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Antioxidants and Age-Related Macular Degeneration

AREDS Results

  • People at high risk for developing advanced stages of AMD lowered their risk of developing advanced AMD by about 25% with antioxidants and zinc. The risk of vision loss was lowered 19% in this group
  • The same high-risk patients taking zinc alone lowered their risk of developing advanced AMD by about 21%. The risk of vision loss was lowered by 11%
  • Supplementation did not provide any apparent benefit for those with either early AMD or no AMD

Cautions with Antioxidant and Zinc Supplementation

  • Beta carotene has been showed to increase the risk of lung cancer in smokers. It is not clear how long a person needs to have stopped smoking to eliminate this risk
  • Taking high levels of zinc may cause a copper deficiency
  • High zinc levels may be associated with genitourinary problems such as stress incontinence

Supplement Comparisons

  PreserVision AREDS-2 softgels (4/day) PreserVision Lutein GelCaps (2/day) Equate Vision Formula (1/day) EyePromise Restore (1/day) Centrum Silver (1/day)
Vitamin A None None 1000 IU# None 5000 IU+
Vitamin C 452 mg 452 mg 200 mg 120 mg 60 mg
Vitamin E 400 IU 400 IU 60 IU 60 IU 45 IU
Zinc 69.6 mg 69.6 mg 40 mg 15 mg 15 mg
Copper 1.6 mg 1.6 mg 2 mg None 2 mg
Lutein* 10 mg 10 mg 2 mg 4 mg 0.25 mg
Zeaxanthin* 2 mg None None 8 mg None
Omega-3 Fatty Acids* 1000 mg None None 250 mg None
  • Information has been gathered from various sources and is believed to be accurate. Many nutrients come in different forms with different potencies. See specific supplements for details
  • # Given as beta carotene and converted for comparison purposes only (3 mg beta carotene equals about 5000 IU vitamin A)
  • + 20% as beta carotene
  • * Lutein, zeaxanthin, and omega-3 fatty acid supplements were not available at the start of the AREDS study, so they were not included in the original AREDS study. They are currently being evaluated as part of the AREDS-2 Study

Current Recommendations of the Williamson Eye Institute

  • Because the AREDS-2 formula is not currently available, for those patients at risk for advanced macular degeneration, we recommend PreserVision with Lutein, 1 softgel twice a day with meals. While there are many other supplements available, the AREDS formulation is the only one used in a well-designed, randomized, long-term, placebo-controlled trial
  • If you have a smoking history or currently smoke, we suggest PreserVision Lutein Gelcaps, 1 tablet twice a day (2 total) to avoid the increased risk of lung cancer in smokers with high-dose beta carotene
  • If you cannot afford the full dose of an AREDS-based formula, the single most important ingredient based on placebo-controlled trials to try to match is zinc. 1 and 1/2 tablets of the Equate Vision Formula will give you approximately the AREDS-recommended doses of zinc at a reduced cost
  • If you already take Centrum Silver or another multivitamin, you should continue to take this as well
  • Patients on coumadin (warfarin) should notify their primary care doctor, and have their PT/INR checked within 1 week of starting these supplements due to the high-dose vitamin E
  • We recommend a cautious approach with herbs and other supplementation. Unlike Ocuvite PreserVision, these have not been subjected to rigorous randomized, controlled clinical trials. In addition, there can be great variability in different preparations. As of now, current evidence suggests that;
    1. Ginko may slow damage
    2. Bilberry has little evidence of any help
    3. St. John's wort may be harmful due to phototoxicity

General Recommendations for All Macular Degeneration Patients

  • Stop smoking
  • Control hypertension
  • Check vision daily with Amsler grid
  • Wear ultraviolet protection