Mandel vision explores the potential benefits of Cannabidiol, or CBD, products in this blog post. | Mandel Vision | Blog Post CBD may be used to treat macular degeneration because of its reported neuroprotective properties that could benefit patients with retinal disorders. Learn more. Age-Related Macular Degeneration affects 11 million people in the US. Medical marijuana has been shown to potentially help patients manage symptoms of AMD.
The Many Potential Health Benefits of CBD (Cannabidiol)
Cannabidiol, or CBD, products have become extremely popular since the passage of the U.S. Farm Bill in 2018, which legalized industrial hemp and CBD in all 50 states.
What is CBD?
According to Miriam Webster, cannabidiol (CBD) is a crystalline, nonintoxicating cannabinoid (C21H30O2) found in cannabis and hemp that is sometimes used medicinally.[i] Although CBD is the second most abundant of the active ingredients of cannabis, better known as marijuana, CBD is derived directly from the hemp plant and therefore contains only trace amounts of THC. THC is the most abundant psychoactive ingredient in marijuana.
Does CBD cause a “high”?
Since CBD only contains trace amounts of THC, the psychoactive ingredient in marijuana which is the mood-altering component, CBD does not cause a high.
Is CBD approved by the FDA?
Technically, CBD is not approved by the FDA. However, FDA approval isn’t required since it contains only trace amounts of THC. For this reason, it is legal to sell and consume CBD products in the U.S. without FDA approval.
Epidiolex, a medication indicated for the treatment of epilepsy associated with Lennox-Gastaut syndrome or Dravet syndrome, is the first FDA approved medication containing cannabidiol as its active ingredient.
What are the known health benefits of CBD?
Companies are touting the many potential health benefits of CBD. Although with the exception of epilepsy, these benefits are not yet clinically proven, some patients have reported relief from sleep problems, chronic pain, inflammation and anxiety.
A recent study also found that cannabidiol is a potent neuroprotective antioxidant.[ii] This suggests that cannabidiol may eventually play a therapeutic role in the treatment of neurological diseases such as Alzheimer’s and Parkinson’s disease.
Can CBD be used to treat Glaucoma?
CBD should not be used to treat glaucoma. Although marijuana has been shown to lower intraocular pressure (IOP) for very short periods of time, a recent study revealed that CBD oil actually raises IOP.[iii] Neither marijuana nor CBD are adequate treatment options for glaucoma as IOP needs around the clock control in order to prevent damage to the optic nerve, which could eventually lead to blindness if not managed properly. Click here to read more.
Does CBD have any eye health benefits?
It’s too soon for a definitive answer as the ocular effects of CBD are still being researched. However, there are a few possible indications for CBD in ophthalmologic conditions. The antioxidant properties of CBD may help slow the progression of age-related macular degeneration (ARMD or AMD) and the neuroprotective properties may help some retinal diseases such as retinal ischemia.
Is CBD safe?
You should check with your doctor to make sure CBD is not only safe for you, but that there aren’t contraindications between CBD and other medications you are taking. In addition, CBD should not be used as a replacement for other medical treatments unless recommended by a physician. Patients with active systemic disease should continue to see their primary care physicians and specialists to monitor their condition and treatment regimen.
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Best CBD Oil for Macular Degeneration – August 2022
Why People Are Turning to CBD for Macular Degeneration
Cannabidiol ( CBD ) could be used to treat macular degeneration due to its reported neuroprotective effects on retinal neurodegenerative diseases (5) .
Research in 2003 revealed that CBD reduced cell death in rat retinas injected with a substance that copied the effects of glaucoma. The study was reportedly the first demonstration of cannabidiol as a retinal neuroprotectant in vivo (6) .
Researchers in a 2006 study learned that CBD treatment significantly reduced oxidative stress and prevented retinal cell death in diabetic rats (7) .
In another study, cannabidiol was shown to decrease retinal inflammation in rats by blocking cells and structures responsible for neuroinflammation (8) .
Although these findings shed a positive light on CBD as a potential treatment for macular degeneration, all of the current research studies were performed on animals.
There have been no human clinical trials completed to prove that cannabidiol can effectively treat this eye condition .
