01 May What About Vitamins?
What vitamins help macular degeneration? I am asked this daily. What should I take? What should I eat? What can I do? The answer is simply………..I don’t really know. The information about supplements, be they vitamins or foods, is really scarce. I usually tell patients that my job is to report the hard data to you and not to promote remedies or pills which are unfounded. I feel pretty strongly about this. It is why western medicine is superior – most everything is tested (kind of like Google).
In 2001, a gigantic study was completed called the Age Related Eye Disease Study (AREDS). It was unique in its size and scope. It was a prospective study (vs. retrospective, prospective studies are better). It was one of the first studies to show that dietary changes can influence as disease, in this case, macular degeneration. Patients were examined for the development of macular degeneration while taking (aka the AREDS Formula); Vitamins C and E, Beta-carotene, zinc and copper. The conclusions of the study;
1) smokers should not take beta-carotene as it increases the chance of lung cancer,
2) patients at moderate/high risk of AMD do benefit from the AREDS formulation supplements
Associated findings, but not conclusively studied;
1) carotenoids such as lutein and zeaxanthin (found in green leafy veggies such as spinach) were associated with decreased AMD in those patients that ate them in the beginning of the study, that is, these were not directly studied.
2) omega 3 fatty acids may be associated with reduced macular degeneration and cardiovascular disease.
What does this mean? The original study was limited in its findings, but several dietary associations were made, but not studied. From this, we assume that eating green leafy vegetables/foods such as spinach, kale, eggs (yolks!), turnip greens, collard greens, etc., are good for you. Similarly, omega 3 fatty acids (found in fish) are good for your eyes and possibly your heart.
A second large, prospective, study is underway. AREDS2 will hopefully answer these questions; 1) the value of beta-carotene in non-smokers, 2) the role of omega 3 fatty acids, 3) the value of carotenoids lutein/zeaxanthin.
Recommendations about Vitamins and ARMD
If your doctor determines that you have moderate or high risk factors in one or both eyes or you have lost significant vision in one eye from either “wet” ARMD or “geographic” ARMD, and you don’t smoke, you should take the AREDS formulation.
Thanks for reading,
Randall V. Wong, M.D.
Retina Specialist/ Ophthalmologist