Researchers from the National Institutes of Health (NIH) have released a new analysis indicating that daily supplements containing antioxidant vitamins and minerals can slow the progression of late-stage dry age-related macular degeneration (AMD). This could be significant for patients looking to preserve their central vision during the advanced stages of the disease. The study, which revisited retinal scans from participants in the Age-Related Eye Diseases Studies (AREDS and AREDS2), revealed that these supplements can reduce the expansion of geographic atrophy regions towards the central foveal region of the retina. The findings were published in the journal Ophthalmology.
Dr. Tiarnan Keenan, M.D., Ph.D., of NIH’s National Eye Institute (NEI), and the lead author of the study, stated, "We’ve known for a long time that AREDS2 supplements help slow the progression from intermediate to late AMD. Our analysis shows that taking AREDS2 supplements can also slow disease progression in people with late dry AMD." This supports the continued use of AREDS2 supplements by individuals with advanced stages of dry AMD.
The analysis reviewed retinal scans from 318 participants (392 eyes) in the original AREDS and 891 participants (1210 eyes) in the AREDS2 trials who developed dry AMD. Researchers calculated the expansion rate and position of geographic atrophy regions. It was found that for those with geographic atrophy far from the fovea, the supplements reduced the rate of expansion towards the fovea by about 55% over an average of three years. However, for individuals whose geographic atrophy had already reached their central vision, the supplements offered minimal benefit.
AMD initially causes small yellow deposits of fatty proteins called drusen to form in the retina, leading to vision issues. As the disease advances to the late stage, patients may experience either leaky blood vessels (wet AMD) or loss of light-sensitive retinal cells (dry AMD), with geographic atrophy expanding and causing progressive central vision loss.
The original AREDS trial identified that a supplement formula with antioxidants (vitamins C, E, and beta-carotene), zinc, and copper could slow the progression from intermediate to late-stage AMD. AREDS2 improved upon this by replacing beta-carotene with lutein and zeaxanthin, enhancing efficacy and reducing risks. Initially, no further benefits were noted for late-stage AMD patients. However, the new analysis accounted for "foveal sparing"—a phenomenon where geographic atrophy begins outside the foveal region, delaying central vision loss until it expands into this critical area.
Dr. Keenan emphasized the importance of central vision for activities such as reading and driving, and highlighted the scarcity of therapeutic options for those with late-stage dry AMD. "Antioxidant supplementation is a simple step that may slow central vision loss, even for those with late disease," he said. The team plans to confirm these findings in a dedicated clinical trial soon.
