High-dosed antioxidant supplementation delays the development of the eye disease AMD

AMD is a common eye disorder that involves symptoms such as blurred central vision and eventual blindness. There are two types of AMD – a wet and a dry form. Neither is curable. However, in a new analysis of data, researchers from the National Institutes of Health (NIH) in the US have found new evidence showing that high-dosed daily supplementation with antioxidants like lutein and zeaxanthin combined with different vitamins and minerals can delay the development of the eye disease and late stages of the dry form of AMD. This could potentially help people with dry AMD maintain part of their central vision. The mentioned antioxidants that are found in eggs and various vegetables may also prevent AMD, altogether.

AMD (age-related macular degeneration) is a disease that affects your central vision. It occurs in the so-called yellow spot in the center of the retina. There are two types of AMD: a dry and a wet form. The wet form often succeeds the dry form. The first sign of dry AMD is that straight lines appear crooked or wavy. As time passes, it becomes increasingly difficult to read, recognize faces, or move in traffic. As the vision loss progresses, patients lose their ability to manage on their own. It is primarily older people who are affected by AMD, and it takes years to develop. In the early stages of the disease, small lipid-containing proteins known as drusen develop. Once AMD changes from its dry to its wet form, leaky blood vessels may form and contribute to the loss of central vision
AMD is incurable. The only treatment that can delay the local atrophy of the macula is frequent local injections in the eye. This therapy is not very effective, it’s costly, and it can be risky. The researchers behind the new study, which is published in Ophthalmology, therefore wanted to investigate if high-dosed antioxidant supplementation can delay the development of AMD and atrophy in a particular part of the macula called fovea. This small, central pit is filled with sensory cells and is critical for sharp vision and the ability to see colors in bright daylight.
The researchers analyzed data from two previous placebo-controlled American studies of patients with moderate AMD. The first study (AREDS) involved 318 patients, where one group got daily high-dosed supplements of antioxidants (500 mg of vitamin C, 268 mg of vitamin E, 15 mg of beta-carotene, 80 mg of zinc, and two mg of copper), while the other group got matching placebo. This study revealed that the high doses of the mentioned antioxidants lowered the risk of developing advanced AMD by 25 percent. Moreover, the risk of developing wet AMD was lowered by 38 percent.
The second study, AREDS2, was a follow-up study of 891 patients who got the same supplements, although they got less zinc (25 mg) and no beta-carotene. However, they got daily doses of lutein (10 mg) and zeaxanthin (two mg). Both are powerful antioxidants that are naturally present in the retina and the macula of the human eye. Lutein and zeaxanthin are also found in foods. Egg yolks are a particularly rich source of both. The study showed that supplementation with lutein and zeaxanthin instead of the related antioxidant beta-carotene is every bit as effective for prevention.
In the new follow-up study from National Institutes of Health (NIH), the scientists have found even more evidence that the mentioned antioxidants can help AMD patients preserve their eyesight. These antioxidants appear to delay the development of AMD by counteracting local atrophy of fovea. When we look at an object, the image is projected upside down on this part of the retina.

How do antioxidants counteract macular damage?

The different antioxidants protect against loss of sensory cells in the macula – also in fovea – by counteracting oxidative stress, which is when harmful free radicals outnumber protective antioxidants. The free radical load is increased with age and by things like smoking, overweight, type 2 diabetes, stress, and poisoning. Oxidative stress sets off chain reactions that attack the sensory cells, which speeds up the progression of AMD. The antioxidants are able to neutralize free radicals. Combined with exercise and healthy living, they can protect against AMD.

• Eat eggs and relevant vegetables every day
• Their content of the antioxidants, lutein and zeaxanthin, help protect against AMD.
• Spinach, broccoli, kale, red bell pepper, and blueberries are also good sources of lutein and zeaxanthin
• Referencer

Tianarnan D.L. et al. Oral Antioxidant and Lutein/Zeaxanthin Supplements Slow Geographic Atrophy Progression to the Fovea in Age-Related Macular Degeneration. Ophthalmology, 2024

NIH/National Eye Institute. Supplements slow disease progression during the late stage of “dry” age-related macular degeneration. ScienceDaily 2024

AREDS2 Research Group. The Age-Related Eye Disease Study 2 (AREDS2): study design and baseline characteristics (AREDS2 report number 1). PubMed 2012

Bamini Gopinath et al. Consumption of eggs and the 15-year incidence of age-related macular degeneration. Clinical Nutrition. 2020

Forebyggelse af AMD.pdf (ojenforeningen.dk)

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