Baran Brothers: Going for Green Keeps Vision Golden

We interact with the marvelous world around us in numerous ways. Without a doubt, our visual contact with the universe may be the most gratifying. We have as a species developed this “visual” side to our senses, causing it to dominate all others. Beyond the aspect of seeing the beauty around us, however, eyesight cripples us when it begins to fail.

Age-related macular degeneration, or ARMD, causes almost half of all cases of impaired vision or blindness in this country. This disease, which causes the macula (part of the retina that controls central vision) to gradually break down, is chronic and degenerative.

There are two types of ARMD: “dry” and “wet,” with over 90% of cases being of the form characterized by progressive deterioration of the retina (dry). Although laser treatments seem to benefit the wet version of the disease, there is very little in the way of treatment for the more common dry form. There is some good news, however, as research is beginning to suggest various nutrients and supplements may help to slow or stop the disease.

A controlled study reported in Optometry (2004;74:1-15) found that supplementation of lutein, either combined with antioxidants and other nutrients or alone, actually improved vision in people with ARMD, in both early and advanced stages.

Lutein is in the carotenoid family of molecules (most famous of these being beta carotene) and in the body actually concentrates itself in the macula portion of the retina. There it filters out the very damaging blue light component of sunlight. It is found in large amounts in kale and spinach, and in lesser amounts in other dark green leafy vegetables, egg yolk, and corn.

In the study, 90 people with ARMD were divided into three groups and were given daily treatments for 12 months. Group 1 received 10 mg of lutein daily (amount present in about two ounces of spinach); group 2 received the same amount of lutein coupled with nutrients to enhance retinal health, such as antioxidants, bilberry, quercetin, taurine, zinc, N-acetyl cysteine and others; group three was the placebo control.

For both groups receiving lutein there was an improvement in visual acuity (equivalent to an improvement of up to one line on a standard eye chart) and in contrast sensitivity. Using certain parameters, combination therapy seemed more effective than lutein alone, and using other measures lutein by itself seemed more effective. Both active groups showed an improved capacity to filter out toxic blue light, and both showed beneficial effects in both early and later stage ARMD subjects.

Because lutein is a potent antioxidant, it may possess health related benefits beyond eye health. Studies now suggest that lutein may possibly protect the circulatory system from deadly plaque build-up, rejuvenate lungs, lower the risk of arthritis of the knee, protect an aging brain, and help to reduce oxidative damage to the skin. Another closely related antioxidant, called zeaxanthin, also concentrates itself in the macula and is typically found in the same food sources as lutein. When supplementing with lutein, look for products that supply zeaxanthin along with lutein. Researchers typically recommend five to 10 mg of lutein per day for optimum eye health.
As always consult your physician or health care practitioner in all these matters that impact your health, seek corroboration of information, and most of all, educate yourself.

Andre Baran IV and his brother Bernard Baran, are co-owners of Brothers Nutrition in Edgewater. They can be reached via e-mail at edge@
brothersnutrition.com.

Eye Health 9 Simple Ways to Keep Your Eyes Healthy

Do you eyes feel tired and sore by the end of the day? Modern life puts a lot of stress on our bodies and eyes are among the first things to suffer. But it doesn't have to be this way. Learn simple things you can do for your eye health and your eyes will feel and look much better in only a few days.

Have your eyes checked every 12 month

Uncorrected vision problems can progress, and wearing corrective contact lenses or glasses that are no longer right for you can cause vision problems and severe headaches.

If your contacts don't feel right in your eyes, it is probably time to visit an eye doctor, even if it hasn't been a year since your last visit.

Go for the best quality contact lenses

Not all contact lenses are equal. Some are safe for you, while others put you at risk of damaging your eyes.

See reviews of quality contact lenses. Knowing what the modern contact lens industry has to offer will help you make an educated choice, not just blindly follow what your doctor says.

In summer, always wear sunglasses

It is proven that UV rays can seriously damage your eyes, but good sunglasses can prevent this damage. When buying sunglasses, make sure that they block at least 98% of UV radiation. Contrary to popular belief, light sunglasses can block UV as well as very dark ones, even though dark glasses usually offer more protection against bright sunlight.

By the way, did you know that you need sunglasses on cloudy days as well? Clouds might provide shade, but they are no barrier for UV light. Clouds are basically water, and water is UV-transparent.

Finally, remember that you would need sunglasses even if your contact lenses offer UV protection. Even a very high quality lens can only protect the area it covers, but the entire surface of your eye needs protection.

Eat what is good for you and your eyes

The good news is that there are no foods that would be harmful for your eyes. Most foods don't affect your eyesight at all, although the right vitamins and minerals are helpful. Recent studies have shown that vitamins of the antioxidant group can prevent, or at least slow down, age-related conditions like macular degeneration and the development of cataracts. So a healthy diet won't restore eyesight that is already lost, but it can definitely slow down the process of the disease, or prevent one from starting.

