Aging of the eye: Lessons from cataracts and age-related macular degeneration

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#1

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Highlights

• Review of common mechanisms and contrasts between age related cataracts and macular degeneration

• Analysis of multitasking functions of the retinal pigment epithelium and general biology of aging

• Up-to-date summary of aging compensatory mechanisms in lens and retinal pigmented epithelium

• Novel insights into the origin of lens crystallins in the drusen deposits

• Summary of recent finding regarding structure and function of individual crystallin proteins

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Abstract

Aging is the greatest risk factor for chronic human diseases, including many eye diseases. Geroscience aims to understand the effects of the aging process on these diseases, including the genetic, molecular, and cellular mechanisms that underlie the increased risk of disease over the lifetime. Understanding of the aging eye increases general knowledge of the cellular physiology impacted by aging processes at various biological extremes. Two major diseases, age-related cataract and age-related macular degeneration (AMD) are caused by dysfunction of the lens and retina, respectively. Lens transparency and light refraction are mediated by lens fiber cells lacking nuclei and other organelles, which provides a unique opportunity to study a single aging hallmark, i.e., loss of proteostasis, within an environment of limited metabolism. In AMD, local dysfunction of the photoreceptors/retinal pigmented epithelium/Bruch’s membrane/choriocapillaris complex in the macula leads to the loss of photoreceptors and eventually loss of central vision, and is driven by nearly all the hallmarks of aging and shares features with Alzheimer’s disease, Parkinson’s disease, cardiovascular disease, and diabetes. The aging eye can function as a model for studying basic mechanisms of aging and, vice versa, well-defined hallmarks of aging can be used as tools to understand age-related eye disease.
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FOR THE REST OF THE STUDY, PLEASE VISIT THE SOURCE HERE

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#2

Well Engadin, it’s very, very long. I fell asleep once trying to get through it, then decided to search for any recommendations it might have on how to prevent, but, better yet, recover from some of the damage my eyes have already received over several decades of use. I found none. How about you? Did you find anything useful in the article for those of us who can’t go back, but would like to prevent further damage and possibly recover from some of the damage that’s already been done? Thanks for whatever you can contribute.

#3

nmn, astaxanthin, omega 3 (dha epa) are the best supplements for the retina of the eye, and ergothioneine is the best supplement for lens health.

#4

Sorry to learn of your eye condition. I kindly invite you to read the study I base my supplementation on. I mainly follow AREDS2 protocol, regarding zeaxanthin, lutein.

AREDS

And omega 3 acids because:

Animal studies, epidemiological data, and evaluations of dietary habits in different countries have indicated that the inclusion of lutein + zeaxanthin, and omega-3 unsaturated fatty acids (docosahexaenoic—DHA and eicosapentaenoic—EPA), in the diet reduces the risk of developing advanced AMD. This became the basis for the AREDS 2 study [63]. It was assumed that DHA is an essential structural component of the retina and EPA affects its biological function. Lutein and zeaxanthin in a ratio of 5:1 were supplemented together because lutein absorption is dependent on the presence of zeaxanthin.

(AMD for Age related Macular Disease.)

Also:

Carotenoids are important in AMD because of their physiological functions and location in the retina. Lutein and zeaxanthin are part of the macular pigment. Trace minerals such as zinc and copper may also be involved in retinal antioxidant functions. Omega-3 fatty acids have been shown to have protective effects against macular degeneration, including anti-angiogenic, anti-inflammatory, and antioxidant effects. Omega-3 fatty acids reduce pathological angiogenesis in various cellular and animal models by affecting multiple angiogenic factors, including platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) [68,69]. Unsaturated fats also facilitate the absorption of lutein and zeaxanthin.

All above info from this study: Lutein and Zeaxanthin and Their Roles in Age-Related Macular Degeneration—Neurodegenerative Disease - PMC

As lutein and zeaxanthin are fat soluble they may be more easily absorbed when taken as oil capsules rather than tablets.

This sentence from Nutrition - Macular Society

All of this said, I am not aware of suffering from AMD in any of its versions, wet or dry, but would be certainly glad to postpone its appearance as much as possible and the mix zeaxanthine, luteine and omega 3 acids seem to push in the right direction, IMHO.

Hope this helps you in some way.

#5

In trying to protect or help one thing with a given intervention, we should always balance that against possible harm elsewhere.

My concern is supplementation with vitamin E. The AREDS vitamin E amount is not trivial. If you are also taking supps which happen to stabilize their pills with vitamin E - and there are a lot of them, fish oil etc. - you could be taking in a worrisome daily levels of vit. E in supplements. It is concerns such as this, that lead them to drop betacarotene from AREDS in AREDS2.

I would try to get my vit. E from food (which I try anyway). I’d also be cautious with zinc and copper. Unless you have serious zinc/copper deficiencies, I would supplement with zinc and only very sparingly, like minimal amounts once/twice a week just to prevent frank deficiencies (copper is pretty prevalent in plants, i.e. veggies). Metals like copper, iron and even zinc can accumulate in the brain with negative neurological consequences, this is more of a concern with supplements, because in food, metals are incorporated and chelated into the matrix, fiber and other modifying compounds which has a different effect than a bolus of metal in a supplement.

