Nutrition and Age-Related Macular Degeneration

Abstract

Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment in developed countries. In the absence of effective treatments to slow AMD progression, it is predicted that the prevalence of AMD will double over the next 20 years. One area of significant interest is the potential role that nutrition may play in preventing and/or delaying the progression of AMD. Specifically, is there any benefit in oral antioxidant and/or mineral supplementation? This review critically evaluates the currently available evidence relating to nutrition and AMD, with particular reference to the key findings of two large National Eye Institute-sponsored clinical studies, namely, the Age-Related Eye Disease Study (AREDS) and AREDS2. Topical controversies relating to nutrition and AMD are considered and analyzed in the context of the published literature to guide practitioners through assessing the merit, or otherwise, of common claims. This article provides a foundation for clinicians to provide informed advice to AMD patients based on available research evidence.

Self‐reported optometric practise patterns in age‐related macular degeneration

“…Contrary to the evidence base, nutritional supplements were rated as highly relevant or relevant (top two responses) by 68 and 34 per cent of respondents in early AMD and normal aging changes, respectively. Optometrists in practice may find it difficult to keep up to date and understand specific recommendations, especially when applying the findings to patients and clinical scenarios . External factors, such as the over‐the‐counter availability of nutritional supplements and patient preference, may also contribute to the use of these agents by optometrists, outside of what the evidence base recommends.…”

Comparing self‐reported optometric dry eye clinical practices in Australia and the United Kingdom: is there scope for practice improvement?

“…Undergraduate optometric training also ranked relatively highly among Australian respondents; this is likely explained by these clinicians having a relatively shorter length of optometric experience compared with UK practitioners (median: 15 vs 29 years, Table ). It is becoming increasingly well recognised that evidence‐based practice is an essential component of optometric training and practice . That practitioners in both regions relied heavily on conference education to guide dry eye management highlights that there is scope to improve the utilisation of primary refereed sources, in particular systematic reviews and meta‐analyses, to guide patient care.…”

“…It is becoming increasingly well recognised that evidence-based practice is an essential component of optometric training and practice. [45][46][47] That practitioners in both regions relied heavily on conference education to guide dry eye management highlights that there is scope to improve the utilisation of primary refereed sources, in particular systematic reviews and meta-analyses, to guide patient care. Only about one in four respondents in both regions indicated using peer-reviewed papers to guide their clinical practice.…”

Advanced imaging for the diagnosis of age‐related macular degeneration: a case vignettes study

“…There is a growing body of evidence showing that patients (especially with the neovascular form) benefit from early detection . Thus, primary eye‐care providers are mandated to provide early and accurate diagnosis of AMD and to instigate appropriate management, including advice about smoking cessation, dietary changes or supplementation, Amsler grid self‐monitoring and an ongoing care plan . Staging of the disease is also important: early and intermediate stages may be detectable before the onset of symptoms and the stage of disease should be used to guide the management plan.…”