How CBD Oil Works to Help with Macular Degeneration
A study published in 2008 investigated the role of adenosine signaling in retinal inflammation and how CBD could potentially modulate this pathway. The results showed that adenosine receptors are abundant in rat retinal cells (9) .
The researchers confirmed that the activation of these receptors plays a crucial role in anti-inflammation in the retina. They also added that CBD inhibited adenosine uptake, an action associated with inflammation (10) .
Another potential target for treating eye diseases is through the endocannabinoid system (ECS), a part of the body that regulates functions involving the nervous system and the immune system. The primary cannabinoid receptors of the ECS (CB1 and CB2) are both present in the retina (11) .
CBD has been found to interact with these receptors, even at reasonably low concentrations (12) . Its affinity with the CB2 receptor is believed to play a part in CBD ’s anti-inflammatory properties.
The Pros and Cons of CBD Oil for Macular Degeneration
- Several clinical trials on animals have shown that cannabidiol could be a potential treatment for retinal diseases due to its supposed neuroprotective effects (13) .
- Researchers consider CBD as a potential retinal neuroprotectant because of its reported ability to reduce cell death in rat retinas subjected to a substance that mimicked the effects of glaucoma (14) .
- Hemp-derived cannabidiol is now legal, according to the United States 2018 Farm Bill (15) . Americans can buy and use CBD products in most states.
- CBD is a non-psychotropic compound of cannabis plants . Although CBD is also found in marijuana , it is THC that causes the mind-altering effects.
- The U.S. Food and Drug Administration supports research on cannabidiol and other cannabis products (16) . The agency also recognizes the potential benefits of CBD .
- There are no human clinical studies that prove CBD to be an effective treatment for macular degeneration.
- Most of the studies on cannabidiol have been performed on animal models, making it difficult to determine if it can be used to treat certain medical conditions .
- Cannabidiol is not a risk-free substance. Human studies have shown CBD consumption to be associated with drug interactions, diarrhea, fatigue, and vomiting (17) .
- Health insurance firms in the United States do not cover CBD or medical marijuana , even if prescribed by a physician.
How CBD Oil Compares to Alternative Treatments for Macular Degeneration
A study on age-related macular degeneration ( AMD ) analyzed dietary supplements as a potential approach to delay the development of the condition. A formula that contained vitamin C, vitamin E, and beta-carotene have been mentioned in the assessment (18) .
One study showed that using a combination of these nutrients could significantly decrease the chances of progression to an advanced type of macular degeneration (19) .
A study published in the journal Antioxidants stated that vitamin C and E are effective nutrients in minimizing the risk of developing macular degeneration. They also stated that carotenoids, such as beta-carotene, are known for their protective effects against eye diseases and macular degeneration (20) .
Similarly, cannabidiol is said to have antioxidant and anti-inflammatory properties that could be used for many health conditions (21) .
One study claimed that CBD is a more effective neuroprotective antioxidant than vitamin C and E (22) .
How to Choose the Right CBD for Macular Degeneration
The three variants of CBD that users can purchase today are full-spectrum, broad-spectrum, and isolate.
Full-spectrum CBD is perhaps the most well-known of the three. This form of cannabidiol has all of the natural components of cannabis plants , including THC , flavonoids, and terpenes.
High-quality full-spectrum CBD has high cannabidiol content and small amounts of the other compounds present. Full-spectrum CBD is also known for the “entourage effect,” a synergism wherein all cannabis constituents are more efficient when taken together (23) .
The second variant of CBD is called broad-spectrum. This type is very similar to full-spectrum, in that it also has various cannabinoids present.
The main difference between the two is that broad-spectrum CBD does not contain THC . Some people prefer broad-spectrum because they wish to avoid the psychotropic effects of tetrahydrocannabinol .
The last form of CBD is the isolate. CBD isolates are made of pure cannabidiol and are often sold as crystals or powder.
Due to how pure they are, CBD isolate products do not have a distinct taste or smell.
Of the three, full-spectrum CBD oil is perhaps the most potent type of cannabidiol because of the entourage effect.
No matter the form one chooses, it is essential to acquire the highest quality CBD products available.
