Dr. Grogg keeps vitamins as the #10 drug in her black bag for consideration in patients with age-related macular degeneration.
AREDS Report
(Arch Ophthalmol, 2001;119:1417-1436)
The first really well-done, long-term study of its kind, the Age-Related Eye Disease Study (AREDS) was a double-masked clinical trial sponsored by the National Eye Institute and conducted at 11 major medical center research facilities around the country.
It studied the effects of zinc and/or antioxidants (Vitamin C, Vitamin E, and Beta carotene) on patients with cataracts and on those with varying stages and types of ARMD--including those with only family history and those with no ARMD. It also studied patients without evidence of cataracts or ARMD to determine whether zinc and/or antioxidants can prevent the development of these conditions.
Dr. Grogg presents handouts with a synopsis of the AREDS conclusions to her patients so that they can make an informed decision on what vitamins to take. She prefers not to suggest brand names to her patients. Many are taking a cocktail of vitamins, so the easiest thing to do medically and legally is to give the patients the results of the study and let them count up what they're taking and figure out what (if any) additional supplements they need to take based on the AREDS.
The doses used in the study were:
- Vitamin C 500 mg
- Vitamin E 400 IU
- Beta-carotene 15 mg
- Zinc 80 mg, as zinc oxide
- Copper 2 mg, as cupric oxide (when taking that much zinc, have to take copper for kidney function)
A different study showed a link between beta-carotene in smokers and an increased risk of lung cancer. It is well recognized that many wet ARMD patients are usually smokers or past smokers. Smokers and ex-smokers probably should be advised that other studies have shown a link between beta-carotene use and lung cancer.
Caution all patients taking "cocktails" of vitamins in general.
What were the results of the AREDS?
- High levels of antioxidants and zinc can reduce the risk of vision loss from advanced ARMD by about 19% in high-risk patients (patients with intermediate ARMD or advanced ARMD in one eye but not the other).
- Supplements do not provide significant benefits to patients with minimal ARMD.
- These nutritional supplements do not prevent the initial development of ARMD, nor do they improve vision already lost to ARMD.
- Nutritional supplements do not seem to prevent cataracts or to keep them from getting worse over time.
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