Vitamins C, A and E, folic acid, selenium and zinc are definitely beneficial for the health of your eyes. The effects of the other vitamins and minerals aren't determined yet, but it seems likely that they affect your eyesight as well. Thousand-page books have been written on the topic of nutrition for eye health but, to summarize, it is known that whatever is good for your body is good for your eyes, too. So put a carrot and a bunch of grapes into your lunch box.

When you read or work on the computer make sure that the light is right

It is a common knowledge that working with poor light can cause eyestrain, but light that is too bright can do as much damage.

Keep your blinds down on sunny days and switch off half of the household lights, if possible. The best lighting for working on the computer is a soft desk light, coming from the side. Also, you can try decreasing the brightness of your monitor. The colors won't be so vivid, but your eyes will feel much better by the end of the day

Give your eyes a health break

The great invention of the 20th century - computers - is not so great from the point of view of health. Almost everybody feels discomfort in their eyes after peering at a computer screen all day long. This is because people blink about 25% less often then usual, while working at the computer, which causes eye dryness.

I won't advise you to blink more often - it is almost impossible to control natural reflexes. One thing you can do, though, is close your eyes and count to 5 before opening them, whenever your computer decides to take its sweet time doing something. Another thing is to look away from the screen and focus on some faraway object, as often as possible. If you train yourself into the habit, your eyes should feel much better at the end of your working day.

If you wear contact lenses, take proper care of them

Contact lenses don't require a lot or fuss, but you can't neglect their cleanliness. Every time you put your lenses in or take them out, rinse them. You should also take care to change the solution, when you are putting your lenses to rest for the night.

Wear your contact lenses to the recommended schedule

Daily disposable lenses should be replaced daily, two weeks replacement lenses should be replaced every two weeks, and so on. Some people try to save money by wearing their lenses for much longer than is intended. This isn't a good idea. Even though the quality of the lens itself might not decline, protein build-up will make your vision less clear. Another thing to consider is that the longer you wear your lenses, the higher is your risk of eye infections.

There are other ways to save on your contacts without risking your eye health. See suggestions on how to get discount contact lenses.

Try not to wear your contact lenses from 6 in the morning until midnight. Most lenses aren't designed to be worn for longer than 12 hours. If this doesn't suit your life style, though, try using extended wear lenses. You can wear Acuvue contacts for a week without removing them, or Focus Night and Day lenses for up to 30 days.

If you want to change the color of your eyes, choose only top quality color contact lenses

Color contact lenses are great fun. If you didn't try them yet, maybe you should. But only high quality color contacts, like Freshlook or Acuvue 2 Colors, are as safe and comfortable as they are beautiful. Many beauty salons, however, sell color contacts lenses of questionable quality, and these can do serious damage to your eyes.

If you follow these simple rules, your eyes should feel much better. They will look better too - you might notice that your eyes shine and their whites are actually white, again.

Macular Degeneration Study Links Behavior, Visual Improvement

Jim Burress ATLANTA, GA (2008-12-11) Gina Lembo is an attractive and energetic 30-year old with Stargardt's Disease, a form of macular degeneration that appears in childhood.

"I see a clear picture; however, it's my peripheral. So we have a central vision loss."

It's unlikely Gina's condition will worsen. That's not the case for most macular degeneration, or "M-D", patients who develop it later in life. Their vision loss starts as a dark, central blur that expands over time.

So, like most with M-D, Gina uses her peripheral vision to compensate for her loss in central vision.

"So we don't see blank, we see a full picture, but it's going to look as though I'm looking to the left or up or down and not straight at you, when I feel I am"


Helping at her brother's pizza parlor in Norcross, Gina demonstrates how she compensates. It's a process of using peripheral vision, memorizing her surroundings and relying on her acute sense of touch as she demonstrates while cutting a lime.

"I very much use my sensory. I don't realize I do. And when people watch me they'll get very nervous that I'll slash my wrist or break something. But I have a system that works, and I've always done it that way."

Gina's brain--and her eyes--made her a perfect candidate for participation in a study by Georgia Tech and Atlanta's Emory Eye Center.

"The question we asked was, 'Does using those peripheral regions cause a change in the brain?'"


That's Eric Schumacher, a Georgia Tech psychology professor and the study's author.

He and a graduate student wanted to know how M-D patients' use of peripheral vision potentially re-wired their brains.


"It'll be different area in different patients, but it will tend to be stable within a patient they'll tend to choose one region to use as their PRL." meaning the part of the eye they use to see best.


Now this is where the science comes in. What we see straight-on largely comes from the part of our eye called the fovea. This fovea 'thing' lets us see small and vivid details, things like words on a page or the color of a traffic light.

But seeing is only partly done with the eye.

What the fovea senses is carried to the very back of the brain where the images are put together. It's an area just loaded with neurons that get all excited when we see. But in a patient with macular degeneration, those neurons don't get stimulated because the fovea doesn't send along any information.

Instead, they just sit there.

What the team found, though, is that that by identifying and stimulating parts of the eye that are strongest, those bored neurons can become re-energized.

