MACULAR DEGENERATION STILL AN ENIGMA

In July, 2019, I published a blog about macular degeneration in which I lamented the absence of a discernible cause, viable preventive measures, and effective treatment. Age-Related Macular Degeneration, or ARMD for short, continues to elude researchers who seek to find a reversible cause, and treatments that will slow the progression or stop it, altogether. The focus has largely been upon finding a chemical substance that when taken over a long period of time, will prevent the condition from developing, progressing, and causing very troublesome vision loss. 

Up to this point, antioxidant vitamins and mineral supplements have been the treatments of choice for delaying the progression of ARMD. I’m not sure why these items were chosen, but that’s the direction in which research has gone. Additionally, lutein, zeaxanthin, zinc, vitamin E, selenium, manganese, resveratrol, and hydroxytyrosol had been taken in various forms as an adjunct to vitamins and minerals in multiple clinical trials.

In these trials, multiple combinations of the available compounds have been studied with mixed results—some good, some not so good. All of these combinations were compared to placebo so it should be assumed the results reported in all instances are compared with placebo. These results from 26 random controlled trials were compiled by family physicians at the Arnett Family Medicine Residency in Lafayette, Indiana, and from their conclusions had made treatment recommendations and guidelines. 

The results from various combinations are reported below:

      1. Antioxidant vitamin and mineral supplements may delay progression of ARMD compared

          with placebo.

      2. Adding docosahexaenoic acid (DHA), lutein, zeaxanthin, resveratrol, hydroxytyrosol to

          the supplements provided NO significant improvement in visual acuity for pts with

          unilateral wet ARMD. 

      3. Adding lutein and zeaxanthin to the supplement formulation may delay progression of

          ARMD compared with placebo.

      4. Zinc supplements decreased the progression to late stage ARMD. 

      5. One study showed vitamin E did not slow progression.

      6. Antioxidant vitamins plus manganese and selenium slowed disease progression.

      7. Antioxidant vitamins plus lutein, zeaxanthin, resveratrol, and hydroxytyrosol slowed

          disease progression in patients with wet ARMD in one eye.

      8. After 10 years, progression to late stage wet ARMD was less likely in the vitamin and

          lutein-zeaxanthin group.

BOTTOM LINE: Antioxidant vitamins, Zinc, lutein, and zeaxanthin combined together delay the progression of wet ARMD, but they do not improve visual acuity in those same patients. It’s like trying to find something that will forever keep you young and avoid one of the many hazards of aging; in this case Age-Related Macular Degeneration. If you have a family history of macular degeneration, it would benefit you to begin taking supplements designed for the prevention of ARMD. Whatever brand you choose, be sure it contains lutein, zeaxanthin, zinc, and vitamin E. It’s not perfect, but it’s certainly better than doing nothing. 

Reference: Alla DA, Gerges L, Philip J, Wirth C. Supplements to Slow Progression of Age-Related Macular Degeneration Am Fam Phys 2025 January;111(1):73-74.