AREDS 2 Vitamin Study for Macular Degeneration

The original AREDS study (Age-Related Eye Disease Study) was published in 2001 and concluded that a combination of vitamins and supplements, the “AREDS Formula,” consisting of  vitamin C, vitamin E, B-Carotene, zinc and copper could reduce the risk of developing advanced ARMD.

1. The “AREDS Formula” has been recommended for patients with intermediate or high risk ARMD.  The AREDS study found that in these patients, the eye vitamins reduced the chance of severe vision loss by 25%.
2. The eye vitamins do not improve the vision or stage of the disease, but do prevent those at high risk from getting worse.  Unless, there is evidence of macular degeneration showing these risk factors…there is no need for taking the AREDS vitamins.
3. Lutein and  zeaxanthin (pigmented anti-oxidants) were never studied directly.  Both were associated with improvements in macular degeneration, but neither were ever proven to improve macular degeneration.
4. Omega-3 fatty acids were suspected to retard macular degeneration, but never proven.
5. B-Carotene increases the chance of lung cancer in smokers.

AREDS Formula (2001)

• Vitamin C
• Vitamin E
• B-Carotene
• Zinc
• Copper

AREDS 2 Study Tested

In 2006, AREDS II was initiated to determine if improvements could be made on the AREDS formula.  Specifically questions asked

1. Do omega-3 fatty acids (DHA/EPA) reduce AMD or cataract?
2. Do antioxidants, lutein/zeaxanthin, reduce AMD or cataract?
3. What is the role of zinc?
4. What is the role of B-Carotene?

AREDS 2 Study Results

1. Omega-3 fatty acids had no effect on reducing macular degeneration nor cataract formation.
2. Antioxidants, lutein/zeaxanthin,  did not retard the progression of macular degeneration.
3. Reducing the amount of zinc did not change the effectiveness of the AREDS formulation.
4. B-Carotene did increase the rate of lung cancer in former smokers (active smokers were not given B-carotene), but there may be advantages to substituting lutein/zeaxanthin  for the B-carotene in smokers.

What Does this Mean?

Though it seems that little new information was produced from the AREDS 2 study, in fact, the study was very positive.

The results of the AREDS study were validated.  Patients who have high risk or intermediate risk factors for AMD should be recommended to take the AREDS formula vitamins.  Those who do not have these risk factors, including “normal” people, do not need to take these vitamins.

B-carotene should not be taken by smokers or former smokers.  This was suspected, but now has been validated.  There are AREDS formulations available for smokers (no B-Carotene).

Unfortunately, omega- 3 fatty acids (e.g. fish oils) and antioxidants also have no role in preventing macular degeneration.  This also means, those products touting the importance of lutein…are unfounded.

Randy

Randall V. Wong, M.D.
Retina Specialist
Fairfax, Virginia 
www.RetinaEyeDoctor.com