Articles | Ask Dr. Mong

A recent study involving 3654 people followed for eleven years sheds startling new light on the quotation "But if thine eye be evil, thy whole body shall be full of darkness". Researchers found that the presence of mild macular degeneration before age 75 increased the risk of dying during the 11 year period by 50%. If one had advanced macular degeneration the risk of an early death was increased by a shocking 250%. Yes, in this study, advanced macular degeneration increased the likelihood of dying during the study by 2.5 times. The association in persons younger than 75 years remained similar after further adjustment for triglyceride level, fibrinogen level, educational level, and walking disability.

In my opinion, evidence is mounting that chronic inflammation as evidenced by subtle changes in ones eyes are a marker of systemic wide dysfunction that leads to heart disease and other problems which result in illness, premature disability and death. So much attention is being given to the latest high tech advance to treat late stage macular degeneration when our emphasis must be redirected to preventing these problems starting from childhood. Diet, exercise, maintaining proper lean body mass, and appropriate dietary supplements are my recommendation for ocular health and general wellbeing. Truly, the eye is a window to the inner workings of the body and beyond-"if thine eye be evil, thy whole body shall be full of darkness", as confirmed by this recent report Visual Impairment, Age-Related Macular Degeneration, Cataract, and Long-term Mortality Arch Ophthalmol. 2007;125:917-924.

I recommend looking over the many posts on this site over the last year or so to find additional useful information to educate and encourage you in your efforts to maintain and optimize your health and wellbeing.

Michael A. Mong, M.D.
Ophthalmologist
Eye Physician and Surgeon
Grapevine, Texas

Filed under Macular Degeneration, Articles, Educational Resources by Michael Mong, M.D..

Permalink • Print • Email

It appears that higher blood levels of Vitamin D can lessen the risk of early forms of macular degeneration. The findings were reported in the May 2007 issue of the Archives of Ophthalmology. This is a very important study and adds to the large body of research that points to the fact that Vitamin D is an essential compound, and low Vitamin D is related to many diseases. Of note, even modest increases in Vitamin D levels showed a protective affect, lowering the risk of macular degeneration by 36%. Most labs list the lower limits of normal for Vitamin D to be between 20 to 25 ng/mL. In this study patients in the lowest level of Vitamin D of less than 16.8 ng/mL had a relative risk of 1.0. Levels between 16.8-21.6 ng/mL had a risk of 0.97, not much difference. At levels of 21.6-27.24 the relative risk was 0.75 or a 25% decrease. From 27.24-33.65 the risk was 0.70, and greater than 35 the relative risk was 0.64 or a 36% decrease.

Now here is what I think is exciting and most significant. Many experts, such as those at the Vitamin D Council are suggesting that all of us should have our Vitamin D levels checked and maintain levels of at least 35 ng/ml and up to 50-80 ng/ml. These levels can not generally be obtained with diet alone and one usually needs supplementation to maintain these levels throughout the year. I would strongly recommend that anyone with macular degeneration have their Vitamin D level checked and work with their doctor to bring their level into the upper end of the normal range. I might also suggest that one might want to read a bit more about Vitamin D at the Weston A price Founation.

And now Vitamin D and Macular Degeneration

From: http://www.westonaprice.org/basicnutrition/vitamin-d-safety.html

Michael A. Mong, M.D.
Ophthalmologist
Grapevine Texas

Filed under Uncategorized, Macular Degeneration, Nutrition, Supplements, Articles by Michael Mong, M.D..

Permalink • Print • Email • Comment

Yet another report that shows a 70% decrease in the progression of macular degeneration in patients who report even modest levels of routine exercise. Imagine that, the mere fact of regular exercise was shown to reduce the chance of serious vision loss in a group of several thousand patients. Exercise may help protect against age-related macular degeneration (AMD), according to the results of a large cohort study published online in the October 31 issue of the British Journal of Ophthalmology.

"These data show a protective effect of physical activity for incident exudative AMD, independent of body mass index and other confounders," the authors write. "These data suggest a possible modifiable behavior that might be protective against developing AMD."

Longer life, less diabetes, fewer Metabolic Syndrome X symptoms, and now less vision loss, are all associated with increased physical activity and increased muscle mass. Now, purpose to exercise 4 to 5 times a week regularly as your health allows. For those of you that are diabetics, I would strongly suggest checking out resources on this blog from Dr. Richard K. Bernstein. He has excellent materials you can view here. Listen to informative audio programs from him here.

