Category: Macular Degeneration

Vitamins for Macular Degeneration

There’s a lot of confusion about which vitamins are recommended for macular degeneration. The National Eye Institute has sponsored two studies over the past twenty years. The Age-Related Eye Disease Study (AREDS) concluded in 2001 and the AREDS2 study culminated in 2013.

AREDS

The initial Age Related Eye Disease Study involved over 3600 patients, all of whom had at least early stages of macular degeneration. Patients without any evidence of macular degeneration (AMD) in either eye were not included.

AREDS was designed to determine the risk factors and progression of AMD and cataracts by testing the effects of high doses of anti-oxidants and zinc on the course of the disease.

The results of AREDS found that;

  • Patients at high risk for developing advanced macular degeneration reduced the risk of developing advanced macular degeneration by 25% when taking the AREDS formulation.
  • Beta-carotene, an anti-oxidant included in the original formulation, was associated with an increase in lung cancer in patients who smoked.
  • There was no effect on the development of cataract.

AREDS 2

The AREDS 2 study was designed to determine if the original AREDS formulation could be improved by substituting lutein and zeaxanthin for beta-carotene and testing the effects of omega-3 fatty acids.

While the results did not show any benefit for those taking lutein and zeaxanthin, there was some evidence that these two anti-oxidants were beneficial in certain groups. AREDS 2 also determined that the removal of beta-carotene was not harmful, and, thus was a good formulation for smokers.

Omega-3 fatty acids has no known effect on the development or progression of AMD.

Vitamins for AMD

The two studies successfully identified an effective and safe formulation for those patients requiring the supplement.

It should be noted that the vitamins have been proven to reduce the chances of developing advanced macular degeneration in only those patients with intermediate or advanced risk factors (based upon the results of a dilated eye examination by your doctor) and who have the diagnosis of macular degeneration. In other words, the vitamins may prevent vision loss by about 25% in those at high risk.

The vitamins do NOT help patients regain lost vision from macular degeneration.

If you are considering your need for taking the AREDS 2 formulation, consult with your eye doctor or retina specialist.

Beovu | New Treatment ARMD

This new FDA approved drug for wet macular degeneration requires fewer injections.

The FDA recently approved another intravitreal injection for the treatment of wet-ARMD. Beovu (brolucizumab) is an anti-VEGF medication which may be useful for extending the frequency of injections in patients requiring multiple treatments.

The FDA found that Beovu may be useful in the treatment wet macular degeneration and offers an extended 3 month dosing schedule.

Anti-VEGF Medications

Other anti-VEGF medications for the treatment of wet macular degeneration include:

  • Avastin
  • Lucentis
  • Eylea
  • Macugen

Wet macular Degneration

There are two forms of macular degeneration: wet and dry. The dry form accounts for about 90% of patients with macular degeneration. Symtoms of distortion, blind spots and blurry vision are less so than the “wet” counterpart.

Wet macular degeneration accounts for the other 10% of ARMD patients. Wet macular degeneration is more aggressive and causes more pronounced and quicker loss of vision.

Wet macular degeneration occurs with the development of abnormal blood vessels growing within the layers of the retina. The abnormal blood vessels, aka neovascularization, are stimulated by a protein called Vascular Endothelial Growth Factor (VEGF).

anti-VEGF medications, like Beovu, work by neutralizing the VEGF protein making it ineffective. As a result, the neovascularization regresses and can not be stimulated to grow.

Timing of Injections

All the anti-VEGF medications work in similar fashion and share similar results. In addition, the dosing schedule of all the anti-VEGF injections usually ranges between every 4-6 week dosing (a shot every 4-6 weeks).

Beovu was compared to Eylea to gain FDA approval. Beovu may have the advantage of achieving similar results (non-inferior) to Eylea, but may be given once every 3 months compared to monthly injections.

FDA approval usually only gives the retina specialist guidance or suggestions on a drug’s use. Though dosing is approved for every 3 months, it does not necessarily mean that a retina specialist will find this necessarily true in practice.

Most retina specialists will slowly try the new drug and determine for ourselves which type of patients will derive the most benefit in terms of treatment efficacy and dosing.

If you would like to schedule an appointment, please call us (877) 245.2020.

Nader Moinfar, M.D., M.P.H.
Retina Specialist
Orlando, FL

Jon Doe