Dr. Montzka: Changing Ophthalmic EHR
The Age-Related Eye Disease Study (AREDS) was a major clinical trial sponsored by the National Eye Institute (NEI), a part of the National Institutes of Health (NIH). The purpose of the study was to learn more about the natural history and risk factors of age-related macular degeneration (AMD) and to evaluate the effect of high doses of antioxidants and zinc, on the progression of AMD.
The clinical trial closely followed about 3,600 participants with varying stages of AMD. The results showed that the AREDS formulation, while not a cure for AMD, may play a key role in helping people at high risk for developing advanced AMD, keep their remaining vision.
People who are at high risk for developing advanced AMD should consider taking the combination of nutrients used in the study. Your eye care professional can tell you if you have AMD and are at risk for developing the advanced form of the disease. The doctor should give you a dilated eye exam in which drops are placed in your eyes. This allows for a careful examination of the inside of the eye, to look for signs of AMD.
Before taking these high levels of vitamins and minerals, you should talk with your doctor about the risk of developing advanced AMD and whether taking the AREDS formulation is right for you.
The specific daily amounts of antioxidants and zinc used by the study researchers were 500 milligrams of vitamin C; 400 International Units of vitamin E; 15 milligrams of beta-carotene (equivalent to 25,000 International Units of vitamin A); 80 milligrams of zinc as zinc oxide; and 2 milligrams of copper as cupric oxide. Copper was added to the AREDS formulations containing zinc, to prevent copper deficiency anemia, a condition associated with high levels of zinc intake.
Yes. A daily multivitamin contains many important nutrients not found in the AREDS formulation. For example, elderly people with osteoporosis, need to be particularly concerned about taking vitamin D, which is not in the AREDS formulation. The AREDS formulation is not a substitute for a multivitamin. In the Age-Related Eye Disease Study, two-thirds of the study participants took multivitamins along with the AREDS formulation.
If you are already taking daily multivitamins and your doctor suggests you take the AREDS formulation, be sure to review all your vitamins with your doctor before you begin.
No. The AREDS formulation's levels of antioxidants and zinc are considerabely higher than the amounts in any daily multivitamin.
No. The high levels of vitamins and minerals are difficult to achieve from diet alone. However, previous studies have suggested that people who have diets rich in green, leafy vegetables have a lower risk of developing AMD.
No. There is no known treatment that can prevent the development of AMD. The study did not show that the AREDS formulation prevented people from developing early signs of AMD. No recommendation has been made for taking the AREDS formulation to prevent early AMD.
Taking the formulation reduced the rate of advanced AMD in people at high risk, by about 25 percent over a 6-year period. We do not know if this treatment effect will persist over a longer period. However, by continuing to follow the AREDS participants, we hope to find out if the treatment effect will last longer than 6 years.
Some 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. Yellowing of the skin, a well-known side effect of large doses of beta-carotene (vitamin A), was reported slightly more often by participants taking antioxidants.
Large clinical trials sponsored by the National Cancer Institute, demonstrated that beta-carotene increases the risk of lung cancer in current smokers. In these trials, most of these smokers were heavy smokers. The only other large clinical trial evaluating beta-carotene (vitamin A) was the Physicians Health Study (PHS). In the PHS, there was no evidence of increased cancer risk in those randomly assigned to beta-carotene, but few physicians were active smokers. There also was no evidence of an increased risk of lung cancer in former smokers. However, many studies suggest that former smokers maintain some increased risk of lung cancer for years after stopping smoking. Therefore, it is reasonable to expect that beta-carotene (vitamin A) may also slightly increase their risk of cancer, at least for a period of several years. There are some AREDS-based formulations (see below) that replace the vitamin A (beta-carotene) with Lutein, for those who should avoid beta-carotene, such as smokers.
Always consult with your eye care professional to see which AREDS formulation may benefit you.
The AREDS only studied age-related macular degeneration. We have no recommendations for younger people with the inherited (juvenile) forms of macular degeneration.
You can purchase the AREDS formulation at drug stores, supermarkets, health food stores, and other retail outlets that sell pharmacuetical products.
Bausch & Lomb provided the antioxidant and zinc supplement for the Age-Related Eye Disease Study (AREDS). They sell PreserŪVision Eye Vitamin AREDS Soft Gel and Ocuvite PreserŪVision Tablets AREDS. They also sell PreserŪVision Soft Gels Lutein, an AREDS based formula that replaces vitamin A with lutein, for those who need to avoid vitamin A, such as smokers.
Another supplement available with the AREDS formulation is ICaps®Eye Vitamin AREDS Formula, by Alcon.
*These vitamin products have not been evaluated by the Food and Drug Administration (FDA) and are not intended to diagnose, treat, or prevent any disease. Always consult with your eye care professional before taking any supplements.
Sources - National Eye Institute (NEI) of the National Institutes of Health (NIH)
Disclaimer: The information contained in this website does not substitute for the advice of a qualified eye care professional and is not intended to constitute medical advice.