Antioxidant Supplement Slows Late-Onset AMD

Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss in people over 50 in developed countries. It is a degenerative process that affects the outer parts of the retina (photoreceptors and pigment epithelium), Bruch’s membrane and choriocapillaris, as defined in a work published in the Revista Española de Geriatría y Gerontologia.

The General Council of Colleges of Pharmacy report documented that “The prevalence of this pathology is estimated from 0.2% to 5.4% in people aged 60 to 85 years and from 12% to 30% in people aged 85 years and older. It is believed that 30% of the population over 70 years of age in older people have some form of AMD, and the incidence is higher in Caucasians. A study published in The Lancet, which aimed to project the number of people affected by age between 2020 and 2040, found that in an analysis of 129,664 people (aged 30 to 97) with 12,727 cases from 39 studies, the pooled prevalence (reported for the age range 45 to 85 years) of early-onset, late-onset and all-age macular degeneration was 8.01%.

There are two types of AMD: wet, also called exudative or neovascular, and dry or atrophic. It is estimated that 86% of AMD are atrophic and 14% are exudative.

New opportunities

Now comes a new analysis that determines than taking daily antioxidant vitamin and mineral supplements known as AREDS2 Helps slow the progression of AMD in later stages. which is confirmed by a study by the US National Institutes of Health (NIH).

The researchers analyzed the original retinal images of participants in the Age-Related Eye Disease Studies (AREDS and AREDS2) and found that in people with advanced dry AMD, taking an antioxidant supplement slowed the expansion of areas of geographic atrophy toward the central foveal retina. The study is published in the journal Ophthalmology.

“We have long known that AREDS2 supplements help slow the progression of AMD from intermediate to late stages. “Our analysis suggests that taking them may slow disease progression in people with late-onset dry AMD,” “These results support the continued use of AREDS2 supplements in people with late dry AMD,” Dr. Tiarnan Keenan, of the NIH’s National Eye Institute and lead author of the study, said in a statement.

Participants

In his new analysis, The researchers analyzed original retinal images of participants in the AREDS (318 participants, 392 eyes) and AREDS2 (891 participants, 1,210 eyes) studies who developed dry AMD.calculating the location and rate of expansion of regions of geographic atrophy. For those people who developed geographic atrophy of central vision, the supplements did not provide any benefit. But for most who developed geographic atrophy outside the fossa, supplements slowed the rate of expansion toward the fossa by about 55% on average over three years.

In early and intermediate AMD, small yellow deposits of fatty proteins called drusen form on the light-sensitive retina at the back of the eye. As the disease progresses to late stages, people may develop leaky blood vessels (called wet AMD) or lose areas of the retinal light-sensitive cells (called dry AMD). Geographic atrophy in these regions slowly expands over time, causing those affected to gradually lose central vision.

New formula

The original AREDS study found that a supplement containing antioxidants (vitamin C, E, and beta-carotene), as well as zinc and copper, may slow the progression of mid- to late-stage AMD. A subsequent study, AREDS2, found that replacing the antioxidants lutein and zeaxanthin with beta-carotene increased the effectiveness of the supplement formula and eliminated certain risks.At that point, none of the studies found any additional benefit if participants developed late-stage disease.

However, this original analysis did not take into account a phenomenon of the dry form of late AMD called “foveal sparing.” Although all areas of the retina are sensitive to light, the area that provides the greatest acuity of central vision is called the fovea. Many people with dry AMD first develop geographic atrophy outside this foveal area, and they only lose central vision when areas of geographic atrophy extend into the foveal area.

“Our high central visual acuity is necessary for tasks such as reading and driving. Because there are few therapeutic options to preserve or restore vision in people with advanced dry AMD, taking antioxidants is a simple measure that may delay central vision loss even in people with advanced disease.”“Keenan said. “We plan to confirm these results in a dedicated clinical trial in the near future.”