Age-Related Macular Degeneration affects 11 million people in the US. Medical marijuana has been shown to potentially help patients manage symptoms of AMD. Treating Glaucoma and Macular Degeneration and other site issues with medical marijuana. Cannabis could be that option for patients.
Cannabis and CBD for Age-Related Macular Degeneration (AMD)
There is no known cure for Age-related Macular Degeneration (AMD), a condition caused when a tiny part of the retina called the macula deteriorates. Rarely, AMD could lead to permanent vision loss for individuals past the age of 60.
Currently, the National Eye Institute reports that 11 million Americans suffer from this age-related condition caused by the weakening of the macula, although it is likely under reported (10). Made up of photoreceptor cells, the macula detects light and images and signals the brain to interpret what is in the central vision (11). Though there are many types of macular disease, AMD is the most common. When AMD sets in, the macula weakens, causing visual impairments including sharp details becoming blurry, difficulty reading, recognizing faces, and differentiating colors.
Unlike other macular diseases, AMD is directly related to aging, primarily affecting the elderly. Bright Focus reports the global cost of the condition is $343 billion, with up to $98 million in collective healthcare costs for the U.S, Canada, and Cuba (1). According to Johns Hopkins University, age-related macular degeneration is the leading cause of vision loss in people 50 and older, and although it can cause a severe loss of central vision it rarely causes people to go blind (5).
How Cannabis Can Help Relieve the Symptoms of Age-Related Macular Degeneration (AMD)
As an anti-inflammatory agent, THC could reportedly assist in temporarily lowering intraocular pressure and free radicals that lead to vision loss specifically for those living with glaucoma. A study published in Pharmacology & Therapeutics suggests that THC helps lower intraocular pressure, potentially preventing vision loss (6). Meanwhile CBD has a THC-countering effect in the eyes that could block its lowering of IOP (intraocular pressure) (8). Some patients with glaucoma who smoked medical cannabis reported clearer vision. These effects are generally short-term and are not yet confirmed by large studies.
However, United Patients Group reports CBD benefits that may assist with clearer vision (2). For example, it stunts the vascular endothelial growth factor (VEGF). A cancer research study on mice suggested that CBD, “lowered the expression of various VEGF pathway-related genes.” Along with the ability to inhibit VEGF, cannabinoids may theoretically alleviate macular disease symptoms since they inhibit angiogenesis, are neuro-protective and reduce ocular pressure (3). Such effects require direct eye research to confirm, as they can only be extrapolated at this time.
Medical Cannabis and Inflammation
Medical cannabis is a powerful anti-inflammatory drug. Cannabinoids play an important role in the regulation of the immune system through activating cannabinoid receptors in the Endocannabinoid system (ECS).
When your body activates your immune system, it sends out inflammatory cells and signals. These cells attack bacteria and often damage healthy tissue as well. Inflammation is a feature of some degenerative eye diseases such as glaucoma and AMD.
Inflammation is one of the most common conditions targeted with medical cannabis. As stated above, cannabinoids are known anti-inflammatory and antioxidant agents (9). Cannabidiol may be an effective treatment for inflammation in glaucoma patients and individuals with AMD although further research in this area in order to make a recommendation.
Medical Cannabis as a Neuroprotectant: A Patient’s Perspective
A patient in Taos, New Mexico who suffered from AMD found amazing results with CBD after taking it sublingually under her tongue at the suggestion of an herbalist, according to the United Patients Group. However, before finding CBD, the patient had several injection treatments to inhibit VEGF, which are painful and invasive. While the United Patients group reports, “no studies have been done on cannabinoid therapy and AMD directly,” there may be a correlation between taking CBD and improvement in symptoms according to patient reports like this one (2).
Until further research takes place, the use of medical cannabis in the treatment of AMD will continue to be studied along with many other conditions for which patients are successfully using cannabinoids.
Research on AMD and Medical Marijuana
To date, there is no direct evidence that cannabis can help with AMD. Cannabis smoke creates tar that contains some of the similar carcinogens of tobacco smoke, and so any kind of smoking should be avoided to prevent the development of AMD since smoking increases your chances of developing it later in life. It may be possible that forms of cannabis ingestion other than smoking could be beneficial for other aspects of treating symptoms that present with AMD but at this time there is currently no research to support using cannabis for AMD.
Types of Age-Related Macular Degeneration
Understanding the different kinds of AMD is important to have a grasp of the disease on the whole. There are two forms of AMD: dry and wet. Let’s explore the two types of AMD and how they are characterized.
Wet age-related macular degeneration is also called advanced neovascular AMD. It is a less common type of late AMD that usually causes faster vision loss. It’s important to note that any stage of dry AMD can turn into wet AMD—but wet AMD is always a late stage.
