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Minerva Oftalmologica 2019 September-December;61(3-4):37-41

DOI: 10.23736/S0026-4903.19.01830-0


language: Italian

Antioxidants of the diet in the treatment of age-related macular degeneration

Maria ALTOMARE COCCO 1 , Patrizia ROBERTO 1, Igino CIRULLI 2

1 Department of Ophthalmology, Hospital of Foggia, Foggia, Italy; 2 Department of Surgery, Hospital of Foggia, Foggia, Italy

BACKGROUND: Age-related macular degeneration is an age-related eye condition that occurs after age 50. Retinal aging goes from paraphysiological stages to pathological stages characterized by a degeneration of the central part of the retina which is the macula. In the context of the same disease, the dry form is distinguished from the defined wet form. In the dry form the symptoms appear slowly even over the years unlike the wet form whose symptoms have a rapid onset and also this characteristic is relevant to the diagnosis. It is shown that a fundamental role is played by the presence of free radicals, which cause oxidative damage. Besides age, various risk conditions in the pathogenesis of the lesion include smoking, excessive exposure to light or UV rays, some nutritional deficiencies and systemic arterial hypertension as well as obesity.
METHODS: In order to highlight the importance of antioxidants present in the diet, we administered a diet rich in antioxidants to two groups of patients, an intervention group and a control group. In both groups we treated patients with the two forms of DMS, both dry and wet. They were divided into four sub-groups according to age group. for all patients we evaluated the value of homocysteine, a risk factor for DMS and we used in the diet all those nutrients that reduce homocysteine values. In the diet for the AMD type of exudative type, we have used some antioxidant nutrients such as resveratrol and lycopene also in the form of supplement because studies have shown the effect of these two powerful antioxidants on the reduction of both hemorrhage and macular edema: the transudation of fluids from the capillaries that make up the internal hematogenous barrier. In the dry form we have enriched the diet in particular with two antioxidants that make up the eye pigments: lutein and zeaxanthin. Studies conducted highlight the role played by melatonia in combination with other vitamins (A-C-E B6- B12, Folate, fatty acids, resveratrol antioxidants, lycopene lutein and zeaxanthin represent the future.
RESULTS: The action of melatonin on the eye is wide-ranging: it protects the retinal epithelium from oxidative damage: free radicals represent the class of substances most harmful to retinal cells and melatonin is considered the endogenous substance with the greatest activity protective against oxidative stress. The decline in melatonin production that progresses with age is in fact considered one of the mechanisms of aging and development of associated diseases, including age-related macular degeneration. In a recent study carried out at Sun Yat-Sen University in China, new clinical evidence was reported in AMD and 100 patients aged between 55 and 82 years were treated with melatonin and the fund examination was performed. eyepiece for assessing the best corrected visual acuity at the beginning of the study and every two months
CONCLUSIONS: After only 2-3 months of treatment, visual acuity stabilized, and a slowdown in the general progression of the disease was shown.

KEY WORDS: Retina; Melatonin; Lutein; Glutens; Homocysteine; Carotenoids; Oxidative stress

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