Lutein + Zeaxanthin and Omega-3 Fatty Acids for Age-Related Macular Degeneration: eInterview with:

Emily Y. Chew, MD
Division of Epidemiology and Clinical Applications
National Eye Institute (NEI)/National Institutes of Health (NIH),
Bethesda, Maryland What are the main findings of the study?

Dr. Chew: For patients who have intermediate age-related macular degeneration (AMD) or those with advanced AMD in one eye, we have recommended a mixture of vitamins and minerals (vitamin C, E and beta-carotene, and zinc oxide and cupric oxide), known as Age-Related Eye Disease Study (AREDS) formulation.  We tested the effects of adding carotenoids, lutein/zeaxanthin, or omega-3 fatty acids or both to the AREDS formulation.  Omega-3 fatty acids did not have any effect on AMD.  Addition of lutein/zeaxanthin provided an additional 10% increase in the reduction of progression to advanced AMD.  In persons with the lowest dietary intake of lutein/zeaxanthin, supplementation with lutein/zeaxanthin provided 25% reduction in rates of developing advanced AMD When we tested lutein/zeaxanthin directly against beta-carotene, the risk of progressing to advanced AMD was reduced by 20%. Furthermore, beta-carotene was found to increase the risk of lung cancer.  To improve the safety and efficacy of the AREDS formulation, we would suggest the elimination of beta-carotene and adding lutein/zeaxanthin.  Omega-3 fatty acids added no further benefit. Were any of the findings unexpected? 

Dr. Chew: As with all clinical trials, we do not know if the treatments will work.  That is the reason for doing the study thus we are not surprised by the results.  It is not surprising that beta-carotene has harmful effects with increased risk of lung cancer given the history of beta-carotene in cigarette smokers. What should clinicians and patients take away from your report? 

Dr. Chew: We have found a safer and more efficacious AREDS formulation by eliminating beta-carotene and replace it with lutein/zeaxanthin.

Omega-3 fatty acids do not have any beneficial or harmful effects on AMD. What recommendations do you have for future research as a result of this study?

Dr. Chew: It would be important to conduct further follow-up to make sure that lutein/zeaxanthin supplementation does not cause adverse effect.


Lutein + Zeaxanthin and Omega-3 Fatty Acids for Age-Related Macular Degeneration: The Age-Related Eye Disease Study 2 (AREDS2) Randomized Clinical Trial.The Age-Related Eye Disease Study 2 (AREDS2) Research Group*.JAMA. 2013 May 5:1-11. doi: 10.1001/jama.2013.4997. [Epub ahead of print]PMID:23644932 [PubMed – as supplied by publisher]


Last Updated on September 19, 2013 by Marie Benz MD FAAD