National Eye Institute’s Age-Related Macular Degeneration Study (AREDS) revealed that taking specific high-dose vitamins reduced progression from dry macular degeneration to wet macular degeneration and risk of vision loss, thus slowing its progress. For AREDS2, however, beta-carotene was removed as it may increase lung cancer risks for smokers while zinc levels were also lowered due to criticism by nutrition experts as being too high.

Vitamin C

Age-related macular degeneration (AMD), commonly referred to as central vision degeneration, occurs when the macula, the part of our retina that controls our central vision, gradually deteriorates over time. A leading cause of blindness, AMD makes driving, reading and other activities that require clear central vision difficult or impossible – but certain vitamins and dietary supplements may reduce AMD risk significantly.

Researchers participating in the AREDS study, funded by the National Eye Institute, discovered that taking specific combinations of vitamins and minerals could decrease severe vision loss by about 25% among certain macular degeneration patients. The AREDS formulation includes vitamin C at 500 milligrams daily dose; vitamin E 400 IU per day); beta carotene (15 milligrams daily; equivalent to 25,000 international units of beta-carotene); lutein/zeaxanthin 15 milligrams daily, plus zinc (zinc oxide 80 mg and copper 2 mg).

Though numerous observational studies have linked high intakes of omega 3 fatty acids, carotenoids such as lutein and zeaxanthin, and vitamin E with decreased prevalence and incident AMD rates, only the AREDS study has proved a correlation between nutritional supplementation (in this case containing vitamin C, E, beta carotene zinc with lutein/zeaxanthin) and reduced progression to advanced AMD by approximately 25% over five years.

AREDS and AREDS2 trials provide proof that eating healthily is essential in preventing or slowing progression of dry macular degeneration; however, no conclusive evidence exists proving supplements alone can stop or reverse its progression.

UCI Health Gavin Herbert Eye Institute ophthalmologists are dedicated to protecting and maintaining your vision. If you would like more information or would like to schedule an appointment, please reach out – we are more than happy to serve! We look forward to providing our services and look forward to providing quality eyecare!

Vitamin E

Age-related macular degeneration (AMD) is an eye condition affecting the macula – the central area of retina that provides central vision – in older adults and has been the leading cause of permanent blindness in those aged 65 and up. Reading, driving and other daily tasks become increasingly challenging because central vision decreases; however certain vitamins and dietary supplements may slow its progress and thus help manage AMD more effectively.

The Age-Related Eye Disease Study (AREDS) clinical trial concluded that taking a combination of vitamin C, E, beta-carotene and zinc was found to significantly decrease the risk of advanced AMD by 25% among people who are at high risk. Furthermore, this combination significantly slowed progression from dry macular degeneration to wet macular degeneration in people at risk.

Note that this decrease in progression was only observed among patients already living with intermediate AMD when the AREDS supplements were initiated; they did not prevent progression from dry to wet AMD or dry to intermediate macular degeneration. Still, these encouraging results demonstrate how AREDS 2 supplements could still prove valuable for those already progressing with AMD.

Researchers conducting the AREDS 2 trials added omega 3 fatty acids and the macular pigments lutein and zeaxanthin as new ingredients into their mix, in hopes that these substances would slow the progression of AMD as well as help prevent its transition from dry to wet AMD. This approach has received widespread interest over recent years.

Studies conducted under AREDS 2 advocate taking supplements of vitamin C, E, L/Z/Z and Zin. For maximum effect these can be found as pill form as part of an AREDS2 supplement regiment; to take them properly however it’s essential that they’re taken at appropriate times as too much of any one can be harmful. If you would like more information about them please reach out to York Eye Associates so we can arrange an appointment with one of our doctors who will be happy to provide additional details and answer any queries that arises; let us help protect your eyesight!

