Macular Degeneration Treatment
Age-Related Eye Disease Study Results
Q. Who should take the combination of antioxidants
and zinc like those used in the Age-Related Eye Disease
People who should consider taking the combination of
antioxidants plus zinc include those who are at high
risk for developing advanced AMD. These people are
defined as having either:
Intermediate AMD in one or both eyes.
Intermediate AMD is defined as the presence of
either many medium-sized drusen or one or more large
Advanced AMD in one eye, but not the
other eye. Advanced AMD is defined as either a
breakdown of light-sensitive cells and supporting
tissue in the central retinal area (advanced dry
form), or the development of abnormal and fragile
blood vessels under the retina (wet form) that can
leak fluid or bleed. Either of these forms of
advanced AMD can cause vision loss.
Q. How do I know if I have AMD and the stage it is
Your eye care
professional can tell you if you have AMD -- and its
level of development -- through an eye exam in which
drops are placed in the eyes to dilate the pupils. This
allows for a careful examination of the inside of the
Q. I am already taking daily vitamins. Should I
stop taking these vitamins if I am advised to take the
combination of antioxidants plus zinc evaluated by the
Age-Related Eye Disease Study?
People with intermediate AMD in one or both eyes, or
those with advanced AMD in one eye only, and who are
advised to take a formulation like those used in the
AREDS, should review the supplements they are taking
with their primary care doctors and/or eye care
professionals. In addition to their study medication,
most of the participants in the AREDS took a
multivitamin that contained the approximate recommended
dietary allowance of most vitamins and minerals. Some
multivitamin supplements are available that remove the
compounds in AREDS vitamins, and are therefore
complementary. One example is
Q. How do people obtain the formulation in the
dosages used by the AREDS researchers? Will it be
available in tablet form in drug stores?
Bausch & Lomb, an eye care company, was a collaborator
in the AREDS and provided the study formulation. The
company markets the formulation used in the AREDS,
Ocuvite Preservision; other companies provide similar
formulations. Some examples are
Antioxidant vitamins and zinc can also be purchased
separately; however, consumers should discuss the use of
these high levels of
minerals with their doctors, and be certain to
include copper whenever taking high levels of zinc.
Q. Will the formulation come in three forms:
"antioxidants plus zinc," "zinc alone," and
"antioxidants alone?" How will I know what to take?
Those who are advised by their primary care doctors to
take the AREDS' "zinc alone" or "antioxidant alone"
formulations, as well as those who choose to purchase
the "antioxidants plus zinc" formulation from another
manufacturer, should compare the labels of those
products with the AREDS formulations. Antioxidant and
zinc formulations can also be purchased separately;
however, consumers should discuss the use of these high
levels of vitamins and minerals with their doctors, and
be certain to include copper whenever taking high levels
of zinc. Your primary care doctor can help you determine
which formulation and dose is best for you.
Q. Are there reasons older people, in particular,
should be cautious in supplementing their diets with the
nutrients and doses used in the AREDS?
Yes. There are reasons to be cautious in using high-dose
vitamins and minerals, particularly among older people.
Many older Americans take prescription medications, and
a considerable number use over-the-counter drugs,
dietary supplements, and herbal medicines. High-dose
nutrients can interfere with medications and interact
with other nutrients to decrease the nutrients'
absorption into the body. This can ultimately affect a
person's nutritional and health status. For example, the
zinc concentration in the AREDS formulation is at a very
high dose and could cause copper deficiency anemia. To
prevent this, copper was added to the AREDS formulation.
People who are being treated for chronic diseases such
as cancer, heart disease, and diabetes should not take
high dose nutrients without talking with their doctors.
Generally, self-medication with high doses of vitamins
and minerals -- such as those in the AREDS formulation
-- is not recommended. Individuals who are considering
taking the AREDS formulation should discuss this with
their primary care doctors and/or eye care
professionals. They can help you determine which
formulation and dosages are best for you.
Q. If I have been diagnosed with early AMD, should
I take the nutrients to help prevent disease progression
to the intermediate stage?
There is no apparent need for those diagnosed with early
AMD to take the nutrients studied in the AREDS. This is
because the study did not demonstrate that the nutrients
provided a benefit to those with early AMD. Many people
with early AMD progressed to intermediate AMD during the
study, and the AREDS formulation did not seem to slow
this progression. However, if you have early AMD, a
dilated eye examination every year can help determine
whether the disease is progressing.
Q. How long will I have to take the nutrients?
The AREDS researchers followed participants for an
average of 6.3 years (with a maximum of eight years), so
the effectiveness of the nutrients beyond this time is
Q. What are the side effects from the AREDS
The AREDS participants reported few side effects from
the treatments. About 7.5 percent of participants
assigned to the zinc treatments -- regardless of whether
they were the "antioxidants plus zinc" or "zinc alone"
treatment -- experienced genitourinary problems that
required hospitalization. Some of these problems
included urinary tract infections, kidney stones,
incontinence, and enlarged prostate. This compares with
five percent of participants who did not have zinc in
their assigned treatment that experienced the same
genitourinary problems. Participants in the two groups
that took zinc also reported anemia at a slightly higher
rate; however, testing of all patients for this disorder
showed no difference among treatment groups. Yellowing
of the skin, a well-known side effect of large doses of
beta-carotene, was reported slightly more often by
participants taking antioxidants.