Dietary and lifestyle recommendations for patients at risk of and showing signs of age-related macular degeneration in Sweden
Age-related macular degeneration (AMD) is a major cause of severe visual impairment in older populations and is characterized by progressive destruction of the retinal pigment epithelial cells and photoreceptors due to low-grade inflammation, ischemia and oxidative stress. Studies show evidence that carotenoids and antioxidants derived either from the diet or from supplements may significantly reduce the risk of visual loss in these patients.
But how often do ophthalmologists and optometrists in Sweden recommend the use of nutritional supplements, changes in diet, or smoking cessation to patients at risk of or with early symptoms of AMD? A study published recently in Dove Medical Press journal, Clinical Optometry, set out to investigate just this and also determine how practitioners rate the strength of evidence for nutritional supplements in the prevention or treatment of AMD, and which sources of information they consult to create those recommendations.
All Swedish optometrists and ophthalmologists who were registered in the membership databases of their professional organizations were invited to participate in a questionnaire. The cross-sectional study looked into four main aspects: use of nutritional supplements, dietary advice, smoking and eye diseases, and strength of evidence and the sources of information regarding nutritional supplement interventions.
The response rate was, surprisingly, 40.3% for optometrists and 5% for ophthalmologists. Optometrists were more likely to recommend nutritional supplements in AMD and provided significantly more advice about diet than ophthalmologists for both patients at risk for AMD and those with established disease. Ophthalmologists, however, were more likely than optometrists to rely on evidence-based findings from the age-related eye disease studies of AMD regarding treatment with and selection of supplements and to recommend smoking cessation.
Author Lene Martin from Mälardalen University, Sweden, and City University of London, UK, said “The role that optometrists play when discussing healthy lifestyle changes is currently a widely discussed topic. Ophthalmologists aren’t the only eye care professionals who meet patients at risk of or with AMD, and this paper summarizes neatly how optometrists can be increasingly involved in preventative strategies for AMD.”
Dr Martin also reflects, “More targeted education and implementation strategies may be needed for both optometrists and ophthalmologists.”
Updated 22 June 2017