Scientifically reviewed by Preeti Subramanian, PhD
Two major clinical trials—the Age-Related Eye Disease Studies (AREDS) and AREDS2—have shown that taking vitamin and mineral supplements can slow the progression of age-related macular degeneration. Now, a long-term follow-up study offers the strongest findings to date that reaffirm the optimal supplement formula.
The first AREDS supplement formula tested contained beta-carotene, which was later found to increase the risk of lung cancer in people who smoked. In light of those findings, the AREDS2 formula replaces beta-carotene with the antioxidants lutein and zeaxanthin.
Emily Chew, MD, director of the Division of Epidemiology and Clinical Application at the National Eye Institute, led a research team that analyzed 10 years of AREDS2 data. The team concluded that the AREDS2 formula was more effective at reducing the risk of macular degeneration progression compared to the original formula – while also reducing the risk of lung cancer due to beta-carotene.
A report on the study, which was funded by the National Institutes of Health (NIH), was published in JAMA Ophthalmology. “These results confirmed that switching our formula from beta-carotene to lutein and zeaxanthin was the right choice,” Dr. Chew said in an NIH report on her research.
How Macular Degeneration Can Lead to Blindness
Macular degeneration is a degenerative disease of the retina, which is the light-sensitive tissue at the back of the eye. The macula is the part of the retina that provides clear and straight-ahead vision. Macular degeneration causes cells in the macula to die, eventually leading to vision loss. There is no cure for macular degeneration, but treatment can slow progression of the disease and prevent vision loss.
There are two types of macular degeneration: dry and wet. Most people with macular degeneration have the dry type (also called atrophic macular degeneration). This happens when the macula gets thinner with age, with cell death progressing slowly over several years.
Wet macular degeneration (also called advanced neovascular macular degeneration) is a less common type and often causes faster vision loss. It happens when abnormal leaky blood vessels grow in the back of the eye and damage the macula. Dry macular degeneration can sometimes turn into wet macular degeneration.
“If you have good vision in one eye and either wet or dry macular degeneration in the other, you have a good chance of being helped by the AREDS supplements,” Dr. Chew said in a 2021 interview with BrightFocus. “Even patients with dry age-related macular degeneration in both eyes and somewhat impaired vision may be helped. But the really severe dry type, where the center [the macula of the eye] is involved and the vision is very poor, may be more difficult. AREDS supplements cannot reverse vision damage that has already occurred.”
Being proactive with macular degeneration is key, but AREDS supplements are not meant to be taken as a preventive measure, Dr. Chew cautioned. “Healthy individuals and those with early macular degeneration are not helped by AREDS,” she said. “Only when you get to the intermediate stage does it help, and even then, it doesn’t help everyone. If you have a family history of macular degeneration or are worried, the most important thing is to see your eye doctor.”
Nutrients in the AREDS2 Formula
The AREDS2 formula contains:
- 500 mg of vitamin C
- 400 IU of vitamin E
- 2 mg of copper
- 80 mg of zinc
- 10 mg of lutein
- 2 mg of zeaxanthin
Lutein and zeaxanthin are micronutrients found in many fruits and vegetables. They help protect the macula by shielding it against damage caused by light.
Research shows it’s safe to take a multivitamin along with an AREDS formula. However, any high-dose nutritional supplement may interfere with certain medications and compete with other important nutrients for absorption into the body.
Therefore, people who are considering taking an AREDS formula should make a list of all supplements and over-the-counter medications they take and share it with their healthcare provider.
How to Purchase AREDS2 Supplements
AREDS2 supplements can be purchased over the counter in drugstores or online. When choosing a supplement, be sure the label says AREDS2 formula and that the listed vitamins and minerals match the amounts in our chart above. If you are uncertain about a specific product, ask your doctor for recommended brands that meet the AREDS2 formulation. The dose is generally one soft gel twice a day with a meal.
Other Steps to Take
Good nutrition plays an important role in eye health, Dr. Chew says. She points to research into the Mediterranean diet, which includes eating more fruit, vegetables, beans, nuts, and fish; minimizing red meat and dairy; including low or moderate wine drinking; and choosing monounsaturated fats such as olive oil over saturated fats such as butter.
For people at risk for macular degeneration, strong dedication to the Mediterranean diet resulted in a 25% reduction in the risk of progressing from early to late macular degeneration, and an almost 30% reduction in the risk of progressing from moderate to late macular degeneration.
“The Mediterranean diet was also associated with a reduced risk of cognitive impairment,” Dr. Chew said. “So, it seems like the brain and the eye are really tied together.”