Lutein and zeaxanthin seem fine at those quantities (and perhaps astaxanthin as suggested by the poster). Irony: my NOW brand lutein & zeaxanthin supplement is stabilized with “mixed tocopherols”, i.e. vit. E… do I really also want to slam back more vit. E in the AREDS stack? I think not.

But really the best thing you can do for your eyes is to protect them from UV radiation (glasses outside, always, even when overcast, as most of the UV gets through the cloud cover), and have regular ophthamology eye exams.

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#6

Well, since cataracts were mentioned in the topic title I’ll list again what others have posted in other threads related to cataracts for those looking for alternative medical solutions. The common one I’ve seen mentioned a number of times is Can-C, an NAC eye drop that is said to reverse cataracts. Some say they have had good luck with it, but I saw no benefit (or harm) when I tried it a few years ago. An old product, but new to me, is Visoluten, a peptide said to help with many eye problems. I have not tried it, but I have been investigating it. I have doubts about it because I can’t find any specific discussion about it. And, the newest thing I have come across is LumenPro, a Lanosterol + NAC eye drop for dogs and other animals. The website for this is https://shop.lumenpro.com/. It looks interesting because I believe I saw reference to some research at the Univ. of Maryland on this product. But, I’m having difficulty finding the actual research. I also don’t find it listed on sites like Chewy.com, only on the lumepro.com site which tends to make me think it may be more hype than reality. But, Lanosterol and NAC do make medical sense because there is information about both in medical research. So, I’ll be keeping track of this one for a while. If it actually works for animals without bad side effects it may go on my list of things to try.

One final thing I just now found is cataract research at Edinburgh Biosciences (https://edinburghbiosciences.com/) called Ledinbio. This, like Visoluten and LumenPro, is on my list of things to investigate. I’m not presenting any of the information about these 3 things because I don’t know enough to give any type of summary. They are just items on my watch list.

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#7
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#8

https://x.com/mike_lustgarten/status/1850670510436131175?t=Jl_lj-pL36X_KuAy8E6uOg&s=19

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#9

I already take lutein, zeaxanthin and astaxanthin for macular health, but no drops or anything wrt. cataracts. The only intervention with cataracts I engage in is trying to prevent uv damage.

But honestly, I’m not super worried about cataracts for one fundamental reason: IOLs. There is rapid progress in IOL development. The biggest advantage of IOLs is not even basically permamently solving the cataract problem and any yellowing of the aging lens (affecting color perception), it is the opportunity to correct common vision problems that are virtually 100% present in all people past 50, 60, 70 years of age. That’s a huge boon. Cataracts, and generally eye lens aging should in principle already be a solved problem, or close to it.

There are still risks and limitations with IOLs and the attendant surgery. Dry eye is a nasty one, and the fact that there can still be things like halos, night vision limitations, and still imperfect vision across all distances necessitating choosing of one over the other (mono vision is still a common if imperfect workaround). But progress really is very, very rapid. I’m optimistic that if one can hold off for a few more years, IOLs can get to the point where they’re pretty much a no brainer.

I’m 66, and my vision is declining pretty rapidly. Already I must wear glasses to watch TV, and my distance vision without glasses is a blurry world. I can still read without glasses, but only because of my natural monovision I’ve had since my 20’s. I do have senile cataracts, but so far minor enough that I experience no real effects, and only know about them because my ophthamologist noted them.

I think I can hang on with glasses for distance (just about 0.25 diopter in one eye), but can feel presbyopia creeping into my reading eye, and once that takes hold, it’s glasses all the time, and time for IOLs. Something new is coming out every few months, example:

https://www.jnj.com/media-center/press-releases/johnson-johnson-rolls-out-new-tecnis-odyssey-next-generation-intraocular-lens-offering-cataract-patients-precise-vision-at-every-distance-in-any-lighting

I figure by the time I’m ripe for the bionic solution, in about another 4-5 years, we should have some really good IOL tech and some longer term track records.

Now, if only there were good low risk solutions for floaters, I’d be super happy, as I developed one last year, that’s pretty annoying… they say you get used to it within months, but so far I have not - I want it gone.

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#10

CronosTempi, since you mentioned IOLs I will add a link related to cataract surgery by tsbrownie who had to have it redone because of miscalculation by the surgeon (rare, but it happens). He points out things I had not considered if or when the time for cataract surgery comes my way. His list of things to do for those contemplating cataract surgery would likely have eliminated the problems he had if he had only known to do them before he had the surgery. I know three people personally who said they had to go back post-op because their vision was getting cloudy. Tsbrownie addresses the problem they experienced and other potential problems. He has 3 additional videos that follow this initial one. I won’t post them, but I will watch them.

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#11

Thank you for this video series, it was very informative! I went ahead and watched all the videos. As always, the better informed and prepared as a patient you are, the better the outcome. And unsurprisingly, a more experienced and skilled healthcare provider will always be the better option.

All surgeries and medical procedures carry risk. But there is steady progress in the IOL technology, surgeon experience, and patient awareness, so good as the IOL options are today, they’re poised to be even better in the future. I’m hoping that by the time I’m ready for an IOL in a few years, the tech will be amazing, and the success rate even more spectacular!