Age Related Eye Disease Study*

Vitamin Supplement for Macular Degeneration

Age-related Macular Degeneration (ARMD) is the leading cause of visual impairment and blindness for patients over 65 years of age in the US. The results of a 10 year National Eye Institute sponsored study of 4,757 patients were released in Archives of Ophthalmology.* This study showed that patients at risk for developing advanced stages of ARMD lowered their risk about 25% by taking the high-dose antioxidant/zinc combination when compared to placebos.

The study divided patients into four categories and all patients had initial best visual acuity (BVA) of 20/32 or better:

Category 1: No ARMD: less than 5 small drusen, which area subretinal deposits (<63 microns)

Category 2: Mild ARMD: multiple small drusen (<63 microns), single or nonextensive intermediate drusen (63 to 124 microns), pigment abnormalities (or any combination of these).

Category 3: Moderate ARMD: Absence of advanced disease in either eye, with at lease one large drusen (125 microns), geographic atrophy NOT involving the center of the fovea and extensive intermediate drusen (or any combination of these).

Category 4: Advance ARMD: No geographic atrophy of fovea, BVA 20/32 or better, no choroidal neovascularization, fellow eye had advanced lesion (central atrophy or wet ARMD) or advance ARMD changes reducing BVA below 20/32.

Average follow –up was 6.2 years, leaving 3,640 study participants remaining as category 1 patients were not included in the treatment trial. The patients of categories 2 through 4 received one of the following daily treatments:

Antioxidants (500 mg Vitamin C, 400IU Vitamin E, 15mg Beta-carotene)

Zinc (80 mg zinc oxide, 2mg cupric acid to prevent anemia form zinc)

Antioxidants and Zinc Combined (as above)

Placebo

The data from this study shows a significantly reduced risk of progression to advanced ARMD for patients in categories 3 and 4 with the use of Zinc alone or a combination of Zinc and antioxidants. For categories 3 and 4, the overall risk reduction for zinc alone was 21%, antioxidants alone was 17% and the antioxidants plus zinc was 25%. The combination of zinc and antioxidants was the only group showing a statistically significant reduction in rates of at least moderate visual loss.

This study suggests persons older than 55 years of age should have an eye exam to determine their level of risk. Those patients at risk for ARMD disease progression  (those having extensive intermediate drusen, at least one large drusen, noncentral geographic atrophy, or advanced disease in one eye with visual loss) should consider taking a supplement of antioxidants and zinc. It is important to note that smokers should NOT take the beta-carotene due to an increased risk of lung cancer.

Visit the National Eye Institute web site for more in depth information regarding this study.
 
*A randomized, placebo-controlled , clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age related macular degeneration and vision loss:AREDS report No. 8. Archives Ophthalmol. 2001;119:1417-1436

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