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

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

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

“In the advanced stages of the disease, people 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 while both forms can cause severe vision loss, the most serious vision loss associated with AMD occurs in people with the wet form of AMD. disease.

Researchers looked at data from 115,954 UK 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. received a formal diagnosis of 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, indicative of AMD, was 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 not diagnosed with the disease had signs of AMD detected by retinal imaging.

After 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, has been 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. Matthew Gorski, ophthalmologist at Northwell Health in New York.

However, Gorski stressed that the study was observational and therefore could not show that AMD is associated with air pollution.

“We have to 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 well-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 in Dallas, said people with drusen – fatty deposits associated with AMD that build up under the retina – can slow the disease down.

“It is essential to start taking specific vitamins that have been shown to reduce 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 be given injections of anti-VEGF (vascular endothelial growth factor). “Injections are currently the main treatment for wet AMD,” she said.

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

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

He said that age is the main risk factor for AMD and that longer life expectancy is also one.

“People who live in underdeveloped countries usually don’t live that long,” Fromer said. “So industrialized countries may have more pollution, but then again, I guess that’s not quite true because you can have countries that have a lot of pollution that are underdeveloped because the laws don’t. not reduce pollution.

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

They include not 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 AMD rates between the wealthier neighborhoods and the low-income neighborhoods where he works.

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

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

Researchers in 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 is still the primary 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.