Michael Mong, M.D.
Ophthalmologist
Grapevine, Texas

Filed under Macular Degeneration, Exercise, Articles by Michael Mong, M.D..

Permalink • Print • Email • Comment

A study published this week in Arch Neurol. 2006;63:1545-1550 gives further support for what I have been advocating for my patients, that taking fish oils such as Carlson’s Cod Liver Oil, can reduce the risk of a number of chronic diseases such as dementia, Alzheimer’s disease and macular degeneration.

There is a strong basis in biology for the neuroprotective effects of DHA (which is a major component of Fish Oil), writes Martha Clare Morris, Sc.D., Rush University Medical Center, Chicago, in an accompanying editorial.

"Lipids, a collective term for fats and oils, make up about 50 to 60 percent of the brain’s dry weight, and DHA is the most abundant fatty acid found in the cell membranes of the brain’s gray matter, she writes. Studies done in the 1980s and 1990s found that DHA is important to a variety of brain cell components and functions. "Indeed, the level of DHA in the brain has been shown to be very important for learning ability and memory in early life in studies of rodents, baboons and humans," Dr. Morris writes. "It is only recently that the omega-3 fatty acids have been investigated for their importance to the aging brain. The DHA composition of the brain decreases with age as a result of increased oxidative [result of oxygen exposure] damage to the lipid membranes."

Michael Mong, M.D.
Grapevine, Texas

Filed under Macular Degeneration, Nutrition, Supplements, Articles by Michael Mong, M.D..

Permalink • Print • Email • Comment

For several years I have been encouraging my patients to consider adding high quality Cod Liver Oil to there diets. In addition to the growing body of evidence that Omega-3 fatty acids play a critical role in reducing ones risk of macular degeneration, Cod Liver Oil is a rich source of natural Vitamin D₃. It now appears that there is growing recognition that the common form of Vitamin D that most people are taking, Vitamin D2, is not as effective as the natural form, Vitamin D3. The case against ergocalciferol (vitamin D2) as a vitamin supplement. Am J Clin Nutr. 2006 Oct;84(4):694-7. "The emergence of 25-hydroxyvitamin D as a measure of vitamin D status provides an objective, quantitative measure of the biological response to vitamin D administration. As a result, vitamin D₃has proven to be the more potent form of vitamin D in all primate species, including humans. Despite an emerging body of evidence suggesting several plausible explanations for the greater bioefficacy of vitamin D3, the form of vitamin D used in major preparations of prescriptions in North America is vitamin D₂. The case that vitamin D₂ should no longer be considered equivalent to vitamin D₃ is based on differences in their efficacy at raising serum 25-hydroxyvitamin D, diminished binding of vitamin D₂ metabolites to vitamin D binding protein in plasma, and a nonphysiologic metabolism and shorter shelf life of vitamin D₂. Vitamin D₂, or ergocalciferol, should not be regarded as a nutrient suitable for supplementation or fortification." I encourage all interested individual to look carefully at their Viatmin D₃ intake.

Filed under Uncategorized, Nutrition, Supplements, Articles, Educational Resources by Michael Mong, M.D..

Permalink • Print • Email • Comment

A recent review article highlights the many essential functions that our muscles play in preventing many of the common chronic health problems of our day including Metabolic Syndrome X. To quote from the article The under appreciated role of muscle in health and disease¹ ^,2^{,3 by}Robert R Wolfe

"The importance of maintaining muscle mass and physical and metabolicfunctions in the elderly is well-recognized. Less appreciatedare the diverse roles of muscle throughout life and the importanceof muscle in preventing some of the most common and increasinglyprevalent clinical conditions, such as obesity and diabetes.It is therefore imperative that factors directly related tomuscle be included in future studies designed to demonstrateoptimal lifestyle behaviors throughout the life span, includingphysical activity and diet."

Exercise is really one of the best "medicines", and I recommend a vigorous exercise program for all my patients who do not have any medical contraindications.

Filed under Exercise, Articles, Educational Resources by Michael Mong, M.D..

Permalink • Print • Email • Comment

A case report in Ophthalmic Plastic and Reconstructive Surgery, May/June 2006 describes a 43-year-old man who was on statin monotherapy (10 mg Lipitor) for hypercholesterolemia and developed unilateral blepharoptosis, that is drooping of his eyelid. The authors conclude that statin-induced myositis in the levator muscle should be considered as a possible cause of acquired eyelid drooping.

Filed under Medications, Side Affects, Ocular Side Affects, Articles by Michael Mong, M.D..

Permalink • Print • Email • Comment