Age-related macular degeneration is the leading cause of vision loss in the US for people over the age of 50. The disease damages the small area near the center of your retina, the macula, causing vision loss in the center of your visual field. For most who have it, there’s no effective treatment and it generally worsens with time.
The advanced disease comes in two main forms: dry, the more common variety, which is treated mainly with dietary supplements and wet, the more serious form, which requires monthly injections from an ophthalmologist with one of three drugs. There are controversies about both the supplements and the drugs. One word of caution, these vitamins will not prevent the disease, and are of benefit if you have already been diagnosed with it.
Research funded by the National Institutes of Health has shown that a specific blend of vitamins and minerals known as AREDS (vitamins C and E, plus copper, lutein, zeaxanthin, and zinc) cuts the risk by about 25 percent that dry AMD will progress. According to Dr. Neil Bressler, chief of the retina division at Johns Hopkins University in Baltimore it really the only treatment.
But not all eye supplements contain the proper formulation. In January 2015 one company was sued for incorrectly marketing its Advanced Eye Health supplement as comparable to the formula used in the published studies. Further, an analysis of 11 eye-health supplements in the March 2015 issue of Ophthalmology, only four contained the right mix and they were all by PreserVision.
There are many manufacturers offering a host of over-the-counter formulas that supposedly help people with macular degeneration promote, maintain or protect eye health. The big question is, do they?
The clinical trial called Age-Related Eye Disease Study (AREDS) was conducted at 11 medical centers around the US by the National Eye Institute and found that a supplement could reduce the risk of worsening macular degeneration and severe vision loss by 25 percent over six years. The effective formula: a high-dose combination of vitamins C and E, beta carotene and zinc oxide, with a dash of copper.
But the benefits of the nutrients only apply to certain stages of the disease. The formula could slow the progression, but it didn’t work for people with mild forms of the disease or with advanced stages in both eyes and it didn’t prevent people from getting the disease. Nor did it cure anybody.
Recently, in a follow-up study called AREDS 2 they examined a formula without beta carotene because it’s associated with higher lung cancer rates in smokers and replaced it with lutein and zeaxanthin and lowered the zinc content. The revised formula worked just as well.
So the vitamins come labeled as either AREDS and AREDS 2. Patients with moderate macular degeneration or advanced degeneration in one eye can take either, but smokers should go with AREDS 2.
In another recent study published in the journal Ophthalmology it was found that most best-selling products didn’t follow the proven AREDS formula. They may contain the same ingredients, but not in the right doseage.
Some added other ingredients that hasn’t been shown to work and might, in fact, actually reduce the effectiveness of the ingredients that do work. Of the 11 supplements examined, only four duplicated the AREDS formula. Manufacturers can get away with this because vitamins aren’t considered drugs. The Food and Drug Administration doesn’t test or approve supplements and they are not evaluated or regulated for efficacy or safety.
The ARED vitamins are not cheap. PreserVision Eye Vitamin AREDS in a 90-pill (a 45 day supply) bottle costs about $30.
These four products duplicated the AREDS or AREDS2 formulas:
PreserVision Eye Vitamin AREDS Formula tablets
PreserVision Eye Vitamin AREDS Formula soft gels
PreserVision AREDS2 Formula soft gels
ICAPS Eye Vitamin AREDS Formula
These vitamins can cause side effects. Allergic reactions such as hives, difficulty breathing, swelling of the face, lips, tongue or throat are possible, as they are with anything. Minerals, especially taken in large doses, can cause side effects such as tooth staining, increased urination, stomach bleeding, uneven heart rate, confusion, and muscle weakness or limp feeling. But taken as directed, multivitamins and minerals rarely cause any serious side effects. Most common side effects would be an upset stomach, headache or an unusual or unpleasant taste in your mouth.
Do not take this medicine with milk, other dairy products, calcium supplements, or antacids that contain calcium. Calcium may make it harder for your body to absorb certain minerals. Also,vitamin and mineral supplements can interact with certain medications or affect how they work, so ask a doctor or pharmacist if it is safe for you to use multivitamins and minerals if you are also using any of the following drugs: tretinoin or isotretinoin, an antacid, an antibiotic, a diuretic, heart or blood pressure medications, a sulfa drug or one of the nonsteroidal anti-inflammatory drugs that consist of ibuprofen or naproxen.
National Eye Institute Information