Nutritional Supplementation in Age-Related Macular Degeneration

Abstract

Our data reveal that Italian patients with age-related eye disease study Categories 3 and 4 have a low adherence to nutritional supplementation. In 65% of cases, patients were not adequately informed by their ophthalmologist of the potential benefits of oral supplementation for age-related macular degeneration; indeed, 108 patients (56%) were not even aware such nutritional treatments are available. Ophthalmologists should be aware of the importance of giving advice to persons with age-related macular degeneration regarding the benefits of oral supplements.

What Advice Is Currently Given to Patients with Age-Related Macular Degeneration (AMD) by Eyecare Practitioners, and How Effective Is It at Bringing about a Change in Lifestyle? A Systematic Review

“…Seventy-five percent of the participants who did not take supplements said this was because it was never recommended to them [ 51 ]. Parodi et al (2016) also recruited patients from a single retinal clinic in a hospital based in Milan, Italy [ 56 ]. They reported that 40% of the patients were taking AREDS supplements and, similar to the Hochstetler et al (2010) findings, 94% of the patients not taking supplements reported that this was because it was never recommended to them [ 56 ].…”

“…These studies [ 46 , 47 , 51 , 56 ] all shared the limitation of recruiting participants from a single hospital site in the same country, thus reducing the generalisability of the findings. Additionally, the severity of AMD status of the participants was not categorised in two of these studies [ 46 , 51 ], which is important as the AREDS trial results specifically recommended the formula for patients who have intermediate AMD or advanced AMD in the fellow eye [ 25 ].…”

“…In summary, there was minimal evidence regarding compliance of patients to advice regarding general dietary changes, with the majority of studies focusing on compliance to vitamin supplement recommendations. The proportion of patients taking vitamin supplements for AMD in the included studies varied widely between around 40% and 68% [ 46 , 47 , 51 , 56 , 60 , 61 ]. It was not always clear whether these supplements conformed to AREDS guidelines.…”

Molecular Features of Classic Retinal Drugs, Retinal Therapeutic Targets and Emerging Treatments

“…Treatment for non-exudative retinal diseases is based on nutraceutics, which employs a combination of different natural substances known to slow down degenerative processes. Although several molecules are under investigation, most of the evidence concerns formulations developed for dry age-related macular degeneration by Age-Related Eye Disease Studies 1 and 2 (AREDS1 and AREDS2) [ 108 ]. The AREDS1 formulation contained vitamin C (500 mg), vitamin E (273 mg/473 IU), beta-carotene (15 mg), zinc (80 mg), and copper (2 mg) [ 109 ], whereas the AREDS2 formulation differed in the removal of beta-carotene and addition of lutein/zeaxanthin and omega-3 long-chain polyunsaturated fatty acid [ 110 ].…”

Precision medicine for age-related macular degeneration: current developments and prospects

“…None of the newly added constituents increased the efficacy of the formulation, but inclusion of lutein and zeaxanthin instead of beta-carotene is now recommended for safety reasons. Supplementation in the USA is popular but in Europe it did not gain the same momentum [40].…”