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The National Eye Institute is sponsoring a second study – AREDS 2 - to learn more about the impact of high-dose vitamin and mineral supplements on the progression of age-related macular degeneration.

Age-related macular degeneration has early and late forms. The late forms can cause gradual or abrupt central vision loss, and until recently this vision loss was irreversible in most people. These late forms of age-related macular degeneration are estimated to affect over 1.75 million Americans as of 2000; and this number is expected to climb to 3 million by 2020. In 2001, the Age-Related Eye Disease Study (AREDS) brought good news: High-dose vitamin and mineral supplements could help slow the progression of age-related macular degeneration.

Now, the National Eye Institute (NEI) is sponsoring a second AREDS study. Through AREDS 2 the investigators hope to fine-tune the recommended vitamin formulation that was evaluated in the original AREDS and test the potential benefit of other nutrients on age-related macular degeneration.

The first AREDS enrolled almost 5,000 people with age-related macular degeneration between age 50 and 85. Over an average of seven years, participants took: an antioxidant supplement containing high doses of vitamins C and E and beta-carotene, a zinc supplement, both the antioxidants and zinc, or a placebo. Participants at the greatest risk for progression of age-related macular degeneration who took zinc plus the antioxidants had a 25 percent less chance of developing advanced-stage disease.

AREDS 2 will study the effects of three nutrients that weren’t tested in the original study: lutein, zeaxanthin, and omega-3 fatty acids.

Lutein and zeaxanthin are antioxidants called carotenoids that are found in egg yolks and brightly colored fruits and vegetables. Both substances also form the yellow pigment of the macula, the small spot at the center of the retina. This pigmentation helps block a harmful form of sunlight called blue light. Researchers theorize that ingesting lutein and zeaxanthin supplements may build extra protective pigment, which in larger amounts may ultimately lower the risk of age-related macular degeneration.

The Lutein Antioxidant Supplementation Trial (LAST), a yearlong study of 90 age-related macular degeneration patients, suggested that lutein supplements might maintain or slightly improve vision clarity. However, the study was too short to produce reliable data on whether lutein slowed age-related macular degeneration progress. The other new ingredients in the AREDS 2 cocktail are the omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). DHA and EPA may be familiar to you since they are postulated to have cardioprotective properties; they may also keep retinas healthy.

A dietary survey completed by participants in the first AREDS found that people who reported eating the most DHA-rich food (i.e., at least two servings of fish a week) were 40% less likely to have age-related macular degeneration.

AREDS 2 will also examine whether eliminating or reducing certain ingredients from the original AREDS formulation will retain the benefits of the therapy while simultaneously reducing potential risks. One group will take the same vitamins C and E, beta-carotene, and zinc formulation that worked so well in AREDS; a second group will take the original AREDS formulation but with lower levels of zinc; a third group will take the original AREDS formulation without the beta-carotene; and a fourth group will take a variation of the original formulation that contains less zinc and no beta-carotene.

Used with permission. Source: Johns Hopkins Health Alerts, Vision Special Report, posted in Vision, www.johnshopkinshealthalerts.com/reports/vision/, June 20, 2008. For further information, visit www.nei.nih.gov/AREDS2, or call (877) AREDS-80 (877-273-3780).