Complementary and Alternative Medicine

More than 30 percent of adults in the United States use health care treatments that fall outside of traditional medicine. When people use healthcare treatments that are outside the bounds of traditional Western medicine, this is often referred to as “complementary” or “alternative” medicine (CAM). Although those two terms are often used interchangeably, they are actually referring to two different kinds of healthcare approaches.¹

Complementary versus alternative medicine

“Complementary” medicine refers to when a non-traditional treatment is used together with conventional medicine. “Alternative” medicine is when a non-traditional treatment is used instead of mainstream, traditional medicine.¹

CAM treatment options

CAM can include acupuncture, supplements, herbs, massage, yoga, chiropractic manipulation, homeopathy, meditation, progressive relaxation or guided imagery, and traditional Chinese medicine (TCM).

You might also hear the term “integrative health,” which is an approach that brings together traditional Western medicine with CAM treatments in a holistic, whole-person approach to healing the patient. In many integrative health systems, care and attention are given to all aspects of the person, including mental, physical, emotional, and social aspects of health and disease.

Acupuncture

Acupuncture is part of TCM and consists of placing very thin needles at strategic points in your body to relieve certain symptoms. There are certain rationales for this. TCM explains it as restoring or balancing the “life force” in the body. Western medicine explains its effectiveness through the stimulation of connective tissues, muscles, and nerves.²

Although there have been studies suggesting some efficacy in relieving symptoms associated with AMD, more research needs to be done.^1,3

Rheopheresis

Rheopheresis, also called double filtration plasmapheresis (DFPP), is similar to the process of kidney dialysis. Blood is removed from one arm via a vein and then returned to the body through a different vein in the other arm.

The rationale for its use in treating macular degeneration is that it decreases the proportion of certain proteins that potentially combine with a certain molecular complex, thus allowing retinal pigment epithelial cells to function more effectively, as well as reducing vascular endothelial growth factor (VEGF), which is implicated in various eye diseases, including AMD.⁴

While it is known that rheopheresis can remove certain chemicals or factors that might contribute to age-related macular degeneration (AMD), this is only temporary, and not permanent. Experts do not know if this is an effective long-term treatment, or what the effects of continued usage are. Early results from a clinical trial were promising and were more effective than a placebo, but the clinical trial was eventually discontinued because of lack of funding.

Microcurrent stimulation

In microcurrent stimulation, a mild electrical current is transmitted to the area around the eyes, ostensibly to get rid of retinal waste products. It is unknown whether this actually has any benefit for people with macular degeneration, or if it affects the course of macular degeneration at all.⁵

Supplements

A varied, well-balanced diet is important for general health and can help reduce the risk of disease. It also benefits eye health and helps treat and reduce the risk of AMD progression. The Age-Related Eye Disease Study 2 (AREDS2), along with the original AREDS, found that certain supplements significantly reduced the risk of developing advanced AMD for people at risk for the condition and may help slow the progression of AMD.⁶

Formulation of supplements

The original AREDS formulation of supplements included:⁶

• Vitamin C (500 mg)
• Vitamin E (400 IU)
• Beta-carotene (15 mg)
• Zinc as zinc oxide (80 mg)
• Copper as cupric oxide (2 mg)

In AREDS2, modifications were made and tested. They included:⁶

• Lutein (10 mg)
• Zeaxanthin (2 mg)
• Omega-3 fatty acids – 350 mg DHA and 650 mg EPA (1000 mg)
• No beta-carotene
• Zinc (25 mg)

Based on the AREDS and AREDS2 studies, the current formulation is:

• Vitamin C (500 mg)
• Vitamin E (400 IU)
• Lutein (10 mg)
• Zeaxanthin (2 mg)
• Zinc (80 mg)
• Copper (2 mg)

Note: This formulation can vary between different over-the-counter products.

Getting involved with AREDS/AREDS2

While general nutritional supplementation (such as a multivitamin) may be considered CAM, the AREDS2 formula has clinically proven benefits and therefore is considered current conventional treatment for those with intermediate AMD.

Talk with both your eye doctor and your general practitioner to see if these supplements are right for you, especially if you are on any other medications or have any other medical issues. Although a healthy diet is important, the levels of these vitamins and nutrients are high enough that you cannot get these levels from diet alone.

What can you do?

While CAM can be helpful for some people, not all CAM treatments interact well with traditional treatments, and none have been officially tested for efficacy or safety. Before you decide to add any complementary treatments or decide on pursuing alternative treatments for macular degeneration, talk with your eye doctor. They will be able to discuss any potential interactions or side effects, as well as any other options that might be right for you.

Before beginning treatment for macular degeneration, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.