The following are some tips to assist users in obtaining the best CBD products:
- Acquire a lab report or certificate of analysis (COA) for the chosen item. A COA is a document detailing and showing the exact content of the CBD product.
- Hemp plants are the best sources of getting high-quality cannabidiol . Be wary of brands that do not use industrial hemp in creating their CBD products.
- Know the legalities about buying and using CBD in the various states, particularly where one decides to consume the compound.
- Testimonials and reviews can help users select a reputable CBD brand for their needs. When buying from a dispensary, ensure that the establishment is authorized to sell cannabidiol products.
- Consult a medical expert before buying any CBD product. A doctor who is experienced in medical cannabis is highly recommended.
CBD Dosage for Macular Degeneration
As of this writing, the FDA has not released official guidelines concerning CBD dosage. This predicament makes it hard for users to know the proper dose range that could benefit patients with retinal disorders.
However, one can look at clinical trials in the past to identify a safe amount of CBD to take.
In a 2017 study, healthy volunteers, who were given 600 mg of cannabidiol , experienced the desired effect of the compound without adverse side effects .
Meanwhile, taking as much as 1,500 mg of CBD each day has been reported to be well-tolerated in human subjects (24) .
First-time users may also talk to a medical expert to know a suitable dose range for CBD .
How to Take CBD Oil for Macular Degeneration
CBD in the form of edibles is one of the easiest ways to consume cannabidiol . Most brands sell CBD gummies that come in various flavors.
There are also CBD capsules and tablets that can be taken in the same manner as supplements.
For users looking to apply CBD immediately, sublingual administration is the preferred method. Taking substances under the tongue has proven to be a faster way compared to the traditional oral route (25) .
CBD tinctures also have droppers that make it easier for people to measure how much of the compound they are going to take.
Inhaling cannabidiol by way of vaping devices is also another quick way of taking CBD because of its high bioavailability (26) . Bioavailability is the measurement of how much a substance enters the body successfully.
However, CBD vapes are not recommended for people with lung problems. The use of vaping products has been implicated in pulmonary toxicity and lung injury (27) .
What is Macular Degeneration?
Age-related macular degeneration , also called AMD , is an eye disorder that causes blurring of the sharp, central vision required for many activities. The condition affects the area of the eye known as the macula and is prevalent in older adults .
Some AMD patients may experience minimal peripheral vision loss or none at all.
AMD happens frequently and is a leading cause of vision loss for individuals above the age of fifty (28) . Although AMD does not result in complete blindness, it can take away much of a person’s central vision , making it very difficult to see.
In some cases, macular degeneration develops slowly. People with early stages of AMD may not always experience vision loss right away.
For others, AMD progresses rapidly and can lead to the loss of vision in one eye .
Wet and dry AMD are the two forms of macular degeneration. Wet AMD is when abnormal blood vessel growth in the eye starts to leak and cause damage, leading to rapid loss of central vision . On the other hand, dry AMD progresses slowly, but can generally affect both eyes (29) .
The causes of macular degeneration remain unclear. However, experts believe environmental factors, such as smoking, alcohol, and diet, and heredity plays a role in AMD .
A person with dry macular degeneration may experience visual impairments, reduced central vision in one or both eyes, and difficulty in adjusting to low light levels.
In wet macular degeneration , abnormal blood vessels begin to leak blood or fluid into the macula. This leakage leads to blurred vision or the development of a blind spot within a person’s visual field .
Macular degeneration has three stages:
- Early-stage AMD – Presence of medium-sized drusen deposits or deposits of dead cells in the retina. An individual with early-stage AMD does not experience pigment changes and vision loss .
- Intermediate AMD – Presence of large drusen deposits and significant pigment changes. Although most do not experience any other problems, mild vision loss is a possibility.
- Late-stage AMD – A person has dry or wet macular degeneration that leads to vision loss .
There are several factors involved before the disease can progress to the late-stage of macular degeneration. The size of the deposits that are formed in the retina is one of them (30) .
Approximately one out of three individuals with small yellow deposits of drusen begin to experience vision problems within five years. Meanwhile, fifty out of a hundred people with large drusen develop late-stage AMD and vision loss within five years.
