Research confirms the benefits of supplements in slowing vision loss from AMD


After 10 years, the AREDS2 formula shows increased effectiveness compared to the original formula, benefit of the elimination of beta-carotene.

Age-related macular degeneration (AMD) is an eye disease that can blur your central vision. It is quite common in the United States, especially among older white Americans, making it the leading cause of vision loss in the United States. In addition to regular physical activity, quitting smoking, and maintaining healthy blood pressure and cholesterol levels, supplements can help reduce your risk of AMD or slow its progression.

Age-Related Eye Disease Studies (AREDS and AREDS2) found that dietary supplements can slow the progression of age-related macular degeneration (AMD), the most common cause of blindness in older Americans . In a new report, scientists analyzed 10 years of AREDS2 data. They show that the AREDS2 formula, which substituted the antioxidants lutein and zeaxanthin for beta-carotene, not only reduces the risk of lung cancer due to beta-carotene, but is also more effective in reducing the risk of AMD progression, compared to the original formula. . A report on the study, funded by the National Institutes of Health has been published in the journal JAMA Ophthalmology June 2, 2022.

Age-related macular degeneration (AMD) is an eye disease that can blur your central vision. It happens when aging damages the macula – the part of the eye that controls sharp, straight vision. The macula is part of the retina (the light-sensitive tissue at the back of the eye). AMD is a common condition – it’s one of the leading causes of vision loss in older people.

“Because beta-carotene increased the risk of lung cancer in current smokers in two NIH-supported studies, our goal with AREDS2 was to create an equally effective supplement formula that could be used by anyone, whether he smokes or not,” Emily Chew said. , MD, director of the Division of Epidemiology and Clinical Application at the National Eye Institute (NEI) and lead author of the study report. “These 10-year data confirm that not only is the new formula safer, it is actually better at slowing the progression of AMD.”

AMD is a degenerative disease of the retina, the light-sensitive tissue at the back of the eye. The gradual death of retinal cells in the macula, the part of the retina that provides clear central vision, eventually leads to blindness. Treatment can slow or reverse vision loss; however, there is no cure for AMD.

The original AREDS study, initiated in 1996, showed that a dietary supplement formulation (500 mg of vitamin C, 400 international units of vitamin E, 2 mg of copper, 80 mg of zinc and 15 mg of beta-carotene) could significantly slow the progression of AMD from moderate to late disease. However, two concurrent studies also found that people who smoked and took beta-carotene had a significantly higher risk of lung cancer than expected.

Emily Chew performs an eye exam

Dr. Emily Chew of the National Eye Institute performs an eye exam. Credit: NEI

In AREDS2, launched in 2006, Chew and his colleagues compared the beta-carotene formulation to a formulation containing 10 mg of lutein and 2 mg of zeaxanthin instead. Like beta-carotene, lutein and zeaxanthin are antioxidants with activity in the retina. The beta-carotene-containing training was only given to participants who had never smoked or who had quit smoking.

AMD develops slowly in some people and quickly in others. If you have early AMD, you may not notice vision loss for a long time. That’s why it’s essential to have frequent eye exams to determine if you have AMD.

At the end of the AREDS2 five-year study period, the researchers concluded that lutein and zeaxanthin did not increase the risk of lung cancer and that the new training may reduce the risk of lung cancer progression. AMD of about 26%. After the end of the five-year study period, study participants were all offered the final AREDS2 training which included lutein and zeaxanthin instead of beta-carotene.

In this new report, researchers followed 3,883 of the original 4,203 AREDS2 participants for an additional five years from the end of the AREDS2 study in 2011, collecting information on the progression of their AMD to late disease and on the whether they had been diagnosed with lung cancer. Even though all participants switched to the formula containing lutein and zeaxanthin after the end of the study period, the follow-up study continued to show that beta-carotene nearly doubled the risk of lung cancer in people who had ever smoked. There was no increased risk of lung cancer in people receiving lutein/zeaxanthin. Additionally, after 10 years, the group initially assigned to receive lutein/zeaxanthin had an additional 20% reduced risk of progression to late AMD compared to those initially assigned to receive beta-carotene.

“These results confirmed that switching our formula from beta-carotene to lutein and zeaxanthin was the right choice,” Chew said.

Reference: “Long-Term Results of Adding Lutein/Zeaxanthin and ω-3 Fatty Acids to AREDS Supplements on the Progression of Age-Related Macular Degeneration: AREDS2 Report #28” by Emily Y. Chew , MD; Traci E. Clemons, Ph.D.; Elvira Agron, MA; Amitha Domalpally, MD, Ph.D.; Tiarnán DL Keenan, BM, BCh, PhD; Susan Vitale, Ph.D.; Claire Weber, MSc; Douglas C. Smith, BS and William Christen, ScD; for the AREDS2 research group, June 2, 2022, JAMA Ophthalmology.
DOI: 10.1001/jamaophthalmol.2022.1640

The study was funded by the NEI intramural program (EY000546) and through contracts (AREDS2 contract HHS-N-260-2005-00007-C; ADB contract NO1-EY-5-0007; AREDS contract NOI -EY-0-2127, and contract HHS-N-263-2013-00005-C). AREDS2 contracts have been supported by the NIH Office of Dietary Office of Dietary Supplements, National Center for Complementary and Integrative Health, National Institute on Aging, National Heart, Lung, and Blood Institute, and National Institute of Neurological Disorders and Stroke . The study took place at the NIH Clinical Center.


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