Abstract
The objective of the Hormones, Oxidative stress, Methylation, Inflammation and Gene expression (HOMING) trial was to assess the efficacy of personalized bio identical hormone, dietary supplement and nutritional care plans on dry and wet Age-related Macular Degeneration (AMD) outcomes. We evaluated 220 Age-related Macular Degeneration (AMD) patients that followed a personalized clinical care plan for up to 9 months. The care plans consisted of bio identical hormones, dietary supplements and nutrition recommendations with the objective to improve lab and clinical measurements linked to oxidative stress, inflammation and gene expression. Serum concentrations of CRP, HbA1c and homocysteine responded favorably to the HOMING protocol with full program compliance.
 Sixty percent (42/70) of wet AMD patients reported improvement in visual acuity and/or a reduction in the frequency of anti-VEGF injections during the study period. Forty eight percent (44/92) of dry AMD patients reported improvement in visual acuity during the study period. Nine percent (4/45) patients reported improvement in visual acuity in the dry AMD control group and no (0/13) wet AMD patients in the control group reported improvement. Six percent (4/70) of wet AMD patients reported that their vision declined and/or that their F frequency increased during the study period. Five percent (4/92) of dry AMD patients reported that their vision was worse. 
 Keywords: Bio identical Hormones, Oxidative stress, Methylation, Inflammation, Gene Expression, Nutrition and AMD.
Highlights
Age-related Macular Degeneration (AMD) is the leading cause of vision loss in the United States.[i]
Five percent (4/92) of dry AMD patients reported that their vision was worse
The American Academy of Ophthalmology (AAO) classifies AMD as a disease of a region of the retina called the macula that is distinguished by well-defined clinical characteristics.[ii]. The cells in the eye are dependent upon essential dietary nutrients for protection from oxidative damage, which can occur as a result of free radicals that are generated in the eye from sunlight and during normal metabolic processes
Summary
Age-related Macular Degeneration (AMD) is the leading cause of vision loss in the United States.[i]. Food intake was assessed in the Melbourne Collaborative Cohort Study and relatively high dietary intake of fruits, vegetables, chicken, and nuts and low intake of red meat were associated with a lower rate of incidence of advanced AMD.[xxviii] Consistent with the findings of these studies, the National Eye Institute (NEI) of the National Institutes of Health (NIH) recommends increased consumption of fish rich in omega-3 fatty acids and green leafy vegetables as a preventative measure in mitigating the risk of developing and/or progressing early and late AMD.[xxix].
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