"So that's the idea that something about the change in their behavior that they begin to use this one peripheral region drives reorganization of the primary visual cortex to begin to activate to that region."

In other words, the part of the brain the fovea stimulates in most people can become the same area M-D patients use. They won't see perfectly. But they might see better.

Dr. Susan Primo of the Emory Eye Center says the next step is to take that science to the bedside.

"...and in turn the patients will be trained to use that particular point and then to be able to use that every day in functioning, whether it is for work, school or for reading."

While science has long known the brain can reorganize itself, this study is the first to show a person's behavior can directly reorganize the brain, at least as it relates to vision.

Researchers stress the results are small steps in a long journey

Jim Burress, WABE News.

NEW YORK (Reuters Health) Nov 27 - Patients who lower their waist-to-hip ratio, particularly those who are obese, can decrease their odds of developin

A new study indicates that the carotenoids lutein and zeaxanthin may help improve vision under glare conditions such as bright sunlight or the beams of car headlights.

Scientists at the Vision Science Laboratory at the University of Georgia recently studied the relationship of lutein and zeaxanthin on macular pigment (MP), glare disability, and photostress recovery.

The macula helps filter damaging light rays. When the concentration of lutein and zeaxanthin in the macula is higher, the higher density of macular pigment enables the macula to absorb the light rays more efficiently.

Researchers studied forty healthy subjects (average age of 23.9) for six months, giving assessments at baseline, 1, 2, 4, and 6 months. Subjects were given 12mg daily of lutein and zeaxanthin supplements.

After 6 months, the lutein and zeaxanthin supplementation was shown to significantly reduce the negative effects of glare for both the visual performance tasks assessed for most of the subjects.

Read other studies about lutein and zeaxanthin, including their role in preventing macular degeneration and cataracts.

Learn more about natural leutein and zeaxanthin supplements

SOURCE: “Macular pigment and visual performance under glare conditions”, Stringham and Hammond, Optom Vis Sci., 2008 Feb;85(2):82-8

Flexible Dosing of Ranibizumab Safe, Maintains Efficacy in Age-Related Macular Degeneration: Presented at AAO

By Emma Hitt, PhD ATLANTA -- November 12, 2008 -- A flexible dosing schedule for ranibizumab maintains efficacy outcomes in treatment-naïve patients with neovascular age-related macular degeneration (AMD), according to research presented at the American Academy of Ophthalmology (AAO) annual meeting.

Frank G. Holz, MD, University of Bonn, Bonn, Germany reported findings from the phase 3b Study of Ranibizumab in Patients With Subfoveal Choroidal Neovascularization Secondary to Age-Related Macular Degeneration (SUSTAIN) here at an oral session on November 11.

SUSTAIN was designed to assess the safety and efficacy of ranibizumab in choroidal neovascularisation secondary to AMD, using a guided, individualised, as-needed, dosing schedule.

The study included 531 individuals who were either ranibizumab-naïve or had completed the Anti-VEGF (vascular endothelial growth factor) Antibody for the Treatment of Predominantly Classic Choroidal Neovascularization in AMD (ANCHOR) trial.

The current analysis was a preplanned interim analysis of 69 of the ranibizumab-naïve patients. Patients received 3 fixed monthly injections of either 0.3 or 0.5 mg ranibizumab in the initial phase and then returned every 4 weeks in the maintenance phase for a total study period of 12 months.

Criteria for retreatment in the maintenance phase included visual deterioration greater than 5 letters or a greater than 100-mcm increase in central retinal thickness.

Ocular adverse events occurred in 55.1% of study eyes and were mostly mild in nature, Dr. Holz explained during his presentation. Adverse events included reduced visual acuity, transiently increased intraocular pressure, retinal or conjunctival haemorrhage, and blepharitis. Serious adverse events included a retinal haemorrhage in one patient and retinal pigment epithelium detachment in another patient.

In ranibizumab-naïve patients, visual acuity was maintained over the course of 12 months using guided, individualised, as-needed dosing; there was a decrease from 9.2 letters to 6.7 letters from months 3 to 12, but this difference was not significant. Likewise, the decrease in central retinal thickness was maintained, with a decrease of 89.6 mcm at month 3 and 78.7 mcm at month 12.

The average number of injections given in the initial phase was 3.0 (range: 2 to 3) and 2.3 (range: 0 to 7) in the maintenance phase, indicating that only minimal doses are needed when using a flexible dosing schedule.

At month 3 and month 12, the change in visual acuity from baseline was within 15 letters for approximately 74% and 71% of patients, respectively, indicating that as-needed treatment maintained visual acuity.

"These results suggest that flexible dosing based on predefined treatment criteria with monthly monitoring results in fewer injections overall and can maintain efficacy outcomes," said Dr. Holz.

Funding for this study was provided by Novartis Pharmaceuticals Corporation.

[[Presentation title: Flexibly Dosed Ranibizumab in Patients With Neovascular AMD: Twelve-Month Interim Results of the SUSTAIN Trial. Abstract PA078]