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

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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!

#12

Phase 2 ArMaDa Clinical Trial for OCU410—a Multifunctional Modifier Gene Therapy for the Treatment of Geographic Atrophy Secondary to Dry Age-Related Macular Degeneration

Ocugen (NASDAQ: OCGN) has completed dosing in the Phase 2 portion of its Phase 1/2 ArMaDa clinical trial for OCU410, a novel gene therapy for geographic atrophy (GA), an advanced form of dry age-related macular degeneration (dAMD). The trial enrolled 51 subjects randomized into treatment and control arms.

The Phase 1/2 study (N=60) showed promising results with a 44% slower lesion growth in treated eyes versus untreated eyes at 9 months, and a clinically meaningful 2-line improvement in visual function. The therapy demonstrated a favorable safety profile with no serious adverse events.

OCU410 is designed as a one-time treatment, targeting multiple disease pathways, unlike current U.S. treatments that require monthly or bi-monthly injections. The trial is being conducted at 14 leading retinal surgery centers across the U.S., with Phase 3 studies planned for 2026 and potential BLA/MAA filings by 2028.

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#13

By about 20%. Not nothing but not substantial either.

#14

I am not at all a cataracts sufferer but I have been taking an AREDS2 formulation for floaters. They were becoming intrusive but have cleared up to the point that I do not notice any at all. Not that floaters are a substantial health issue but they can be annoying.

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#15

That’s somewhat unusual. The AREDS2 formulation was targeted at macular degeneration. Which is not to say it can’t help some people with floaters, but that was not the original indication. I’ve been taking the AREDS2 ingredients (but lower vit. C dose) separately, but no effect so far on my one floater.

#16

One floater? Haha. I had multiple large floaters. Yes I am aware of the intent of AREDS2 but thought it was worth a try. In my singular case it seems to have been very effective. I have been taking the AREDS formulation for about 3 months.

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#17

I have some floaters that really annoy me. Can you share the link to the product that helped resolve your floaters? Thanks.

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#18

Those are crazy-high doses of vitamin E and zinc in the Preservision Areds 2 supplement. Also more vit C than I’d want. Hoping I’m getting plenty of lutein and zeaxanthin from the leafy greens in my diet and that these are the key ingredients in AREDS rather than the megadose vitamins/minerals.

#19

AREDS2 is better than nothing for those on a standard American diet. But that doesn’t mean better can’t be had. Lower dose/frequency of zinc, and supplementing with C and E should generally be avoided unless there’s a special reason. Better make sure you get enough in diet, which is easy to do. I avoid E supplements, and do take one dose of 100mg of C three times a week for an extra boost in blood vessel health. However, there seems to be decent evidence for benefits of supplementing with select carotenoids, lutein, zeaxanthin, meso-zeaxanthin, astaxanthin, though they need a protocol (f.ex. astaxanthin competes with other carotenoids, so better to take away from the others timewise etc.).

I think one can easily replicate the benefits of AREDS2 supplementation, and even do better. But for those with a subpar diet who don’t want to be bothered, AREDS2 is better than doing nothing.

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#20

Yes I used Vision Defender from Intelligent Formula (UK company). I use VISION DEFENDER MAC. They have other formulations with the AREDS vitamins but I get those elsewhere.

I have used for 3 months. I had improvement within the first month.

Link

I note that Life Extension have a similar product Macuguard but I think it has less of the anti-oxidants.

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#21

LEF Macuguard has 10mg lutein and 4mg zeaxanthin per gelcap and no Vit C/E or Zinc/Copper (Preservision has 5mg lutein and 1mg zeaxanthin per cap)

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#22

Vision defender has 10mg Meso-Zeaxanthin, 10mg Lutein and 2mg Zeaxanthin and none of the vitamins which I prefer as I get those in my multi

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#23

Their latest study investigates a potential therapy that could slow or even reverse the aging process in the eye while helping prevent conditions like age-related macular degeneration (AMD).

“We show the potential for reversing age-related vision loss,” explains Dorota Skowronska-Krawczyk, PhD, an associate professor in UC Irvine’s Departments of Physiology and Biophysics and Ophthalmology and Visual Sciences. The research was conducted in collaboration with the Polish Academy of Sciences and the Health and Medical University in Potsdam, Germany. The team published their findings in Science Translational Medicine under the title “Retinal polyunsaturated fatty acid supplementation reverses aging-related vision decline in mice.”