It occurs when abnormal, leaky blood vessels grow in the back of the eye and damage the macula. As mentioned before it is the less common type of AMD and only accounts for about 10 percent of cases. Wet AMD accounts for roughly 10% of AMD cases, but 90% of the time leads to legal blindness (1).
Unlike dry AMD, wet AMD can be treated effectively with medication. Treatments can also include visual therapy and vision aids. With regard to pharmaceutical treatments, “ Wet AMD is usually treated using the following medications, which belong to a group of drugs known as anti-vascular endothelial growth factor (anti-VEGF) drugs Ranibizumab (trade name: Lucentis) and Aflibercept (Eylea) (4).”
Side effects of these treatments may include temporary eye pain, raised pressure inside of the eye, and seeing spots or dots that follow the eye’s movements.
Additionally, it should be noted that serious side effects of this treatment are “inflammation of the inside of the eye (endophthalmitis) or the middle layer of the eye (uveitis), cataracts or retinal damage. In total, these types of side effects occur in less than 1 out of 100 people (4).”
Most people with AMD have dry AMD, which is also referred to as atrophic AMD. This is when the macula gets thinner with age. The symptoms of dry AMD depend on the stage. Dry AMD happens in 3 stages: early, intermediate, and late.
It usually progresses slowly over several years, and symptoms tend to worsen over time. While early-stage dry AMD and some cases of intermediate dry AMD typically do not cause symptoms, some patients with intermediate dry AMD and patients with late AMD will often notice symptoms including blurriness and trouble seeing in low lighting. Over time these symptoms progress to colors appearing less bright and the blurry area expanding. Straight lines appearing wavy is a warning sign for late AMD, and patients should seek care from their eye doctor immediately.
Annual dilated eye exams can help catch the early stages of AMD and other optical diseases, which adds to the importance of routine eye exams. Individuals with preexisting conditions like diabetes, hypertension, and hyperlipidemia may need more regular eye exams. Persons with known family history of AMD or vision problems should consult their doctor and optometrist for evaluation and follow up.
There is currently no treatment for late dry AMD, but if unfortunately caught in a late stage you can find ways to make the most of your remaining vision and relieve symptoms. Prevention and early detection are always best practices.
Risk Factors of Age-Related Macular Degeneration
According to Mayo Clinic, risk factors of AMD include:
- Age – People over 60 are at higher risk
- Family history and genetics – Several genes are linked to this disorder that can be inherited
- Race – Caucasian people have more odds of developing AMD
- Smoking – First and second-hand smoke increases odds of developing AMD
- Obesity – May accelerate the development of intermediate stage AMD to more severe late stage
- Cardiovascular disease – Conditions that affect the heart and blood vessels like diabetes and high blood pressure may increase the risk of AMD (7).
Lowering Your Risk for AMD
Research shows that you may be able to lower your risk of AMD (or slow vision loss from AMD) by making these healthy choices:
- Avoid smoking
- Regular physical activity
- Maintain healthy blood pressure and cholesterol levels
- Eat healthy foods, including foods high in nutrients such as leafy green vegetables and fish (10)
Note: The content on this page is for informational purposes only and is not intended to be professional medical advice. Do not attempt to self-diagnose or prescribe treatment based on the information provided. Always consult a physician before making any decision on the treatment of a medical condition.
Cannabis and Macular Degeneration: Can It Help?
There was a time when people correlated marijuana and the eyes only with dryness, redness and dilated pupils. Time (and some very pinpointed research) has indeed changed this perception for the better. Now there is an overall consensus of the power of cannabis to help with some eye afflictions, especially glaucoma. But what about the BIG ONE that is estimated to affect 6.3 million baby boomers alone by the year 2030? Might cannabinoid therapy be able to help with age-related macular degeneration as well?
What is Macular Degeneration?
According to the American Macular Degeneration Association, macular degeneration (or MD) is the leading cause of vision loss in the country, currently affecting more than 10 million Americans of all ages, more than cataracts and glaucoma combined. Considered an “incurable disease,” MD is caused by the deterioration of the central portion of the retina, i.e. the inside back layer of our eye that first “records” images before they are sent to the optic nerve and brain, where they are translated into scenes we can comprehend. The job of the “macula” is to focus the central vision of the eye. It controls our ability to read, drive and recognize colors and faces. We are able to see details in objects because of the macula as well.
When the cells of the macula begin to deteriorate, the result is that images are not received correctly. In the early and intermediate stages of the disease, blurred vision or waviness may occur. As MD worsens, however, central vision may become lost altogether (although peripheral sight remains).
As we shall see, there are quite a few attributes of cannabis that may correlate it chemically with MD relief. But first, let’s hear about one case where the results of CBD oil in particular on Intermediate MD were crystal clear.