How is Macular Degeneration Treated?
Similar to glaucoma patients , people with dry AMD can only rely on treatments to alleviate the symptoms of their condition.
Wet macular degeneration is generally treated using drugs that are injected directly into the eye to stop blood vessel growth . This medication is known as an anti- vascular endothelial growth factor ( anti-VEGF ) and is applied to the VEGF pathways .
Although the treatment does not cure AMD , it is capable of stopping or slowing down its progression. Some individuals experience vision improvements during treatment.
However, repeated eye injections ( Lucentis and Avastin ) have been associated with increased intraocular pressure ( eye pressure ) (31) .
Photodynamic therapy is sometimes used to treat AMD . This method is a two-step process wherein a laser is directed to the affected area to seal and prevent the progression of abnormal blood vessels .
Compared to anti-VEGF drugs, patients taking photodynamic therapy may continue to experience vision loss within six months of treatment. Their condition eventually stabilizes, stopping the eye from progressing to severe vision loss .
Laser photocoagulation is another approach that uses a concentrated beam of heated light. This laser is directed to a part of the retina to destroy and seal any leaky blood vessels .
However, there is a fifty percent chance for AMD to recur after laser photocoagulation. That is why close monitoring by way of an expert ophthalmologist is necessary.
Certain dietary supplements are said to help slow down the progression of the disease. Taking vitamins and minerals, such as vitamin C, vitamin E, beta-carotene, zinc, copper, and lutein, could be beneficial for AMD patients.
Many of these vitamins can be found in green, leafy vegetables.
Patients with macular degeneration are advised to avoid highly processed foods and partially hydrogenated fats. Fat-filled snacks may increase the risk of developing advanced AMD.
Promising New Treatments for Macular Degeneration
Below are some of the upcoming treatments for the wet and dry forms of AMD .
- Gene therapy – This type of treatment offers a promising alternative to the constant eye injections to counteract VEGF . This therapy aims to provide patients with a one-and-done treatment by helping the eye create its own anti-VEGF medicine.
- Port delivery system – This refillable device stores anti-VEGF drugs that are inserted in the wall of the eye through surgery. Its purpose is to continuously release anti-VEGF substances in the eye, which can last for up to two years.
- Eye drops – Eye drop products for AMD have already been tested in animal trials. Once approved, these drops could become the first at-home solution to help with macular degeneration.
- Oral tablets – Anti-VEGF drugs as pills have already entered clinical trials . Early results suggest that the medication may be used to reduce or eliminate eye injections.
- Combination drug treatments – Mixing drugs that are already out on the market may help treat wet macular degeneration . Scientists are experimenting with combination medicines to find a solution that is more effective than the standard treatments.
- Stem cell therapies – Using stem cells, doctors could replace the cells lost due to retinal damage in macular degeneration. Although having been tested only in small clinical trials , the results thus far are promising.
- APL-2 – This injected medication is intended to slow the disease by saving retinal cells from destruction. The drug is currently being tested and is still a few years away from being available to the public.
- Oracea – This oral antibiotic is currently being tested for its anti-inflammatory properties that could benefit patients with geographic atrophy, an advanced form of AMD .
- Zimura – This eye injection is meant to slow the progression of geographic atrophy in patients with late-stage macular degeneration.
Cannabidiol has the potential to treat age-related macular degeneration because of its purported neuroprotective effects on retinal diseases.
Several studies have shown that CBD may reduce cell death and oxidative stress in animal retinas, which are conditions that occur during AMD .
Despite the positive findings, there are no clinical trials that directly involve CBD as a treatment for macular degeneration. There is also a lack of human clinical trials to prove that cannabidiol can effectively be used for AMD .
Macular degeneration is an incurable disease affecting the central part of the retina. People, especially older adults , are advised to consume supplements rich in specific vitamins and minerals to prevent or delay its onset.
Although there is no evidence that cannabidiol can improve vision, it offers antioxidant properties similar to these supplements that could be beneficial for eye health .
People need to consult a doctor first before deciding to take cannabidiol for any condition.
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.