Antioxidants improve visual function in non-advanced AMD

Eye Shop News   •   June 13, 2019

Supplementation with macular carotenoids in two formulations, containing and not containing mesozeaxanthin, in combination with coantioxidants, showed efficacy in improving vision in patients with nonadvanced age-related macular degeneration.

The Central Retinal Enrichment Supplementation Trial 2 (CREST 2) included 121 patients randomized to receive the AREDS 2 formula with reduced amount of zinc (10 mg/d lutein, 2 mg/d zeaxanthin plus 500 mg/d vitamin C, 400 IU/d of vitamin E, 25 mg/d zinc, and 2 mg/d copper), with or without the addition of 10 mg of mesozeaxanthin.

All patients had nonadvanced AMD with best corrected visual acuity of 20/40 or better and no more than 5 D of spherical equivalent in the study eye. Ninety-eight participants completed the final assessment at 2 years.

A significant improvement in contrast sensitivity (CS) was reported during the study period, with no statistically significant difference between the two groups.

CS was chosen as the primary outcome, because it “can effectively predict how well patients see targets typical of everyday life, which has important implications for quality of life,” the authors wrote.

Other measures of visual function also improved significantly in both groups, including BCVA, glare disability, retinal straylight, photostress recovery and reading performance.

Importantly, only one participant (from the group without additional mesozeaxanthin) progressed to advanced AMD during the study period. No serious adverse events relating to the study intervention were reported.

“Eye care professionals should be aware of the observed visual benefits afforded to patients with nonadvanced AMD as a result of supplementation with macular carotenoids (and coantioxidants) in the short, medium and long terms, and the indication for recommending such supplements should no longer be limited to risk reduction for disease progression in the long term,” the authors wrote.

Of note, the study was representative of a well-nourished population. The benefits of supplementation may be even more remarkable in subjects with less healthy eating habits, they said.

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