Lutein/Zeaxanthin

Areds vitamins contain natural carotenoids known as lutein and zeaxanthin, which are concentrated in the central region of retina known as macula. Together, lutein and zeaxanthin act as antioxidants to absorb high-energy blue light to protect eye health and prevent macular degeneration; additionally they act as natural sunblocks by blocking most ultraviolet (UV) rays that could damage retina. Lutein and zeaxanthin can be found in dark leafy green vegetables such as spinach kale Swiss chard collard greens mustard Chinese broccoli; nuts such as peanuts rapeseed almonds sunflower seeds as well as eggs containing these essential carotenoids.

Study participants of the AREDS clinical trial revealed that adding lutein and zeaxanthin to their original formulation of vitamin C, E, beta-carotene, zinc, and copper reduced risk of progress to advanced macular degeneration by 19 percent and reduced risks associated with losing three or more lines of vision as a result of supplementation.

Though individual studies of lutein and zeaxanthin exist, no comprehensive evaluation has yet been undertaken. Evidence mapping provides a new research approach that helps assess evidence strength as well as identify gaps in knowledge.

The Centers for Disease Control and Prevention offers an evidence map on its website. Nine prospective, randomized, placebo-controlled trials were included in this analysis: six evaluated serum lutein isomers while four focused on macular pigment optical density (MPOD). Each study also featured a control group who received only AREDS supplements as control measures.

Researchers with the AREDS study also evaluated dietary data and discovered that those with higher intakes of lutein/zeaxanthin were less likely to suffer advanced AMD (both NV and GA) and more likely to avoid large or extensive intermediate drusen than those with lower intakes, even after controlling for factors like nutritional factors, age, sex and caloric intake. This relationship remained even when accounting for factors like nutritional intakes as well as covariates such as age, sex or caloric intakes.

Importantly, it should be remembered that AREDS was a clinical trial rather than a randomized controlled study; thus its results cannot be generalized to all members of society. Furthermore, certain people are at increased risk of macular degeneration than others – such as those with family histories of macular degeneration, smokers or diabetes/hypertension patients. It remains vitally important for people with these risks to maintain a healthy diet, limit smoking habits and wear UV blocking sunglasses whenever possible while visiting York Eye Associates twice annually for dilated eye exams with York Eye Associates specialists for comprehensive exams.

Zinc

Zinc is an essential mineral, vital for immune function, wound healing, cell production, metabolism of certain vitamins and minerals like vitamin C and lutein/zeaxanthin metabolism, stunted growth, reduced immunity, skin irritation as well as other health complications. Zinc can be found in seafood, meat poultry eggs dairy vegetables fortified cereals or in diet supplements.

The National Eye Institute’s (NEI) AREDS and AREDS2 studies have revealed that taking a combination of vitamin C, beta-carotene, zinc and lutein/zeaxanthin may reduce the risk of dry macular degeneration progressing into wet macular degeneration by as much as 25%. However, this reduction was observed only among patients who already had advanced macular degeneration known as geographic atrophy; vision loss from early or mild dry macular degeneration did not decrease as significantly.

Dry AMD, or macular degeneration, occurs when fatty deposits known as drusen collect in the macula. Over time, these fatty deposits can eventually cause retinal cells to thin and rupture, creating blurry central vision and eventually leading to new fragile blood vessels that bleed and leak within it, eventually leading to rapid vision loss.

Wet AMD is less common but much more severe than its dry form. When macular degeneration progresses to this stage, more fluid collects in the retina’s center leading to swelling and bleeding in the macula and speedier loss of central vision compared with dry AMD. Unfortunately, neither form can be reversed.

There is no known treatment for wet macular degeneration; however, the AREDS2 study demonstrated that taking high-dose supplements of antioxidants, copper, vitamins C and E, zinc and lutein/zeaxanthin could significantly slow vision loss in those at risk for advanced age-related macular degeneration. The new formulation refined from its predecessor by eliminating beta-carotene due to increased lung cancer risks in smokers as well as decreasing zinc amounts since this can interfere with some medications such as antibiotics.