Photo Credit: bit245

The following is a summary of “Oral Antioxidant and Lutein/Zeaxanthin Supplements Slow Geographic Atrophy Progression to the Fovea in Age-Related Macular Degeneration,” published in the January 2025 issue of Ophthalmology by Keenan et al. 

Researchers conducted a retrospective study to specify oral micronutrient supplementation which slows the progression of geographic atrophy (GA) in age-related macular degeneration (AMD).  

They executed analysis of the Age-Related Eye Disease Study (AREDS) and AREDS2, multicentre randomized placebo-controlled trials of oral micronutrient supplementation, each with a 2 × 2 factorial design. A total of 392 eyes (318 participants) with GA in AREDS and 1,210 eyes (891 participants) with GA in AREDS2 were included. In AREDS, participants were randomly allotted to oral antioxidants (500 mg vitamin C, 400 IU vitamin E, 15 mg β-carotene), 80 mg zinc, combination, or placebo whereas in AREDS2, individuals were randomly assigned to 10 mg lutein/2 mg zeaxanthin, 350 mg docosahexaenoic acid/650 mg eicosapentaenoic acid, combination, or placebo. Consenting AREDS2 participants were also randomly assigned to alternative AREDS formulations: original, no beta-carotene, 25 mg zinc instead of 80 mg, or both.  

The results showed that in AREDS, eyes with noncentral GA (n = 208) progressed slower towards the central macula with antioxidants (50.7 μm/year; 95% CI, 38.0–63.4 μm/year) compared to no antioxidants (72.9 μm/year; 95% CI, 61.3–84.5 μm/year; P = 0.012). In AREDS2 eyes with noncentral GA, in participants assigned to AREDS antioxidants without β-carotene (n = 325), progression was slower with lutein/zeaxanthin (80.1 μm/year; 95% CI, 60.9–99.3 μm/year) compared to no supplementation (114.4 μm/year; 95% CI, 96.2–132.7 μm/year; P = 0.011). In AREDS, eyes with any GA (n = 392), area-based progression did not significantly differ between antioxidants and no antioxidants (P = 0.63). In AREDS2, eyes with any GA (n = 505) did not show significant area-based progression differences between lutein/zeaxanthin and no supplementation (P = 0.64).  

Investigators concluded the oral micronutrient supplementation might have slowed the progression of GA towards the central macula by potentially enhancing the natural phenomenon of foveal sparing. 

Source: sciencedirect.com/science/article/abs/pii/S0161642024004251