Fabi is a small business owner and active part of the tiny, artist community of Taos, New Mexico. About a year ago, Fabi contracted a tick-born disease. At the suggestion of a friend, Fabi began using a straight CBD oil that she was able to obtain at her local herb store for the condition. She started using the CBD oil internally as instructed by the trained herbalist on staff there.
While she says that her disease symptoms did seem to disappear while she has been on the CBD oil (although she couldn’t say for sure because her symptoms tend to come and go), ANOTHER healthy side effect of CBD was undeniable.
Fabi had also been suffering from macular degeneration for a while (longer than the tick-born illness). About three weeks after starting to use CBD oil, Fabi went to an appointment with her eye doctor. In the beginning months of her MD diagnosis, she received the “standard of care” for someone with her condition: injections of either Lucentis, Avastin or Eylea directly into the eye. All three of these drugs, two of which are off-shoots of colorectal cancer treatment drugs, are designed to inhibit the growth of vascular endothelial growth factor (VEGF). An overabundance of VEGF proteins in the eye area are thought to contribute to abnormal blood vessel growth in the retina, one of the factors contributing to macular degeneration. Because the injections were so unpleasant for her and they weren’t improving the condition, Fabi decided to discontinue them months ago. At the time, she simply resolved to live with the condition, and possibly the loss of her eyesight, as best she could.
That day, her doctor took the usual round of photos of her eyes to see how the condition was progressing. She began with the “wet” right eye, which before that day had been classified as being “Intermediate MD,” meaning some loss of vision and symptoms of MD were clearly present. Her doctor couldn’t believe what she saw.
“The eye doctor treating me for macular degeneration couldn’t believe the photo of the macular,” Fabi said in a recent Facebook post about the visit. “The leaking in the blood vessel that causes lesions, bumps, swelling, etc. (which causes the loss of vision) was mostly gone.”
According to Fabi, her doctor commented: “This can’t be! You haven’t been getting injections so how did the swelling go down?”
Fabi wrote (and confirmed later in a brief interview with UPG), that the only thing she had changed over the course of the three weeks prior to her doctor’s appointment was the introduction of taking CBD oil sublingually (under the tongue). Fabi says that her right eye has gone down from an “Intermediate MD” to an “Early Stage MD” diagnosis. She is now excited to keep up with her CBD oil protocol, which she is confident will clear up the right eye even more and begin to work its magic on the left as time goes on.
“I’m estatic!” says Fabi.
Do Cannabiniods Help Macular Degeneration?
Was it the CBD oil that caused the macular degeneration in Fabi’s right eye to reduce so dramatically in such a short time? Since no studies have been done on cannabinoid therapy and MD directly, scientifically, no one can say for sure. However, there are some interesting correlations between certain characteristics of the healing power of cannabis and the particular mechanisms of macular degeneration:
- There are cannabinoid receptors in the eye area. In a ground-breaking Finnish study on glaucoma conducted in 2002 and published in the journal Pharmacology & Therapeutics, researcher Tomi Järvinena and his team discovered that the eye area has cannabinoid receptors, making this intricately complicated area of the body also a part of the all-encompassing endocannabiniod system (which helps to balance and regulate all other body systems). In the study, smoking cannabis directly was found to lower intraocular pressure in glaucoma patients, but “the discovery of ocular cannabinoid receptors implied an explanation for the induction of hypotension by topical cannabinoid applications.”
- Cannabis is an anti-inflammatory. The fact that cannabis is an anti-inflammatory is nothing new. But cannabidiol has also been shown to be an anti-inflammatory specifically for the retina area, especially when that inflammation is associated with endotoxin exposure and diabetes. Believe it or not, there is a direct correlation between all three of these conditions. Diabetes and macular degeneration often go hand in hand (specifically because of low glutathione levels). Exposure to bacterial endotoxins, on the other hand, can often be an initial cause of MD. And all three of these conditions are instigated by the inflammatory response, which, of course, CBD has proven to be able to mitigate quite effectively.
- Cannibinoids have been shown to inhibit VEGF growth. The whole point of administering the grueling injection of drugs directly into the eye for MD patients is because, supposedly, these drugs have the ability to stop the progression of vascular endothelial growth factor (VEGF). But cannabis has also been shown to do the same thing, with little to no harsh side effects. A 2004 mouse model study of gliomas (brain tumors) conducted by researchers at Comlutense University in Madrid, Spain found that cannabinoids inhibited VEGF pathways, thus slowing tumor growth in the mice. The same effect was also seen in two glioma patients as well.
“Because blockade of the VEGF pathway constitutes one of the most promising anti-tumoral approaches currently available, the present findings provide a novel pharmacological target for cannabinoid-based therapies,” the final report, published in the journal Cancer Research, reported.
Science may someday prove cannabinoid therapy to be the safe, effective, go-to therapy for the millions of Americans affected with macular degeneration. In the meantime, for Fabi (and others like her), perhaps the only proof she needs is the kind she can see with her own two eyes.