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DANISH ABDUL ALLA, MD, LOUIS GERGES, MD, JUDITH PHILIP, MD, AND CARRIE WIRTH, MD

Am Fam Physician. 2025;111(1):73-74

Author disclosure: No relevant financial relationships.

CLINICAL QUESTION

Do antioxidant vitamin and mineral supplements slow the progression of age-related macular degeneration (ARMD)?

EVIDENCE-BASED ANSWER

Use of antioxidant vitamin or zinc supplements may delay progression of ARMD compared with placebo. (Strength of Recommendation [SOR]: A, systematic review and meta-analysis.) The addition of docosahexaenoic acid (DHA), lutein, zeaxan-thin, resveratrol, and hydroxytyrosol to the supplements used in the original Age-Related Eye Disease Study (AREDS) provided no significant improvement in visual acuity for patients with unilateral wet ARMD. (SOR: B, multicenter randomized controlled trial [RCT].) Adding lutein and zeaxanthin to the original AREDS supplement formulation may delay progression of ARMD compared with placebo. (SOR: B, prospective cohort study.)

EVIDENCE SUMMARY

In 2023, a systematic review and meta-analysis of 26 RCTs (N = 11,952) compared various antioxidant vitamin and mineral supplements with placebo or no intervention for their ability to slow disease progression in adults 65 to 75 years of age with ARMD.1 The review included participants who had ARMD in one or both eyes and compared outcomes of ARMD progression in groups given vitamin or mineral supplements, alone or in combination, with placebo or no intervention. The supplements included multivitamins and single-component formulations of lutein, vitamin E, and zinc. The length of intervention and follow-up ranged from 6 months to 5 years.

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Help Desk Answers provides answers to questions submitted by practicing family physicians to the Family Physicians Inquiries Network (FPIN). Members of the network select questions based on their relevance to family medicine. Answers are drawn from an approved set of evidence-based resources and undergo peer review. The strength of recommendations and the level of evidence for individual studies are rated using criteria developed by the Evidence-Based Medicine Working Group (https://www.cebm.net).

The complete database of evidence-based questions and answers is copyrighted by FPIN. If interested in submitting questions or writing answers for this series, go to https://www.fpin.org or email: questions@fpin.org.

This series is coordinated by John E. Delzell Jr., MD, MSPH, associate medical editor.

A collection of FPIN’s Help Desk Answers published in AFP is available at https://www.aafp.org/afp/hda.

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