Understanding the “Aging” Gene

This work expands on an earlier study of the Elongation of Very Long Chain Fatty Acids Protein 2 (ELOVL2), a gene known to be an important marker of aging. “We showed that we have lower vision when this ELOVL2 enzyme isn’t active,” says Skowronska-Krawczyk, who is also part of the Robert M. Brunson Center for Translational Vision Research at UC Irvine’s School of Medicine. In that previous research, boosting ELOVL2 activity in older mice increased levels of the omega−3 fatty acid docosahexaenoic acid (DHA) in the eye, resulting in better vision.

Restoring Vision Through Fatty Acid Supplementation

As people grow older, changes in lipid metabolism reduce levels of very-long-chain polyunsaturated fatty acids (VLC-PUFAs) in the retina. This decline can harm vision and contribute to AMD. The ELOVL2 gene helps produce both VLC-PUFAs and DHA, but when its function weakens with age, so does the eye’s ability to maintain these essential molecules.

To compensate, the UC Irvine team injected older mice with a specific polyunsaturated fatty acid. The result was striking — the animals’ visual performance improved. “It’s a proof-of-concept for turning lipid injection into a possible therapy,” says Skowronska-Krawczyk. “What is important is that we didn’t see the same effect with DHA.” Others have also questioned the ability of DHA to slow AMD progression.

“Our work really confirms the fact that DHA alone cannot do the work, but we have this other fatty acid that is seemingly working and improving vision in aged animals,” says Skowronska-Krawczyk. “We have also shown on a molecular level that it actually reverses the aging features.”

Full story: https://scitechdaily.com/scientists-may-have-found-a-simple-way-to-reverse-aging-eyes/

Relates to earlier post by @adssx here: Predicting Alzheimers & Dementia (and minimizing risk) - #570 by adssx

Research Paper (paywalled):

Retinal polyunsaturated fatty acid supplementation reverses aging-related vision decline in mice

https://www.science.org/doi/10.1126/scitranslmed.ads5769

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#24

Retinal implants restore vision in people with severe macula, allowing them to read again.

https://www.nytimes.com/2025/10/20/health/retinal-implant-macular-degeneration.html

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#25

Here is a preprint from people at Department of Ophthalmology, Byers Eye Institute, Stanford University:

Background: Mitochondrial dysfunction is an emerging metabolic hallmark of age-related diseases, yet tools to directly profile mitochondrial pathways and test metabolic interventions in the living human eye remain limited. Multi-omics ocular liquid biopsy enables real-time proteomic and metabolomic profiling of the intraocular microenvironment, complementing systemic biomarkers and imaging surrogates. Here, we used this approach to define mitochondrial and tricarboxylic acid (TCA) cycle dysregulation in geographic atrophy (GA) and to assess whether oral α-ketoglutarate (α-KG) supplementation can modulate mitochondrial metabolites within the eye. Methods: Mitochondrial and TCA cycle-related proteins were profiled in aqueous humor (AH) samples from patients with GA using DNA-aptamer-based proteomics. In a phase 0 study, a second cohort undergoing sequential cataract surgery provided paired AH samples collected at first-eye surgery and at second-eye surgery after interim α-KG supplementation. These samples underwent targeted metabolomic profiling using hydrophilic interaction liquid chromatography coupled with mass spectrometry. Results: In GA, 64 mitochondrial proteins were differentially expressed, including coordinated TCA-cycle deficiencies marked by reduced expression of enzymes regulating TCA entry and flux, including PDHB and DLST. In the phase 0 cohort, oral α-KG supplementation significantly increased intraocular α-KG levels and the α-KG-to-succinate ratio (P < 0.05), with coordinated shifts across TCA intermediates consistent with enhanced TCA cycle flux. Conclusions: AH proteomics demonstrated mitochondrial pathway depletion in GA, consistent with reduced oxidative bioenergetic capacity. AH metabolomics provided first-in-human in vivo evidence that systemic α-KG supplementation can modify intraocular metabolites and may enhance intraocular energy metabolism. These findings support ocular liquid biopsy as a precision-health framework for per-patient biomarker-guided metabolic trials in GA.

According to Google, geographic atophy is “an advanced, progressive form of dry age-related macular degeneration (AMD) causing permanent, irreversible central vision loss.”

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