Age-related macular degeneration (AMD) is a progressive eye disease and a leading cause of irreversible vision loss in older adults. This condition damages the macula, the small central part of the retina responsible for sharp, detailed central vision needed for activities like reading and driving. AMD affects millions of Americans. For those diagnosed or at high risk, the question of whether a supplement can help slow the progression of this disease is important.
Understanding Age-Related Macular Degeneration (AMD)
AMD is categorized into two primary types: dry and wet. The dry form, also known as atrophic AMD, is the most common, accounting for about 90% of all cases. This type is characterized by the gradual thinning of the macula and the accumulation of yellowish waste deposits called drusen beneath the retina. Dry AMD typically progresses slowly, causing a gradual blurring of central vision.
The less common but more severe form is wet AMD, or neovascular AMD, occurring in about 10% of cases. Wet AMD is caused by the abnormal growth of fragile new blood vessels beneath the macula, a process called choroidal neovascularization. These vessels are prone to leaking fluid and blood, which causes rapid damage. This can lead to sudden, severe central vision loss.
The Definitive Research-Backed Formula
The only scientifically proven supplement formulation for slowing the progression of AMD is derived from the Age-Related Eye Disease Studies (AREDS and AREDS2), conducted by the National Eye Institute. The original AREDS trial demonstrated that a high-dose combination of antioxidants and zinc could reduce the risk of advanced AMD progression by about 25% in high-risk individuals. This finding established a standard of care for managing the disease.
A subsequent large-scale trial, AREDS2, was initiated to refine the original formula by investigating the effect of adding lutein and zeaxanthin and removing beta-carotene. Researchers were concerned that beta-carotene increased the risk of lung cancer in current and former smokers. The AREDS2 study confirmed that replacing beta-carotene with the carotenoids lutein and zeaxanthin was safer and provided an incremental increase in benefit.
The specific, high-dose combination recommended today is the AREDS2 formula. This formula has been shown to continue reducing the risk of progression to advanced AMD for at least ten years. While it is not a cure and cannot prevent the disease from starting, it is the standard recommendation for delaying the disease’s advancement. It is necessary to choose a supplement that adheres precisely to the ingredient list and dosages established by the AREDS2 research.
Key Ingredients and Their Role
The AREDS2 formula contains six specific components at precise dosages: 500 mg of Vitamin C, 400 IU of Vitamin E, 10 mg of Lutein, 2 mg of Zeaxanthin, 80 mg of Zinc, and 2 mg of Copper. Lutein and Zeaxanthin are carotenoids, which are yellow pigments that accumulate naturally in the macula. These compounds act as a natural filter for high-energy blue light and function as antioxidants to neutralize free radicals in the retina.
Vitamins C and E are potent antioxidants that protect the delicate light-sensing cells of the macula from oxidative stress and damage. The retina is vulnerable to this type of damage due to its high oxygen consumption and constant exposure to light. Zinc is a mineral that also possesses antioxidant properties and is necessary for the activity of many enzymes involved in retinal health.
The high dose of zinc is balanced with a small amount of copper, typically 2 mg, in the form of cupric oxide. This addition is included because high-dose zinc supplementation can interfere with the body’s ability to absorb copper, potentially leading to a copper deficiency. The combination ensures the intended benefits are achieved without creating a nutritional imbalance.
Determining Eligibility for Supplementation
The AREDS2 supplement is not intended for the general population or for everyone with an AMD diagnosis. The clinical trials demonstrated benefit only for individuals who have progressed to certain stages of the disease. Specifically, the supplement is recommended for people with Intermediate AMD in one or both eyes, or Advanced AMD in one eye but not the other.
Intermediate AMD is defined by the presence of numerous medium-sized drusen or at least one large drusen in the macula. Individuals with only Early AMD, characterized by few small drusen, or those with no signs of the disease, do not benefit from taking this high-dose formulation. Taking the supplement when it is not indicated provides no benefit and may carry risks due to the high concentration of certain vitamins and minerals. Therefore, a consultation with an eye care professional is necessary to determine if the AREDS2 formulation is appropriate.