Researchers have found that taking a daily vitamin and mineral supplement can slow the progression of Geographic Atrophy (GA), an advanced form of Dry Age-Related Macular Degeneration (AMD) that leads to irreversible vision loss. In the UK, there is currently no approved treatment for GA, which accounts for more than 25% of legal blindness.
Led by the National Institutes of Health (NIH) in the US, the research team concluded that widely available AREDS2 supplements, containing vitamins C and E, lutein, zeaxanthin, zinc and copper, could slow the expansion rate of GA into the fovea (where central vision loss occurs) by approximately 55% over an average of three years. The study has been published in Ophthalmology.
AREDS2 supplements take their name from two large clinical trials, AREDS (Age-Related Eye Disease Study) and AREDS2, carried out by the NIH National Eye Institute between 1992 and 2012. Both studies tested antioxidant supplements on patients with dry AMD, finding that they were effective in slowing disease progression in the early and intermediate stages.
In the new analysis, researchers reviewed the retinal scans of 1,209 people from the original study cohorts, revealing that AREDS2 supplements also appeared to hinder disease progression in people with the later stages of the disease, particularly when the area of GA was located outside the fovea, rather than inside the fovea where little slowing effect was observed.
In most people, GA begins outside the fovea, implying that if AREDS2 supplements are taken early enough they can impede the progression of atrophy into the fovea where central vision loss occurs. Central vision is essential for tasks such as reading and driving.
Lead author of the study, Tiarnan Keenan of the NIH National Eye Institute, said in a news release: “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. These findings support the continued use of AREDS2 supplements by people with late dry AMD.”
Co-author Pearse Keane said: “Although AREDS2 supplements are used widely in the UK, we don’t typically recommend them to patients who already have late AMD in both eyes. I think this paper will lead us to recommend their use more widely in people with late AMD. This is exciting because it is a cheap, safe, and well tolerated treatment.” Pearse Keane is Professor of Artificial Medical Intelligence at University College London’s Institute of Ophthalmology, a consultant ophthalmologist at Moorfields Eye Hospital, and Director of the INSIGHT Health Data Research Hub programme at Moorfields.
The authors hypothesise that the micronutrients contained in AREDS2 supplements help to support a biological phenomenon called “foveal sparing”, in which areas of retinal atrophy are contained, or held back, outside the fovea for a period of time before eventually invading the fovea late in the course of disease progression.
For more information on the study, please visit the NIH National Eye Institute website.
Pearse Keane's work is supported by NIHR Moorfields Biomedical Research Centre and Moorfields Eye Charity.
For more information about the work of INSIGHT, or applying to access data for your research project, please contact us: enquiries@insight.hdrhub.org
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