Patients who are at risk or who have early signs of age-related macular degeneration should take high dose zinc and antioxidants with possible further supplementation with lutein, zeaxanthin, fish oil and selenium if dietary intake of these is inadequate.
Over the past 12 years the public’s awareness of age-related macular degeneration (AMD) has increased from 5% to 85%. Along with this has come an increasing awareness of the importance of diet and nutritional supplements in preventing or slowing disease progression. Increasingly we are being asked, ‘what vitamins should I take for my macula, doctor?’
Our advice is driven primarily by the appearance of the early signs of AMD: soft drusen and focal pigment changes in the retina (Figure). Soft drusen are yellow deposits of 125 micrometres or more in diameter in the macula and indicate a significant risk of progression to ‘wet’ (i.e. neovascular) or ‘dry’ (i.e. geographic atrophy) AMD and loss of vision. Patients with these signs are the patients for whom dietary and lifestyle advice and possibly nutritional supplements are important to reduce their risk of losing vision.
Free radical damage – oxidation – plays a major role in the genesis of AMD. All of the dietary and lifestyle advice and the nutritional supplementation shown to be of benefit for patients with AMD can be related to protecting the retina from free radical damage.