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Nutritional Supplements for Age-Related Macular Degeneration: A Systematic Review [Internet]

Nutritional Supplements for Age-Related Macular Degeneration: A Systematic Review [Internet]

Evidence-based Synthesis Program - Department of Veterans Affairs (US)

Version: January 2012

RESULTS

We reviewed 4,335 titles and abstracts from the electronic search, and identified 22 additional references through manual searching of reference lists or from input from technical advisors.

EXECUTIVE SUMMARY

Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss in the developed world. In 2004, AMD affected 1.75 million persons in the United States, a number that is expected to rise to nearly 3 million by 2020 due to the aging of the population.

DISCUSSION

We conducted a systematic review of the benefits and harms of nutritional supplements for treatment of AMD. We found good evidence mainly from one large RCT that supplementation with carotenoids and antioxidants decreased the risk of functional vision loss among patients with Category 3 or 4 AMD. One smaller RCT also found zinc supplementation may decrease the risk of clinically significant visual loss among patients with Category 3 or 4 AMD, but six other RCTs found no clinically significant benefit from nutritional supplements in AMD patients. The effects of carotenoids or omega-3-fatty acids alone have not been well-studied.

INTRODUCTION

Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss in the developed world. In 2004, AMD affected 1.75 million persons in the United States, a number which is expected to rise to nearly 3 million by 2020 due to the aging of the population. AMD is characterized by the appearance of involutional changes (e.g. drusen) in the structure of the central retinal pigment epithelium (RPE) leading to the loss of normal central (macular) vision. AMD can be categorized as dry (non-exudative) or wet (exudative). Dry AMD represents the great majority of AMD patients (90%) and may lead to slow visual loss over many decades, with the most severe cases developing geographic atrophy and profound loss of central vision. Dry AMD can progress to wet AMD with the development of neovascularization beneath the diseased RPE leading to hemorrhage, scarring, and the devastating loss of macular vision over a period of months.

METHODS

In patients with age-related macular degeneration, do nutritional supplements containing carotenoids, antioxidants, or omega-3 fatty acids alone or in combination prevent functional visual loss?

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