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Complementary and Alternative Medicine

More than 30 percent of adults in the US use health care treatments that fall outside of traditional medicine.1 When individuals use health care treatments that are outside the bounds of traditional Western medicine, it’s often referred to as “complementary” or “alternative” medicine (CAM). Although those two terms are often used interchangeably, they’re actually referring to two different kinds of health care approaches:

Complementary vs alternative medicine

“Complementary” medicine refers to when a non-traditional treatment is used together with conventional medicine.1 “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

What do we know about rheopheresis?

While it’s 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. We don’t 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 to individuals 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, but is also beneficial for eye health and to help 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 individuals at risk for the condition and may help slow the progression of AMD.6

Formulation of supplements

The original AREDS formulation of supplements included6:

  • 500 mg of vitamin C
  • 400 IU of vitamin E
  • 15 mg beta-carotene
  • 80 mg zinc as zinc oxide
  • 2 mg copper as cupric oxide

In AREDS2, modifications were made and they included6:

  • 10 mg lutein and 2 mg zeaxanthin
  • 1000 mg of omega-3 fatty acids (350 mg DHA and 650 mg EPA)
  • no beta-carotene
  • 25 mg zinc

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’re 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 can’t 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 about it. They will be able to discuss any potential interactions or side effects, as well as any other options that might be right for you.

Jaime R. Herndon | January 2019
  1. National Institutes of Health: National Center for Complementary and Integrative Health. Complementary, Alternative, or Integrative Health: What’s in a Name? 2018. https://nccih.nih.gov/health/integrative-health#hed1. Accessed October 14, 2018.
  2. Mayo Clinic staff. Acupuncture. 2018. https://www.mayoclinic.org/tests-procedures/acupuncture/about/pac-20392763. Accessed October 14, 2018.
  3. Jiao NJ. Observation on therapeutic effect of age-related macular degeneration treated with acupuncture. Zhongguo Zhen Jiu. 2011; 31(1): 43-45. https://www.ncbi.nlm.nih.gov/pubmed/21355157. Accessed October 14, 2018.
  4. Pulido J, Sanders D, Winters JL, et al. Clinical outcomes and mechanism of action for rheopheresis treatment of age-related macular degeneration (AMD). J Clin Apher. 2005; 20(3): 185-94. https://www.ncbi.nlm.nih.gov/pubmed/15892078. Accessed October 14, 2018.
  5. Dunaief J. Alternative Medicine for Macular Degeneration: Does It Work? BrightFocus Foundation website. 2017. https://www.brightfocus.org/macular/article/alternative-medicine-macular-does-it-work. Accessed October 14, 2018.
  6. National Institutes of Health: National Eye Institute. What the Age-Related Eye Disease Studies Mean For You. 2018. https://nei.nih.gov/areds2/PatientFAQ. Accessed October 14, 2018.