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Macular Degeneration

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Related Terms

AMD

Age-related macular degeneration (AMD) is a leading cause of vision loss. It is a deterioration of the central portion of the retina called the macula. The macula is needed to create focused and detailed central vision. Later stages of AMD can make it hard to see fine details. Over time, AMD progresses to legal blindness.

The cause of AMD is not clear. It may result from a combination of genetics and environment. However, smoking is known to increase the risk of AMD.

AMD is classified as:

  • Early—The presence of medium-sized drusen, yellow deposits found under the retina. There are no symptoms at this stage.
  • Intermediate—Large drusen are present. Most people do not have symptoms, but some vision loss may occur.
  • Late—Vision loss and macular damage are present. Macular damage may consist of drusen, growth of new blood vessels, and/or retinal bleeding. These types include:
    • Dry—An area of the retina becomes diseased. The central vision is gradually lost. Dry AMD accounts for the majority of cases.
    • Wet—As dry AMD worsens, new blood vessels may begin to grow. These new blood vessels often leak blood and fluid under the macula. Wet AMD is not common, but it accounts for most cases of blindness from this disease.

There is no cure for AMD, but treatment may help slow its progress. Options include medications, lasers, photodynamic therapy, or surgery.

Natural Therapies

Antioxidant vitamins and minerals may be considered alternative therapy for some conditions. With AMD, they may be part of the overall treatment plan will be covered here. Keep in mind that eating a well-balanced diet with plenty of fruits and vegetables (especially leafy greens) may reduce the risk of developing AMD.

Likely Effective

  • Antioxidants vitamins and minerals —Daily supplements of vitamin C, vitamin E, beta-carotene and zinc may slow visual loss and reduce the risk of progression to more advanced stages in those with at least intermediate disease.A1,A4-A5
    • Note: Supplementation with antioxidants is unlikely to reduce risk of developing AMD.A2-A3
    • Note: High doses of antioxidants and zinc may cause side effects

Possibly Effective

  • Zinc aloneB1
    • Note: High doses of antioxidants and zinc may cause side effects
  • Lutein or zeaxanthin (carotenoids found in concentrated amounts in the macula)—Alone or in combination with antioxidant vitamins and minerals.C1-C5

Unlikely to Be Effective

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about all herbs or supplements you are taking. Some may interact with your treatment plan or health conditions.

In general, antioxidants, vitamins, and supplements are safe when taken as directed. Do not exceed the recommended daily upper intake levels (ULs).

 

References►

Antioxidants

A1. Evans JR, Henshaw K. Antioxidant vitamin and mineral supplementation for preventing age-related macular degeneration. Cochrane Database Syst Rev. 2000;(2):CD000253.

A2. Evans JR, Lawrenson JG. Antioxidant vitamin and mineral supplements for preventing age-related macular degeneration. Cochrane Database Syst Rev. 2012;(6):CD000253.

A3. Christen WG, Glynn RJ, Sesso HD, Kurth T, Macfadyen J, Bubes V, Buring JE, Manson JE, Gaziano JM. Vitamins E and C and medical record-confirmed age-related macular degeneration in a randomized trial of male physicians. Ophthalmology. 2012;119(8):1642-1649.

A4. Chew EY1, Clemons TE, Agrón E, et al. Long-term effects of vitamins C and E, β-carotene, and zinc on age-related macular degeneration: AREDS report no. 35. Ophthalmology. 2013;120(8):1604-1611.

Evans JR, Lawrenson JG. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. Cochrane Database Syst Rev. 2017;7:CD000254.

Zinc

B1. Evans JR, Lawrenson JG. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. Cochrane Database Syst Rev. 2017;7:CD000254.

Lutein and Zeaxanthin

C1. Age-Related Eye Disease Study 2 (AREDS2) Research Group, Chew EY, Clemons TE, et al. Secondary analyses of the effects of lutein/zeaxanthin on age-related macular degeneration progression: AREDS2 report No. 3. JAMA Ophthalmol. 2014;132(2):142-149.

C2. Liu R, Wang T, Zhang B, et al. Lutein and zeaxanthin supplementation and association with visual function in age-related macular degeneration. Invest Ophthalmol Vis Sci. 2014;56(1):252-258.

C3. Huang YM, Dou HL, Huang FF, et al. Changes following supplementation with lutein and zeaxanthin in retinal function in eyes with early age-related macular degeneration: a randomised, double-blind, placebo-controlled trial. Br J Ophthalmol. 2015;99(3):371-375.

C4. Wu J, Cho E, Willett WC, Sastry SM, Schaumberg DA. Intakes of lutein, zeaxanthin, and other carotenoids and age-related macular degeneration during 2 decades of prospective follow-up. JAMA Ophthalmol. 2015;133(12):1415-1424.

C5. Evans JR, Lawrenson JG. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. Cochrane Database Syst Rev. 2017;7:CD000254.

Vitamin E

D1. Taylor HR, Tikellis G, Robman LD, McCarty CA, McNeil JJ. Vitamin E supplementation and macular degeneration: randomised controlled trial. BMJ. 2002;325(7354):11.

D2. Christen WG, Glynn RJ, Chew EY, Buring JE. Vitamin E and age-related macular degeneration in a randomized trial of women. Ophthalmology. 2010;117(6):1163-1168.

D3. Christen WG, Glynn RJ, Sesso HD, et al. Vitamins E and C and medical record-confirmed age-related macular degeneration in a randomized trial of male physicians. Ophthalmology. 2012;119(8):1642-1649.

Omega 3 Fatty Acids (Fish Oil)

E1. Chong EW, Kreis AJ, Wong TY, Simpson JA, Guymer RH. Dietary omega-3 fatty acid and fish intake in the primary prevention of age-related macular degeneration: a systematic review and meta-analysis. Arch Ophthalmol. 2008;126(6):826-833.

E2. Christen WG, Schaumberg DA, Glynn RJ, Buring JE. Dietary ω-3 fatty acid and fish intake and incident age-related macular degeneration in women. Arch Ophthalmol. 2011;129(7):921-929.

E3. Lawrenson JG, Evans JR. Omega 3 fatty acids for preventing or slowing the progression of age-related macular degeneration. Cochrane Database Syst Rev. 2015;(4):CD010015.

Last reviewed February 2019 by EBSCO NAT Review Board Richard Glickman-Simon, MD  Last Updated: 2/22/2019