For Patients - Macular Degenaration & Vitamins

Diet, Vitamins & Macular Degeneration
By Keshav Narain, M.D., Specialist in Vitreo-Retinal Disease and Surgery

The Age Related Eye Disease Study (AREDS) is a multi-center, randomized, double masked study involving more than 4000 patients conducted by the National Eye Institute (NEI), a division of the National Institutes of Health (NIH). (ie it is a very well done and powerful study carried out by objective competent researchers without any commercial interest.) It showed beneficial effects of supplementing the diet with vitamins C, E, beta carotene, and most importantly, zinc for patients with moderate to severe macular degeneration. This benefit was similar in patients who took a daily multivitamin (Centrum Silver) in addition to those who did not take any daily multivitamin at all. The dosages of supplement used in the study are given below in the table to the right. These doses are substantially greater than what is found in an ordinary multivitamin.

Two studies that were carried out around the time that the AREDS study was beginning indicated that those individuals who had a history of smoking were at slightly higher risk of developing lung cancer when put on high dose beta carotene. For this reason, smokers were allowed to use zinc alone as a supplement and also showed a positive benefit from it with respect to the macular degeneration. As in studies done before, smokers still did worse overall than their non-smoking counterparts.

A study carried out before the AREDS study analyzed the dietary habits of people who had macular degeneration. This smaller study showed that individuals with macular degeneration who had diets that were the highest in Lutein and Zeaxanthin were the least likely to develop the severe, wet form of macular degeneration.

A second study (AREDS II) is underway to investigate the benefits of the original formula with 3 variations: no beta-carotene, lower amounts of zinc, or both no beta-carotene and lower amounts of zinc. This study is expected to complete its data collection in 2012.

Dr. Narain has analyzed the price, composition, and dosages of a variety of vitamin supplements that are recommended for the treatment of individuals with age related macular degeneration. The results are interesting and show that you do not always get what you pay for. Prices were obtained from local warehouse stores or online pharmacies.

*B & L = Bausch & Lomb

Name Number/day Manufacturer	I-Sense (4) Akorn	I-CAPS AREDS (4) Alcon	I-CAPS Lutein/zea (2) Alcon	Ocuvite Preservision (4) B & L*	Ocuvite Lutein (2) B & L*	Ocuvite Extra (2) B & L*	Premiere Hi-Health ?	Ocu-tabs (2) Walgrens	Centrum Silver(1) Wyeth	AREDS Capsules 4/day
Zinc mg	69.6	69.6	60	69.6	30	80	15	40	15	80
Vit E IU	400	400	150	400	60	200	110	30	30	400
Vit C mg	452	452	400	452	120	600	400	60	60	500
Vit A IU (B-carotene)	28640	28640	6600	28640	0	2000	12000	5000	5000	25000
Lutein mg	6	0	4	0	12	4	7.5	0	0.25	0
Selenium ug	0	0	40	0	0	110	30	40	40	0
Vit B3 mg	0	0		0	0	80	0		0	0
Vit B2 mg	0	0	10	0	0	6	15	0	1.7	0
($) /30 days	$15.00	$17.00	$7.50	$16.00	$4.62	$12.00	$47.91	$6.00	$2.67	STUDY