Released 10/12/01
High levels of antioxidants and zinc significantly reduce the risk of advanced age-related macular degeneration (AMD) and its associated vision loss. Scientists found that people at high risk of developing advanced stages of AMD lowered their risk by about 25% when treated with a high-dose combination of vitamin C, vitamin E, beta-carotene, and zinc.
"This is an exciting discovery because, for people at high risk for developing advanced AMD, these nutrients are the first effective treatment to slow the progression of the disease," said Paul A. Sieving, M.D., Ph.D., director of the NEI. "AMD is a leading cause of visual impairment and blindness in Americans 65 years of age and older. Currently, treatment for advanced AMD is quite limited. These nutrients will delay the progression to advanced AMD in people who are at high risk -- those with intermediate AMD in one or both eyes, or those with advanced AMD in one eye already."
"The nutrients are not a cure for AMD, nor will they restore vision already lost from the disease," Dr. Sieving said. "But they will play a key role in helping people at high risk for developing advanced AMD keep their vision."
"The AREDS formula is the first demonstrated treatment for people at high risk for developing advanced AMD." Frederick Ferris, M.D., Director of clinical Research at the NEI and Chairman of the AREDS said, "Slowing the progression of AMD to its advanced stage will save the vision of many who would otherwise have had serious vision impairment."
Dr. Ferris said some people with intermediate AMD may not wish to take large doses of antioxidant vitamins or zinc because of medical reasons. "For example, beta-carotene has been shown to increase the risk of lung cancer among smokers," he said. "These people may want to discuss with their primary care doctors the best combination of nutrients for them. With the use of the high levels of zinc, it is important to add appropriate amounts of copper to the diet to prevent copper deficiency."
In the cataract portion of the study, researchers discovered that the same nutrients had no significant effect on the development or progression of age-related cataract. A cataract is a clouding of the eye's lens that blocks some light from reaching the retina and interferes with vision. "Participants taking the 'zinc alone' treatment, the 'antioxidants alone' treatment, or the combination of zinc and antioxidants were all about as likely to develop a cataract as those taking a placebo." Dr. Ferris said.
"At the time the study was planned, laboratory and animal research had suggested that antioxidants might be of benefit in treating or preventing cataract," he said." Also at that time, limited epidemiologic and clinical trial data suggested that antioxidants might affect the development of cataract. However, our analyses did not find any connection between the antioxidant vitamins used in the AREDS and cataract development."
Despite the evidence that these nutrients did not lower the risk of cataract development over the seven-year period of the study, Dr. Ferris noted that a effect over a longer period of time, or with different doses of these or other antioxidants, cannot be ruled out.
The AREDS participants reported minor side effects from the treatments. About 7.5 percent of participants assigned to the zinc treatments - compared with 5 percent who did not have zinc in their assigned treatment - had urinary tract problems that required hospitalization. Participants in the two groups that took zinc also reported anemia at a slightly higher rate; however, testing of all patients for this disorder showed no difference among treatment groups. Yellowing of the skin, a well-known side effect of large doses of beta-carotene, was reported slightly more often by participants taking antioxidants.
"The AREDS formula is the first demonstrated treatment for people at high risk for developing advanced AMD," Dr. Ferris said. "Slowing the progression of AMD to its advanced stage will save the vision of many who would otherwise have had serious vision impairment."
AREDS is of paramount importance because the highest level of government research has validated a treatment for macular degenerative disease. Therefore, this study is a milestone. However, it must be kept in perspective because it started 8-9 years ago, before any information about the carotenoid lutein was available. Numerous studies indicate lutein's primal role in the health of the macula and as a risk factor for macular degeneration. There are studies in progress to clarify lutein's role in macular degenerative disease, however it takes years for the results. Also, most nutritionists do not recommend high doses of zinc because of potential complications. Therefore, the most effective supplement based on current information would contain antioxidants, reasonable amounts of zinc, and sufficient lutein.
For more information on supplements for macular degeneration contact Customer Service at Lange Eye Care and Associates.
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