Common cause of vision loss from air pollution: what you need to know

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Macular degeneration is one of the most common causes of blindness in the United States Sergio Marcos / Stocksy United
  • According to the World Health Organization, air pollution accounts for nearly 4.2 million dead per year, mainly due to stroke, heart disease, lung cancer and chronic respiratory disease.
  • British researchers have now found that air pollution can be significantly associated with the development of age-related macular degeneration (AMD), which can lead to vision loss.
  • The biggest risk factor for developing AMD is age.

Despite major advances in the fight against air pollution in recent years, the World Health Organization (WHO) estimates that about 91 percent of the world’s population live in places where air quality levels exceed WHO limits.

According to the WHO, air pollution is responsible for nearly 4.2 million deaths per year, mainly due to stroke, heart disease, lung cancer and chronic respiratory disease.

a observational study published Monday in the British Journal of Ophthalmology, air pollution could also affect vision.

The results suggest that poor air quality could significantly increase the chances of developing a condition called age-related macular degeneration (AMD).

“Age-related macular degeneration is an age-related condition preferentially affecting the macula, which is the center of vision” Dr Vaidehi S. Dedania, a retinal surgeon at the NYU Langone Eye Center and assistant professor in the department of ophthalmology at the NYU Grossman School of Medicine, told Healthline.

Dedania said AMD is the third leading cause of vision loss in people over 50 worldwide.

“In the advanced stages of the disease, individuals can experience central vision loss, resulting in severe and permanent visual impairment,” she said. “AMD can be classified as ‘dry’, also called non-exuding, or as ‘wet’, also called exudative. “

Dedania said that dry AMD is more common than wet AMD, and although both forms can cause severe vision loss, the most severe vision loss associated with AMD occurs in people with the wet form of disease.

The researchers looked at data from 115,954 British Biobank Study participants aged 40 to 69 who had no eye problems when the study began in 2006. Participants were asked to report whether they had been formally diagnosed with AMD by their doctor.

The researchers then looked at measurements of air pollution that included particulate matter (PM), nitrogen dioxide (NO2), and nitrogen oxides (NOx). Vehicles emit NO2 and NOx gases.

Any structural change in the thickness or number of light receptors in the retina, a sign of AMD, were evaluated in 52,602 people for whom researchers had complete data in 2009 and 2012, using a type of retinal imaging called non-invasive optical coherence tomography (OCT).

By the end of the study, 1,286 participants had been diagnosed with AMD, and 12% of those who had not been diagnosed with AMD had signs of AMD detected by retinal imaging.

Once the researchers took into account potentially influencing factors, such as underlying health conditions and lifestyle, analysis of the data showed that exposure to higher levels of fine particles (PM2.5) was associated with an 8% increased risk of AMD.

Exposure to all other pollutants except coarse particles was associated with unwanted changes in the retina of the eye.

“The results of this study are fascinating because they describe another possible risk factor for macular degeneration that can be modified to decrease the chances of developing this disease,” said Dr Matthieu Gorski, ophthalmologist at Northwell Health in New York.

However, Gorski stressed that the study was observational, so it could only show that AMD is associated with air pollution.

“We must be careful in interpreting the results of this observational study,” he said, “and understand that we cannot conclude that the pollution caused the macular degeneration.”

Gorski added that not smoking, maintaining healthy blood pressure, and eating a balanced diet low in saturated fat and cholesterol are the best ways to reduce the risk of developing AMD.

Dr Karen Saland, an ophthalmologist at Texas Health Presbyterian Hospital Dallas, said people with drusen – fatty deposits associated with AMD that build up under the retina – can do things that slow down the disease.

“It is essential to start taking specific vitamins that have been show to decrease the rate of progression of degeneration, ”said Saland. She said these include:

  • 500 milligrams (mg) of vitamin C
  • 400 IU of vitamin E
  • 80 mg of zinc
  • 10 mg lutein
  • 2 mg of zeaxanthin
  • 2 mg of copper

Saland added that people who develop wet AMD may receive injections of anti-VEGF (vascular endothelial growth factor). “Injections are currently the main treatment for wet AMD,” she said.

Dr Mark Fromer, NYPD honorary police surgeon and director of eye surgeons for the New York Rangers and the Oyama World Karate Organization, said the results of this study should be taken “with a grain of salt.”

“I don’t know what you can do with this information,” Fromer said. “After reading the article, how do you contextually change the amount of air pollution in a given society if we already have so many laws in place to reduce it? “

He said age is the number one risk factor for AMD, and longer life expectancy is also a factor.

“People who live in underdeveloped countries usually don’t live that long,” Fromer said. “So industrialized countries might have more pollution, but again, I guess that’s not quite true, because you can have heavily polluted countries that are underdeveloped because the laws don’t limit Pollution. “

Fromer said there are things people can do on their own to keep their eyes healthy.

They include banning smoking, eating a balanced diet, maintaining a moderate weight, and managing risk factors for high blood pressure and heart disease.

“I think people [should] pay attention to those things that we can change and not wait for society to change them for us – then they will have the best chance of preserving their vision, ”said Fromer.

Fromer pointed out that he sees a big disparity in rates of AMD between the wealthier neighborhoods and the low-income neighborhoods where he works.

Since these neighborhoods are only 10 miles apart, “I’m willing to bet [those neighborhoods] have the same pollution levels, ”he said.

One of the reasons for these disparities may be inequalities in health care in low-income areas, including lack of access to preventive care.

Researchers from the UK have found that air pollution can be significantly associated with the development of age-related macular degeneration (AMD), which can lead to vision loss.

But experts say that while environmental and genetic factors can cause AMD, age remains the biggest risk factor for the disease. Maintaining a healthy lifestyle is the most effective prevention.

Experts stress that these new findings should also be taken with “a grain of salt”, as the effects of air pollution are difficult to isolate.


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