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Eagle Eye Sciences' Age-Related Macular Degeneration Vitamins:

Our AMD supplement is derived from the landmark AREDS study, the ongoing AREDS II study, and the numerous studies on Lutein, Zeaxanthin, and Omega-3s.

Our recommendations are as follows:

Antioxidant Vitamins C & E: Vitamin C and vitamin E have some benefit in slowing the progression of AMD.i

Beta Carotene
: We eliminated beta carotene (vitamin A) completely from the formula. There is no present scientific evidence documenting that beta carotene has any positive effects on AMD. The Physicians’ Health study showed no difference in AMD between those taking a supplement of 50mg of beta-carotene every other day compared to those who did notii. Since we eliminated beta carotene, it is not necessary to pre-screen your patients for smoking.

Zinc: In the AREDS trials, zinc alone and zinc with antioxidants, were shown to slow the progression of AMD. Because zinc is a trace metal and can lead to prostate enlargement in large doses, we lowered the daily amount to an optimal 35mgiii. The AREDSII study also lowered total zinc.

Carotenoids- Lutein and Zeaxanthin:
Lutein and zeaxanthin, primarily found in dark green leafy vegetables, are concentrated in the fovea, and protect the macula from light-induced damage and free radicals. Evidence has shown that 6-30mg/day of Lutein reduces the risk and progression of AMD. A Harvard University study (1994, JAMA 272:1413-20) found that 6 mg of lutein led to a 43 percent lower risk for macular degeneration. A recent study from Australia showed that dietary lutein and zeaxanthin reduced the risk of the development of AMD long-termiv. The LAST study used 10mg of Lutein with antioxidants and recorded actual improvement in several key visual functions among patients with AMDv. A recent study from a group in Milan, Italy (University Eye Clinic, San Paolo Hospital Milan, Milan, Italy, Department of Ophthalmology, University of Brescia, Brescia, Italy) showed that feeding patients diagnosed with AMD a vitamin and antioxidant supplement cocktail, which included 15 mg of lutein for 18 months, resulted in a two-fold improvement in visual acuity relative to the placebo group. Note that Lutein and Zeaxanthin were not used in the AREDSI trial because these nutrients were not yet available in a commercial form.

B12, B6, Folic Acid: A recent double blind placebo study at Harvard Medical School, funded by the NEI, found that women who took the supplements (B12,B6, folic acid) had a 41% lower likelihood of getting macular degeneration, as compared to those in the placebo groupvi.

Omega-3 EPA/DHA: NEI scientists analyzed AREDS dietary data and determined the risk for AMD was significantly reduced for the highest vs. the lowest quintiles of total omega-3 intakevii. In fact, there was a fifty percent reduction in advanced AMD for this groupviii. Recent literature indicates that higher intake of omega-3 fatty acids is associated with decreased likelihood of having wet AMD and reduces the likelihood of a patient advancing from dry to wet AMDix. Omega-3 fatty acids also protect from dry eye syndrome.x




References:
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 i Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS Report No. 8. Arch Ophthalmol. 2001;119(10):1417–1436.

iiChristen WG, Glynn RJ, Ajani UA, et al. Age-related maculopathy in a randomized trial of low-dose aspirin among US physicians. Arch Ophthalmol 2001; 119: 1143-9.

iii http://www.nei.nih.gov/amd/faqs.asp

iv 2. Tan, JSL, Wang, JJ, “Dietary Antioxidants and the Long-term Incidence of Age-Related Macular Degeneration.” Ophthalmology 2008;115-334-341

v Richer S, Stiles W, Statkute L, Pulido J, Frankowski J, Rudy D, Pei K, Tsipursky M, and Nyland J. Double-masked, placebo-controlled, randomized trial of lutein and antioxidant supplementation in the intervention of atrophic Age-Related Macular Degeneration: the Veterans LAST study (Lutein Antioxidant Supplementation Trial), Optometry 2004; 75:216-230.

vi William G. Christen; Robert J. Glynn; Emily Y. Chew; Christine M. Albert; JoAnn E. Manson. Folic Acid, Pyridoxine, and Cyanocobalamin Combination Treatment and Age-Related Macular Degeneration in Women: The Women's Antioxidant and Folic Acid Cardiovascular Study. Archives of Internal Medicine, 2009; 169 (4): 335 DOI: 10.1001/archinternmed.2008.574­

vii http://www.medscape.com/viewarticle/453454

viii SanGiovanni JP, Chew EY, Agron E, et al. The relationship of dietary omega-3 long-chain polyunsaturated fatty acid intake with incident age-related macular degeneration: AREDS report No. 23. Arch Ophthalmol. 2008 Sep;126(9):1274-9. Augood C, Chakravarthy U, Young I, et al. Oily fish consumption, dietary docosahexaenoic acid and eicosapentaenoic acid intakes, and associations with neovascular age-related macular degeneration. Am J Clin Nutr. 2008;88(2):398–406.

ix Arch Ophthalmol.2008;126(6):826-833

x October 2005 American Journal of Clinical Nutrition (82(4): 887-893) Harvard Women's Study Dry Eyes

Additional References:
Am J Clin Nutr Vol 87, No. 5, May 08

Article for no vitamin A http://www.medrounds.org/amd/2008/07/byebyebeta-carotene-say-hello-to.html

Landrum JT, Bone RA, Joa H, Kilburn MD, Moore LL, Sprague KE. “A one year study of the macular pigment: the effect of 140 days of a lutein supplement.”

Exp Eye Res., July, 1997; 65(1):57-62. Seddon JM, Ajani UA, Sperduto RD, Hiller R, Blair N, Burton TC, Farber MD, Gragoudas ES, Haller J, Miller DT, et al.

“Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group.” JAMA, Nov 9, 1994; 272(18):1413-20. Snodderly, D.M.

“Evidence for protection against age-related macular degeneration by carotenoids and antioxidant vitamins.” Am. J. Clin. Nutr., 1995, 62(suppl):1448S-61S. Bagchi D, Bagchi M, Stohs SJ, Das DK, Ray SD, Kuszynski CA, Joshi SS, Pruess HG.

“Free radicals and grape seed proanthocyanidin extract: importance in human health and disease prevention.” Toxicology, Aug 7, 2000;148(2-3):187-97. USDA Human Nutrition Research Center on Aging.

“Can foods forestall aging?” Agricultural Research, February, 1999. Taylor A, Jacques PF, Epstein EM.

“Relations among aging, antioxidant status, and cataract.” Am. J. Clin. Nutr., 1995; 62(suppl):1439S-47S. Rosenthal JM, Kim J, de Monastario F, et al. Dose-ranging study of lutein supplementation in persons aged 60 years or older.

Invest Ophthalmol Vis Sci. 2006;47:5227-5233. Bartlett HE, Eperjesi F.

Effect of lutein and antioxidant dietary supplementation on contrast sensitivity in age-related macular disease: a randomized controlled trial. Eur J Clin Nutr. 2007 Jan 31. [Epub ahead of print]