|PreserVision AREDS 2, by Bausch + Lomb, helps reduce the progression in people with moderate to advanced AMD.|
|ZeaVision’s QuantifEye MPS II provides an accurate and affordable way to screen for sub-optimal MPOD.|
The Macular Densitometer‘ (Eye Solutions Technologies, LLC) uses heterochromatic flicker photometry to measure macular pigment.
QuantifEye MPS II (ZeaVision) provides a reliable, accurate, fast, and affordable way to screen for sub-optimal MPOD.
|The Macular Densitometer by Eye Solutions uses heterochromatic flicker photometry to measure macular pigment.|
|EyePromise Restore is just one of many products available in ZeaVision’s nutraceutical brand family.|
Education is key to understanding your patient’s vitamin options.
You can’t walk into a drugstore today without being bombarded by a shelf full of ocular vitamins and supplements, all promising to protect your eyes, save your vision, and restore your ocular health. Needless to say, it’s confusing. Which is why it’s our job to help patients navigate through the miscellaneous information and prescribe the correct supplement for their needs. New technologies now allow us to diagnose Age-Related Macular Degeneration (AMD) earlier, modify patients’ risk factors, and help prevent or retard vision loss.
THE AMD EPIDEMIC
AMD has reached widespread proportions, with conservative estimates saying there will be a minimum of 2.7 million new dry AMD cases each year, adding to the existing 15 million dry AMD patients. Eyecare experts estimate at least 210,000 new wet AMD patients each year, which adds to the already 1.7 million patients.
How does this impact our practices? We have the ability to implement strategies of AMD prevention and awareness, and treat early dry AMD patients. We know there are non-modifiable risk factors for AMD, such as family history and gender (women are more likely to develop the disease).
One modifiable risk factor is low macular pigment optical density (MPOD). This “internal protection” declines with age. However, we can identify patients who have a low or sub-optimal MPOD score, and through proper supplementation, rebuild this protection over time. Other risk factors include smoking, diet/lifestyle, and blue light exposure.
How do we modify MPOD? There are two instruments currently available (see “Measuring MPOD,” TK) that can be incorporated into your pretest sequence. This, combined with a patient’s family history and other risk factors, allows you to determine if one of the macular supplements available can help him in slowing the progression of AMD or lower his risk of developing the disease.
There are many macular supplements available that contain varying amounts of lutein, zeaxanthin, and mesozeaxanthin as well as other vitamins and minerals. The macular pigments are comprised of zeaxanthin, lutein, and mesozeaxanthin, which are present at a 1-1-1 ratio in the macula. These pigments are highly concentrated in the “yellow spot” or macula lutea. Zeaxanthin and mesozeaxanthin accumulate to a greater extent in the fovea and lutein is more prevalent in the parafoveal region.
Clinical research has led us to the important understanding that mesozeaxanthin is derived from a lutein-conversion process in the body. Though part of the macular pigment, it is not yet understood whether oral supplementation of meso-zeaxanthin increases macular pigment density in the target organ (eye) as there have been no supplementation trials conducted with mesozeaxanthin alone to date.
The diet-derived macular carotenoids, zeaxanthin, and lutein are constituents of the AREDS 2 study formulation and have been researched extensively. In addition to their important antioxidant properties and protection, they also act as a blue light filter, protecting the photoreceptors.
High concentrations of lutein are found in dark green leafy vegetables such as spinach, kale, and collard greens. A small amount of zeaxanthin is also found in dark green leafy vegetables, however higher concentrations are found in brightly colored fruits and vegetables. (Zeaxanthin can also be found in minimal amounts in corn and egg yolks.) Most of the U.S. population has a total daily carotenoid intake of less than 2mg’s and therefore sub-optimal macular pigment protection of their photoreceptors.
MacuHealth: Distributed exclusively in North America by Eye Solutions, MacuHealth’ is a revolutionary macular pigment supplement that contains a unique formulation proven to maximally augment central pigment density. The 10-10-2 (meso-zeaxanthin, lutein, and zeaxanthin, respectively) has been shown to enhance visual performance in normal subjects, as well as those with early AMD.
MacuHealth also contains sunflower seed oil (acts as a carrier and protects from oxidation), Vitamin E (which slows down oxidation), beeswax, and beef gelatin (used as the envelope). It is one of the only supplements on the market today that includes meso-zeaxanthin.
ZeaVision: There are many products available in the EyePromise nutraceutical brand family to support the ocular nutrition needs of patients encountered in daily optometric practice, specifically EyePromise Restore, EyePromise AREDS 2 Plus, EyePromise Zeaxanthin and Lutein, EyePromise Zeaxanthin, EyePromise Diabetes Vision Support, EyePromise EZ Tears, and EyePromise Vizual Edge.
EyePromise Restore and EyePromise AREDS 2 are also available in zinc-free formulas for genotype directed supplementation. EyePromise macular formulas are uniquely guaranteed to increase macular pigment optical density and EyePromise EZ Tears is guaranteed to provide dry eye symptom relief in 30 days.
EyePromise brands contain natural ingredients, are manufactured in the USA in a FDA cGMP facility, are supported by extensive research, and are reinforced with extensive patient and practice tools.
Ocuvite and PreserVision: Bausch + Lomb has a series of vitamins for general eye health. These include Ocuvite Eye Vitamin Adult 50+ Formula (5mg lutein and 1mg zeaxanthin), Ocuvite Lutein and Zeaxanthin (6mg lutein/zeaxanthin), and the original Ocuvite formula (2mg lutein). The PreserVision AREDS 2 formula contains the exact levels of six clinically proven nutrients recommended by the National Eye Institute to reduce the progression in people with moderate to advanced AMD. The PreserVision AREDS Formula soft gels are based on the original AREDs formula, while the PreserVision Lutein Formula soft gels substitutes 10mg of lutein for the original beta-carotene.
Measuring and monitoring MPOD, along with prescribing the proper macular supplements, will put us on the forefront of macular degeneration prevention and treatment. Incorporating this type of testing and service in our practices will garner more patient referrals, increase profit, and enhance a patient’s satisfaction.
Jennifer L. Stewart is in private practice at Norwalk Eye Care in Norwalk, CT.
WHERE TO FIND IT:
EyeSolutions LLC •866-704-0845 •youreyesolutions.com