食疗预防视网膜黄斑恶化

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降低因视网膜黄斑恶化而引起视力衰退的机会
看看哪些食物会有所帮助

克里斯*A*诺布，医学博士
助理临床教授
美国达拉斯德克萨斯州立大学西南医疗中心

视网膜老化性黄斑病变（AMD）是与中央视力逐渐退化相关联的，这种病症目前尚无治愈的方法。它是导致老年人视力下降并无法恢复的最主要原因。有可能引起中央视觉敏感度的严重损伤，从而失去阅读、驾驶的能力或无法识别熟悉的面孔。但是，就像很多病症一样，它也是可以预防的，所有患有AMD或可能患上这种病的人都应该了解一些基本常识。

导致AMD的原因有很多，包括遗传，高龄，吸烟和高血压等。不幸的是，这些原因对于很多患上AMD的人或有可能患病的人来说都无法控制，除了唯一的可能：营养。在本文中，我们将回顾两宗与营养有关的标志性个案，从而向AMD病患及患病高危人群提供详细的营养建议。

麻塞诸萨州眼科及耳科医院的眼科医师和视觉科学家1994年11月在美国医学联合会的杂志上，发表了一份研究结果，说明了和AMD相关的膳食因素。研究发现进食大量富含类胡罗卜素（叶黄素和玉米黄质）的蔬菜的人与那些极少吃此类食品的人相比，患上AMD的机会降低了43%。富含类胡罗卜素的蔬菜包括多叶的深绿色蔬菜，特别是菠菜、羽衣甘蓝和绿色散叶甘蓝等。在研究报告的结尾，作者还表示“食用富含一定类胡罗卜素的，尤其是多叶的深绿色蔬菜，还可以减少患渗出性（“湿”）AMD的机会，这是老年人群中最常见的视觉黄斑恶化类疾病。”

另一项由国家健康学院/国家眼科学院主持的研究显示，大量的抗氧化维他命和锌可以有效地减少高龄黄斑恶化及与其相关的视力减退。本次研究名为老化性眼疾研究（AREDS），对患有AMD的病人来说真是另一项标志性的研究。研究人员表示：“当可能患上重度AMD这种导致视觉损失的主要诱因的高危人群服用大剂量的维他命C、维他命E、叶红素和锌的组合时，患病的比例下降了25%。”

国家眼科学院主任，医学博士，哲学博士保罗*A*西文说：“这是一项令人兴奋的发现，因为对能患上重度AMD这种导致视觉损失的主要诱因的高危人群来说，这些营养品是第一道有效减缓疾病恶化的屏障。AMD是65岁及以上的美国老人最主要的导致视觉损伤和目盲的原因。目前，重度AMD的治疗方法很有限。这些营养物质可以减缓高危人群患上重度AMD的时间，这类高危人群包括一只或两只眼患有中度AMD的人，以及那些已经有一只眼睛患上了重度AMD的人。”西文博士还说AMD患者应该清楚这种病没有治愈的办法，因此这些营养物质并不能恢复已经丧失的视觉能力，但是，研究结果显示它们的确在帮助维持高危人群现有视力中扮演了关键角色。

在AREDS研究中评估的营养物质含有500毫克维他命C，400国际单位的维他命E，15毫克的叶红素，80毫克的锌或氧化锌，和两毫克的铜或氧化铜。在这次研究中，国家眼科学院得到了博士伦的支持和配合，这家眼科产品及药品生产公司提供了营养物，实验室的财务资助以及自行分发了营养物品。今天，我们已经可以在一种叫Ocuvite® Preservision™的配方中找到这些营养物质。

原文：

Reduce Your Risk of Vision Loss From Macular Degeneration
Find Out Which Foods Will Help

Chris A. Knobbe, M.D.
Assistant Clinical Professor
University of Texas Southwestern Medical Center - Dallas

Age related macular degeneration (AMD) is associated with a slowly progressive deterioration of central vision for which there is no cure. It is the leading cause of irreversible vision loss among the elderly. The condition may lead to severe loss of central acuity, such that the affected may lose ability read, drive a vehicle, or recognize familiar faces. However, as in many disease states, prevention may be possible and every person with AMD or at risk for AMD should understand the basic principles.

There are a number of risk factors for AMD, including genetic inheritance, advancing age, smoking, and high blood pressure. Unfortunately, many people that get AMD or are at risk for the disease don’t have any risk factors that are under their control, except possibly one: nutrition. In this article, we’ll review two landmark studies linking nutrition to AMD and we’ll provide specific nutritional advice to those with AMD as well as those at risk for the disease.

Ophthalmologists and vision scientists at the Massachusetts Eye and Ear Infirmary published the results of a study investigating the relationship between dietary factors and AMD in the Journal of the American Medical Association in November, 1994. This study found that individuals who had the highest consumption of vegetables rich in carotenoids (lutein and zeaxanthin) had a 43% lower risk of developing AMD than those who ate these foods the least. Vegetables rich in carotenoids include dark, leafy green vegetables, especially raw spinach, kale, and collard greens. The authors stated, at the conclusion of the study, that “consumption of foods rich in certain carotenoids, in particular dark green, leafy vegetables, may decrease the risk of developing exudative (“wet”) AMD, the most visually disabling form of macular degeneration among older people”.

A second study investigating nutritional factors and AMD, supported by the National Institutes of Health/National Eye Institute, showed that high levels of antioxidant vitamins and zinc significantly reduced the risk of advanced age-related macular degeneration and its associated vision loss. This study, known as the Age Related Eye Disease Study (AREDS), was truly another landmark study for patients with AMD. The investigators state, “people at high risk of developing advanced stages of AMD, a leading cause of vision loss, lowered their risk by about 25 percent when treated with a high-dose combination of vitamin C, vitamin E, beta-carotene, and zinc”.

“This is an exciting discovery because, for people at high risk for developing advanced AMD, these nutrients are the first effective treatment to slow the progression of the disease,” said Paul A. Sieving, M.D., Ph.D., director of the National Eye Institute. “AMD is a leading cause of visual impairment and blindness in American 65 years of age and older. Currently, treatment for advanced AMD is quite limited. These nutrients will delay the progression to advanced AMD in people who are at high risk – those with intermediate AMD in one or both eyes, or those with advanced AMD in one eye already”. Dr. Sieving further states that patients with AMD should understand that there isn’t a cure for AMD and that proper nutrition will not restore vision that is already lost. However, the study results also clearly demonstrate that nutrients play a key role in helping to maintain vision in people at high risk for developing advanced AMD.

The nutrients evaluated in the AREDS study contained 500 milligrams of vitamin C, 400 international units of vitamin E, 15 milligrams of beta-carotene, 80 milligrams of zinc as zinc oxide, and two milligrams of copper as cupric oxide. In this study, the NEI was supported by and collaborated with Bausch and Lomb, an ophthalmic products and pharmaceuticals company that provided the nutritional supplements, financial support for laboratory testing, and distribution of the supplements themselves. Today, these supplements can be found in a formulation called Ocuvite® Preservision™.

华夏近视网www.chinaeye.com独家译稿，未经允许，不得转载。

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