The Age-Related Eye Disease Study (AREDS) was an 11-centre, double-masked, clinical trial that in 2001 found a high-dose of antioxidant vitamins plus zinc was effective in protecting against progression of age-related macular degeneration (AMD) in patients with moderate to high risk of progression to advanced AMD. The outcomes from the surviving 4,203 trial participants (over an average follow-up period of 6.3 years) showed that combined treatment with high dose antioxidants (vitamin C 500 mg, vitamin E 400 IU and beta-carotene 15mg) and zinc reduced the risk of progression to advanced AMD in comparison to placebo. Of the participants, 3,549 subsequently agreed to additional follow-up to 2005, thus giving a total of 10 years of follow-up. This follow-up study found that the beneficial effects of antioxidants plus zinc persisted for those originally randomised to them. Additionally, these patients also had a reduced risk of moderate and severe vision loss. No serious long-term adverse effects were found. However, it was interesting that patients randomised to zinc had a significant reduction in mortality, but the reasons for this remains unclear. The results from this study reaffirm the long-term beneficial effects of the AREDS formulation in patients with intermediate AMD or advanced AMD in one eye. 

Long-term effects of Vitamins C and E, ß-Carotene, and zinc on age-related macular degeneration. AREDS Report No. 35.
Chew EY, Clemons TE, Agron E, et al.
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Brian Ang

Royal Victorian Eye and Ear Hospital, Melbourne, Australia

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