Is a balanced diet sufficient, or is nutritional supplementation necessary in AMD?

Age-related macular degeneration (AMD) affects central vision. Evidence shows AREDS/AREDS2 supplements can reduce progression in intermediate AMD, but they neither prevent AMD nor improve vision on their own.

What the evidence says: AREDS & AREDS2

NEI trials conclude that AREDS/AREDS2 reduces the risk of progression from intermediate to advanced AMD by ~25%. AREDS2 replaces beta-carotene with lutein/zeaxanthin, safer for current/former smokers.

Early AMD: diet, follow-up and risk-factor control

In early stages, prioritise an antioxidant‑rich diet (oily fish, leafy greens, colourful produce, EVOO, nuts, avocado) and smoking cessation, without routine supplements if diet is adequate.

Intermediate AMD: when to use AREDS2

For intermediate AMD, combining a healthy diet with AREDS2 supplementation reduces the risk of progression. Typical components include vitamin C, vitamin E, zinc/copper, lutein, zeaxanthin. Individualise with your ophthalmologist.

Advanced AMD: ophthalmic management first

In advanced stages, classic multivitamins show no clear benefit; the priority is specialised ophthalmic care. In selected cases, consider omega‑3 (1–2 g/day) as supportive nutrition under supervision.

Food vs. pills: what to prioritise

Nutrients are generally better absorbed from food than tablets. If maintaining an optimal diet is difficult, AREDS2 may be indicated in intermediate AMD.

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