Vitamin Supplements & AMD

The retina specialists at Retina Consultants of Nevada would like to inform our patients and their families about the results of an important research study known as the Age-Related Eye Disease Study (AREDS). The AREDS study was designed to investigate whether high levels of zinc and antioxidant supplements (Vitamins A, C & E) would reduce the risk of advanced age-related macular degeneration (AMD) and its associated vision loss. The results were reported in the October 2001 issue of the Archives of Ophthalmology.

Background:

AMD is the leading cause of visual impairment in people 65 years or older. The role of nutrition in the development of AMD has long been of great interest to patients and researchers. Antioxidant nutrients have been studied since they may help protect the ocular tissues from degenerative and oxidative damage. Previous studies have shown that patients who eat diets high in green leafy vegetables such as spinach are at lower risk for AMD. These vegetables are known to be good sources of two carotenoids (lutein and zeaxanthin) that are concentrated in the macular tissue. Also, some people with AMD have been shown to have diets deficient in the mineral zinc.

Despite these apparent links between nutrition and AMD, prior to the AREDS study, there was no good scientific proof that dietary supplements were helpful in treating this disease. The doctors at Retina Consultants find the AREDS results particularly exciting since they provide the best evidence to date of an effective way to slow the progression of this potentially devastating eye disorder. The vitamins will not improve your vision, reverse the damage already done by macular degeneration or prevent further progression, but they have been shown to slow down the progression of the disease.

Note: The AREDS trial was not able to study the effect of lutein and zeaxanthin supplements since neither nutrient was available as a research formulation when the study began recruiting patients in 1992. There is a trial currently ongoing looking at these supplements, however, results will not be available for several years.

Recommendations:

All patients with AMD or at risk for developing AMD should consult with their retinal specialist to assess how the AREDS findings apply to their specific cases. In general, the specialists at Retina Consultants recommend that all patients with advanced stages of AMD or at high risk for developing advanced stages of AMD consider taking high potency antioxidant and zinc supplements after discussing their eye findings with their doctor and consulting their general physician regarding safety.

There are a number of over-the-counter supplements currently available in most pharmacies and health food stores. While they all contain A, C, E & zinc, they are not in the same doses used in the trial. Many contain additional nutrients such as lutein, zeaxanthin, selenium, L-Glutathione, which are also being studied as possibly helpful in AMD. Bausch & Lomb and Alcon have supplements that will contain the exact doses given to patients in the AREDS study. Several other substances such as bilberry, ginkgo biloba, bioflavinoids and shark cartilage have received attention in the popular media. There is no good scientific evidence supporting effectiveness of these remedies in preventing or treating macular degeneration.

Currently available nutritional supplements for AMD:

Brand Name Manufacturer
Ocuvite, PreserVision
Icaps Lutein & Zeaxanthin Formula
Bausch & Lomb
Alcon

Brand Name Manufacturer Ocuvite, PreserVision Bausch & Lomb Icaps Lutein & Zeaxanthin Formula Alcon

Those patients who smoke or recently quit smoking should avoid Vitamin A because of an association between Vitamin A and progression of lung cancer. There are formulations specifically made for smokers. Ask your doctor which vitamins are best for you.

In addition, as a reminder to our patients, everyone with AMD, regardless of disease severity, should take the following precautions to protect their eyes.

  1. Wear UV absorbing lenses and a hat with a brim when in bright sunlight.
  2. Do not smoke.
  3. Eat a balanced diet rich in green, leafy vegetables such as spinach, kale and collard greens. Include plenty of fruit and avoid excessive saturated fats and cholesterol.
  4. Treated high blood pressure if present.
  5. See your retina specialists for regular dilated eye examinations to evaluate AMD findings and check for evidence of disease progression.
  6. Monitor your own vision i.e. with the Amsler Grid. Let your doctor know if you notice any changes in your vision or distortions in vision.

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