safety of Bilberry + Gingko Biloba for 'wet' MD

[Ray007]

Although there appears to be clinical data showing that both Bilberry and Gingko Biloba herbs "increase" vascular dilation - at least one, and often both of these herbs, are included in the commercially available neutrical products people with macular degeneration are encouraged to take by ophthalmic clinicians.

My question relates therefore, to the risk of taking these preparations for people with "wet" macular degeneration.  It would seem to me to be a contra-indication, but strangely I have never seen this topic discussed or indeed engaged with at all.  I would be most grateful therefore, to get your feedback on the issue.

Thank you,
Ray

[Janie80]

A related discussion, bilberry reactions was started.

[Ray007]

Dear Dr. Hagan,

Thank you so much for your further clarification.

best wishes,
Ray

[John C Hagan III, MD, FACS, FAAO]

Hello Ray,  there is precious little true science/evidence based medicine on bilberry. I have not heard nor read any articles that say that bilberry is contraindicated in wet ARMD nor that it is helpful for Dry ARMD.

In the end it appears we would avoid bilberry.

JCH III MD

[Ray007]

Dear Dr. Hagan,

Thank you again for your clarification.  It is so appreciated, as obtaining impartial  info like this is not at all easy.  I have one last remaining question however, and hope that you might be kind enough to respond one more time, but with respect with Bilberry.

My lay person's understanding is that Bilberry has been implicated in the support of collagen production (itself substantially implicated in myopic macular degeneration)  and that has also been clinically implicated in the strengthening of capillary walls.  However, I also understand that it may increase blood flow.

For anyone with a history of wet macular degeneration, would you agree that the claim for Bilberry facilitating increased vascular flow outweighs the claims for its collagan and capillary support -  such that it might be best not to take it at all?

Thank you
Ray

[John C Hagan III, MD, FACS, FAAO]

There are no controled studies on the Ginko or for that matter blood thinners like heparin, aspirin, Plavix, coumadin in making wet macular degeneration or vitreous bleeding worse/better/unchanged.  I suppose I would leave it up to the individual Eye MD.  I'm not a fan of Ginko and on all my patients with the possibility of bleeding in the eye, especially proliferative diabetic retinopathy I advise them not to take it, we also stop it several weeks before anyone having surgery if they tell us about it.

JCH III MD  Eye PHysician

[Ray007]

Dear Dr. Hagan,

Thank you for your comprehensive answer, though one thing still puzzles me.  You say that Ginko has indeed caused some serious bleeding, but then you go on to say that it is unlikely to hurt wet ARMD. Are these statements perhaps slightly at odds with each other ?

Even if there is no hitherto controlled clinical data that specifically link sGingko with "retinal" bleeding, do you not think that in this case, discretion might be the better part of valour?

Thank you,
Ray

[John C Hagan III, MD, FACS, FAAO]

Bilberrry has been used for eye problems for many decades, in WWII it was given to improve night vision.  There is no well controlled, evidenced based medicine that bilberry or ginko biloba are beneficial for any eye disease including wet or dry macular degeneration.  There are mountains of uncontrolled studies, testimonials, anecdotal stories about many types of herbs and 'health' supplements. Gingko has caused some serious bleeding problems in users.

Neither bilberry or ginko is likely to hurt wet ARMD but it is equally unlikely to help.

JCH III MD   Eye MD