Q. Do vitamins help a person with age-related macular degeneration (AMD)?

A. Good question! Yes, certain vitamins are recommended for certain patients. A large study called AREDS (the Age-Related Eye Disease Study) conducted by the National Eye Institute in the United States showed that when patients with either moderate or advanced dry AMD in one eye took antioxidant supplements, their risk of AMD progression was lowered.

That doesn't mean that any vitamin at your local drug store will do, however. The recommended AREDS dosages of vitamins are much higher than what you would get in a typical multi-vitamin.

People with moderate or advanced dry AMD should talk to their ophthalmologist about taking an AREDS formulation of vitamins. If you have been advised by your ophthalmologist to take these vitamins, let your primary care physician know you are taking them.

The AREDS study did not show any benefits for people with no AMD or early dry AMD. But if you do have early dry AMD, you should monitor your vision (in partnership with your eye care professional) and consider AREDS vitamins if it progresses.

Smoking and AREDS

The complete AREDS formulation may not be for you if you currently smoke cigarettes or have stopped smoking within the last year. You should avoid taking beta-carotene, one of the ingredients in some AREDS vitamin formulations, due to an increased risk of lung cancer.

Further Study

Lutein and zeaxanthin are yellow pigments found in the macula and some researchers believe they may protect retinal cells from oxidative damage. There have been mixed results from studies looking at these micronutrients to date, and also at omega-3 polyunsaturated fatty acids, so further research is being done in this area.

An AREDS II study is now looking at whether these supplements will decrease the risk of progression of AMD. AREDS II will also test beta-carotene to see if it may decrease the effectiveness of the combination of vitamins and minerals used in AREDS I.

Diet and Nutrition

A study from the Netherlands recently reported that individuals who consumed higher amounts of vitamins C and E, beta-carotene, and zinc than others had a reduced risk of AMD.

Diet is an important factor in retinal health. Vegetables such as spinach, kale and corn are good sources of lutein and zexanthin. Wild salmon, sardines and flaxseeds are some examples of excellent sources of omega-3 fatty acids. Even though these nutrients are currently being studied for their effectiveness in reducing the risk of AMD, it can't hurt to include them in your diet anyway.

The Bottom Line

The topic of vitamin supplementation and diet in AMD prevention is complicated and evolving. Your best bet? Make sure you find reputable sources of information, for example, by talking to your eye-care professional. Keep asking questions, and stay tuned to this space as we learn more about AMD and nutrition.

Colour picture of Dr. Mary Lou Jackson The Expert:
Mary Lou Jackson, MD
Director, Vision Rehabilitation Service Clinical Instructor, Harvard Medical School

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