in prevention of advanced ARMD. Various researchers have explored the association between diet, nutrient intake and advanced ARMD. In the Age Related Eye Disease Study (AREDS), use of a daily antioxidant supplementation reduced the rate of progression from intermediate to advanced ARMD by 25% over a period of 5 years and resulted in a 19% reduction in the risk of moderate visual loss². A high dietary fat intake was reported to be associated with a higher incidence of late ARMD whereas higher intakes of fish or n-3 fatty acids were associated with lower incidence of ARMD³. Chiu et al. reported that quality of dietary carbohydrates influences the risk of ARMD⁴. But at present, research shows insufficient evidence to recommend dietary modifications and nutritional supplementation in ARMD. Therefore to summarize, the temporal relationship of the diet to advanced ARMD, is a function of the quality of diet. Observational studies suggest that increased dietary intake of omega-3 fatty acids, macular carotenoids, antioxidants and oriental dietary pattern reduces the risk of ARMD whereas, poor dietary carbohydrates quality (as defined by dietary glycemic index) and western dietary pattern may increase the risk of ARMD.

Keywords

Age Related Macular Degeneration (ARMD), Nutritional Supplementation, Carotenoids, Omega-3 Fatty Acids, Glycemic Index.

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Suri Manjula ¹, Mamta Bhardwaj ², Kapur Punam ³, Pathak Ashok ³

Affiliations
1 Dept. of Physiology and Promotive Health, Institute of Home Economics, University of Delhi, New Delhi, IN
2 Dept. of Biology, Institute of Home Economics, University of Delhi, New Delhi, IN
3 Dept. of Ophthalmology, Ram Manohar Lohia Hospital, New Delhi, IN

Abstract

Various researchers suggest that in up to 50% of patients with type 1 diabetes and 30% of those with type II diabetes, potentially vision-threatening retinal changes develop over time. Diabetic retinopathy is a common micro-vascular complication of diabetes mellitus. The present review outlines the dietary strategies to manage these complications of diabetes mellitus and studies the relationship between diet and retinopathy-associated risk factors in the development and progression of diabetic retinopathy. Though retinopathy therapy is currently limited to invasive procedures like laser photocoagulation and vitrectomy but there is a paradigm shift in favor of a preventive and protective, natural and safe dietary approach which can be used in treatment or prevention of diabetic retinopathy. Dietary carbohydrates, fats, proteins, dietary fibers, vitamins, antioxidants, minerals, phyto-estrogens, exogenous advanced glycation end-products, herbs, spices and protective dietary approaches play a role in development of diabetic retinopathy. This rationale can be applied to food interventions e.g. changing the composition of diet which favors metabolic improvements in type II diabetes and diabetic retinopathy. The ophthalmologists should encourage an interdisciplinary approach with endocrinologists and dietitian for optimal care of diabetic patient so as to prevent the development of diabetic retinopathy.

Keywords

Diabetic Retinopathy, Exogenous Advanced Glycation End-Products, Microvascular Complication.

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