Eye Retina Anatomy Diagram

Study confirms benefit of supplements for slowing AMD vision loss

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

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

The Age-Related Eye Disease Studies (AREDS and AREDS2) found that dietary supplements may 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 replaces the antioxidants lutein and zeaxanthin with beta-carotene, not only reduces the risk of beta-carotene lung cancer, but is also more effective at reducing the risk of AMD progression, compared to the original. formula. † A report on the study, funded by the National Institutes of Health, was published in the journal JAMA Ophthalmology on June 2, 2022.

Age-related macular degeneration (AMD) is an eye disease that can cloud your central vision. It happens when aging causes damage to the macula — the part of the eye that controls sharp, straight forward vision. The macula is part of the retina (the light-sensitive tissue at the back of the eye). AMD is a common condition – it is a leading cause of vision loss in older adults.

“Because beta-carotene increased lung cancer risk for current smokers in two NIH-supported studies, our goal with AREDS2 was to create an equally effective supplement formula that can be used by anyone, whether they smoke or not,” Emily said. Chew. , 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 the new formula is not only safer, but even better at slowing AMD progression.”

AMD is a degenerative disease of the retina, the light-sensitive tissue at the back of the eye. Progressive 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 studyLaunched in 1996, a nutritional supplement formulation (500 mg vitamin C, 400 international units vitamin E, 2 mg copper, 80 mg zinc, and 15 mg 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 than expected risk of lung cancer.

Emily Chew performs eye exam

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

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

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

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

In this new report, the 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, gathering information about whether their AMD had progressed to late disease and whether they had been diagnosed with AMD. lung cancer. Although all participants had switched to the lutein-zeaxanthin formula after the end of the study period, the follow-up study continued to show that beta-carotene increased the risk of lung cancer for people who had once smoked nearly double that. There was no increased risk of lung cancer in those receiving lutein/zeaxanthin. In addition, the group originally assigned to receive lutein/zeaxanthin had an additional 20% lower risk of progression to late AMD after 10 years compared to those originally assigned to receive beta-carotene.

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

Reference: “Long-term results of adding lutein/zeaxanthin and ω-3 fatty acids to the AREDS supplements on age-related macular degeneration progression: AREDS2 report #28” by Emily Y. Chew, MD; Traci E. Clemons, PhD; Elvira Agron, MA; Amitha Domalpally, MD, PhD; Tiarnán DL Keenan, BM, BCh, PhD; Susan Vitale, PhD; 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). The AREDS2 contracts were supported by the NIH Office of Dietary Office of Dietary Supplements, the National Center for Complementary and Integrative Health, the National Institute on Aging, the National Heart, Lung and Blood Institute, and the National Institute of Neurological Disorders and Stroke. The study took place at the NIH Clinical Center.

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