Ординатура / Офтальмология / Английские материалы / Retinal and Vitreoretinal Diseases and Surgery_Boyd, Cortez, Sabates_2010
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Figure 7: Many studies demonstrated that dietary interventions with vegetables, fruits, wholegrain bread, eggs, chicken, fish, milk and breakfast cereals were related to an increased folate intake and inversely associated with serum homocysteine levels; thus might potentially contribute to the effort of lowering homocysteine levels on ocular vasculopathic patients.
Figure 8: Foods that are rich in iron include beef, veal, fish, eggs, soya bean, broccoli and green beans.
Conclusion
Currently, evidence-based data on the role of nutritional factors on retinal disease are relatively limited. Results of the different studies are often inconsistent and precise nutritional recommendations on retinal diseases are not easy to be given in an absolute way.
Regarding AMD there is some evidence that patients with moderate AMD may benefit from a high-dose supplementation of a combination of vitamin C, vitamin E, β-carotene, zinc and copper in the dosages proposed by the AREDS trial and may be considered in
some cases. Additionally lutein, zeaxanthin and omega-3FAs may have a beneficial effect on AMD but their role has to be further determined. On the other hand, actually there is no evidence from randomized trials that nutritional elements may help healthy people to prevent or delay the onset of AMD and consequently no specific dietary patterns or nutritional supplements are currently recommended.
Further trials are warranted in order to clarify the role of nutritional elements on AMD. The results of several ongoing studies such as AREDS II are awaited with interest.
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Considering patients presenting diabetic retinopathy a tight glycemic control is essential. Consequently, several nutritional patterns can adequately contribute to glycemic control and are currently highly recommended in these patients. In addition a low-fat diet is suggested. The role of specific micronutrients supplements, like antioxidants, on diabetic retinopathy although promising has yet to be further elucidated and is not currently recommended.
Regardingretinalvasculardiseasesalthough there are some indications that nutritional factors may play a role to their pathogenesis actually there is not enough evidence based data to recommend specific dietary patterns or nutritional supplements. Further studies are needed to clarify these associations.
Finally, one should consider that even if dietary recommendations regarding retinal diseases cannot be given a healthy diet, rich in green, leafy vegetables and fish, avoidance of high fat diets especially rich in saturated, monounsaturated, polyunsaturated, transunsaturated fats and linolenic acid is more probably beneficiary than harmful.
In conclusion, nutrition may have potentially important implications in the prevention and treatment of retinal diseases and its role has to be further clarified.
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