A new article was recently published online in JAMA Ophthalmology that determined a common blood test that assesses cardiovascular disease risk can also indicate a risk for age related macular degeneration (ARMD), which is the leading cause of vision loss among older adults in the United States. The research concluded that those with high levels of high-sensitivity C-reactive protein (hsCRP) have a 49 percent greater risk of developing all forms of ARMD compared to those with low levels of hsCRP. It was also determined that high levels of hsCRP is also associated with an 84 percent increased risk for developing wet AMD, which is the form of the disease more likely to cause severe vision loss.
What is high-sensitivity C-reactive protein and how does it relate to vision loss?
C-reactive protein is a protein that the liver makes when there is inflammation in the body. It has also been called a “marker” of inflammation in the body. Typically it has been used to measure the risk of developing cardiovascular disease.
In the Harvard Women’s Health Study, results of the CRP test were found to be more accurate than cholesterol levels in predicting heart problems. Twelve different markers of inflammation were studied in healthy, postmenopausal women. After three years, CRP was the strongest predictor for risks of cardiovascular disease. Women in the group with the highest CRP levels were more than four times as likely to have died from coronary disease, or suffered a nonfatal heart attack or stroke. This group was also more likely to have required a cardiac procedure such as angioplasty or bypass surgery than women in the group with the lowest levels.
This new study elucidates a new reason to have the hsCRP test done, as chronic inflammation is an important contributing factor in the development of ARMD. The eyes are a microcosm of the entire body. Degenerative eye disease is a complex process that requires us to look at how the entire body is functioning. Optimal health in all areas of the body will benefit the health of your eyes.
Chronic Inflammation and Vision Loss
When one normally thinks of inflammation, they usually think of pain somewhere in the body. For instance, rotator cuff injuries or sprained ankles will cause pain, heat, and swelling to the part of your body associated with the trauma. However, there is a deeper form of inflammation that can affect your body systemically. This is considered a chronic inflammatory state. Chronic inflammation causes a continual response of simulataneous tissue destruction and attempted repair in the body that can lead to the formation of weak, new blood vessels sprouting off of already formed blood vessels (neovascularization), an increase in cell production (a negative process called hyperplasia), the formation of fibrous connective tissue (fibrosis), ulceration, and even cancer.
Chronic inflammation can be caused by many different factors including free radical damage, certain foods and oils, infection, autoimmune disease, stress, pollutants, allergies, high blood insulin levels, and obesity. The trick is to find out which factors are producing the inflammation and address them specifically.
Drusen are tiny white deposits of waste material that build up in the eye and are one of the key diagnositic hallmarks in diagnosing ARMD.
(Macular soft Drusen in the right eye of a 70 year old male.)
The presence of these drusen are seen by the body as a foreign substance and initiates part of the inflammatory reaction. Over time this inflammatory reaction becomes a chronic condition, creating chronic inflammation.
However, what created the drusen in the first place? This is one of the important mysteries that many scientists are currently trying to unravel. Although it’s not completely understood yet, it is known that cellular debris begins to form at a very early age on the retina. This is a type of waste product that cells in the retina exude. Damage to the cells in the retina by free radicals can exacerbate this process forming an increase in cellular debris. The body then tries to protect the eyes from this debris by encapsulating it through an inflammatory reaction. The end product is drusen.
Vision loss then occurs through:
- genetic processes
- the destructive process of inflammation damaging the tissues of the retina
- drusen distorting and blurring your vision
Ways you can decrease inflammation in your body
There are multiple ways to decrease chronic inflammation in your body. Dietary changes need to be made, supplements can be added, and a regimented exercise program are all important.
Some steps that can be taken are:
- Increase the amount of good fat (Omega 3’s) in your diet by eating more wild caught salmon, flax seeds, walnuts, and pumpkin seeds. Take at least 1 gram of Omega 3 fatty acids per day.
- Consume a diet low in Omega 6 rich foods by limiting intake of meat, dairy, baked goods, flour products, and grains.
- Increase the amount of antioxidants in your diet to fight free radical damage. This can be done by eating more dark colored berries and dark leafy greens.
- Add turmeric to your diet or take an encapsulated form of it
- Frankincense (also known as Boswellia) is another anti-inflammatory that can be found in capsule form
- Add ginger to your diet
- Drink green tea
- Exercise regularly
- Get plenty of sleep
Dr Stephen Rose, the chief research officer for the Foundation Fighting Blindness says, “If someone gets a blood test that shows high levels of high-sensitivity CRP, that should raise a red flag. Hopefully, it will motivate them to be vigilant about getting their eyes checked as well as giving up smoking and other unhealthy habits that increase risk for both heart disease and AMD.”
Primary source: JAMA Ophthalmology
Mitta VP, et al “C-reactive protein and the incidence of macular degeneration. Pooled analysis of five cohorts” JAMA Ophthalmol 2013; DOI: 10.1001/jamaophthalmol.2013.2303.