- Age-related macular degeneration (AMD) is an eye disease that may cause
- Abnormal blood
vessels grow underneath the retina which can leak fluid and blood, and
damage the macula, the part of the retina responsible for central vision.
- Treatment with
zinc and copper might be inexpensive, as well as, effective means of slowing down the progression of age-related macular degeneration.
A combination of
antioxidants with zinc and copper might be inexpensive, as
well as, effective means of slowing down the progression of age-related macular degeneration (AMD). The disease
causes irreversible blindness and calls for immediate treatment.
The current methods to treat the disease
are expensive and have an increased risk of side effects. Thus, data from the Age Related
Eye Disease Study (AREDS) was used to develop a complimentary treatment.
‘A daily supplement combining high dose antioxidants and zinc lowered the risk of developing wet AMD in patients with early stage AMD.’
Age related macular degeneration (AMD) Age related macular degeneration
related maculopathy which usually occurs over the age of 50 years, is, the
degeneration of the central part of the retina referred to as the macula.
Neovascular maculopathy is often
referred to as wet or exudative maculopathy. In
wet AMD, detachment, exudation or scarring of retina and abnormal new vessels
originating from the choroid are found. The vessels extend forward through a
defect in Bruch's membrane which is the innermost layer of choroid.
AMD accounts for about 8.7 % of the
and is more common in developed
countries. As the disease is closely related to aging, the number of people
affected may increase as the percentage of aging population increases.
Eighty percent of patients diagnosed with
AMD have the wet type and it accounts for 90% of severe visual loss.
Treatment For AMD
One of the
mechanisms that cause AMD is the release of Vascular
endothelial growth factor (VEGF)
in response to oxygen deprivation in
tissues. It promotes the growth of
new and abnormal blood vessels. These new vessels grow through the breaks in Bruch's
membrane and result in bleeding and protein leak underneath the macula.
The current treatment involved in AMD is
the use of anti-VEGF therapies. They are expensive
drugs and may cause inflammation of the inside of the eye (endophthalmitis) and
Antioxidant Doses For AMD
Two types of supplements were
tested in people with early stage disease in one (category 4) or both (category
The first formulation contained
high doses of vitamins C and E, beta carotene, zinc and copper. The second
formulation had lutein and zeaxanthin instead of beta carotene but other
constituents remained the same.
A daily supplement combining
high dose antioxidants and zinc lowered the risk of developing wet AMD.
Statistical analysis showed that
both formulations are cost effective for treating patients with early stage wet
AMD, but they were more cost effective for those with the condition in just one
Cost Effective -
The research team calculated that the patients in the study would
need nearly eight fewer injections of anti-VEGF therapies into their eye. This
represents a cost saving to the NHS of nearly 3000 pounds per patient, adding
up to around 131 million pounds a year.
Vision For Longer Years
- The patients would live longer without impaired vision compared
to those who did not have the supplements.
"Given the burden and cost
of treatment, prevention of nAMD seems, therefore, an attractive strategy to
avoid the chronic and costly anti-VEG therapies and preserve visual
function," write the researchers.
The scientists believe that the
reduced cost and improved vision can motivate the people with wet AMD in one
eye to take the supplements and stave off vision loss in the second eye.
For those with intermediate
stage wet AMD in both eyes, there would still be savings to be made by giving
supplements. The NHS currently provide funds for the treatment of wet AMD but
the argument for funding those with intermediate stage continues.
"AREDS supplements are a
dominant cost-effective intervention for category 4 AREDS patients, as they are
both less expensive than standard care and more effective, and therefore should
be considered for public funding," they conclude.
- Aaron Y Lee, Thomas Butt, Emily Chew, Elvira Agron4, Traci E Clemons, Catherine A Egan, Cecilia S Lee, Adnan Tufail. Cost-effectiveness of age-related macular degeneration study supplements in the UK: combined trial and real-world outcomes data, British Journal of Ophthalmology (2017). DOI: 10.1136/bjophthalmol-2017-310939