There is now evidence from the Age-Related Eye Disease Study (AREDS) that high dose multivitamin and zinc usage can decrease the risk of exudative age related macular degeneration (‘wet’ ARMD), vision loss in high risk patients with extensive nonexudative (‘dry’ ARMD), or advanced ARMD in the fellow eye.

Who Benefits From Vitamin Therapy?

Generally, high dose vitamin supplementation is only recommended for patients who have already lost vision in one eye, to reduce the risk of visual loss in the fellow eye, i.e., patients with evidence of exudative disease in one eye and patients with extensive drusen or vision loss in one eye attributable to nonexudative disease are considered high risk and high dose vitamin therapy should be considered.

Patients with early disease without any loss of vision (only a few small drusen, minimal intermediate drusen or pigment abnormalities alone) have a low risk of future exudative disease and vitamin therapy was not beneficial.

What Vitamins Benefited High Risk Patients?

High doses of multivitamins C, E, beta carotene, and zinc significantly decreased the risk of exudative disease and vision loss in high risk patients. Zinc alone also had a benefit, albeit diminished, in high risk patients.

Where Can The Vitamins Be Obtained?

Multivitamins and zinc, at doses proven beneficial in this study, are available as preparations such as “Ocuvite”, “Icaps” and “Santogen Gold” amongst others. These are available over the counter without a prescription.

Caveats

1. Patients should discuss the risks and benefits of high dose vitamin therapy with their doctor prior to commencing therapy.

2. Smokers should consider taking zinc only given the possible association between high dose beta carotene therapy and increased lung cancer rates.

3. Patients at risk for cerebrovascular disease should consider taking zinc only given the possible association between high dose vitamin E and stroke.

4. There were no significant systemic complications reported in the AREDS.

5. Vitamin therapy doses not influence active exudative (‘wet’ ARMD) disease.

6. Vitamin therapy does not alter our current treatment strategies for exudative (‘wet’) ARMD.
7. Copper supplementation is recommended to prevent potential anaemia in patients taking zinc supplements.

Further reading: Are These High Levels of Antioxidants and Zinc Right For You? From the National Eye Institute (USA).

This page was last modified on Wednesday, February 18, 2009