The Effect of Dietary Supplementations on Delaying the Progression of Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis

Nutrients
Q1
Oct 2022
Citations:18
Influential Citations:2
Systematic Reviews / Meta-Analyses
80
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Methods
Systematic review and meta-analysis of randomized controlled trials and cohort studies in adults with diagnosed AMD (early to wet); 20 studies included (5634 participants); mean age range ~55–80 years; eight studies contributed to meta-analyses.
Intervention
Oral dietary supplement regimens including lutein (10–20 mg/day) and/or zeaxanthin (10 mg/day), with or without omega-3 long-chain fatty acids (DHA/EPA); some regimens included zinc with antioxidants (AREDS-type); one trial used a curcumin-based formulation with resveratrol; durations ranged from 6 months to about 24 months (up to 2 years).
Results
Carotenoids overall did not significantly improve BCVA versus controls. Lutein alone showed no significant BCVA gain, but regimens containing lutein and zeaxanthin with n-3 LC-PUFA significantly improved BCVA. Lutein-containing regimens also improved mfERG and increased macular pigment density (MPOD). When lutein plus zeaxanthin were given with n-3 LC-PUFA, BCVA improvement was observed (pooled SMD ≈ -2.0; high heterogeneity). Overall, combinations of carotenoids with n-3 LC-PUFA may offer the most consistent BCVA benefit in early/intermediate AMD; carotenoids alone for durations <1 year show little effect. Evidence for non-carotenoid supplements is limited due to few studies; further standardized trials with well-defined populations are needed.
Limitations
High heterogeneity across studies; small number of trials; diverse supplement formulations and outcome measures; potential confounding factors (ethnicity, BMI, education); incomplete reporting (gender) in some studies; difficulty attributing effects to single nutrients.

Abstract

Purpose: Age-related macular degeneration (AMD) is a neurodegenerative ophthalmic disease. The purpose of this systematic review (SR) and meta-analysis was to evaluate if dietary supplementation alone or in combinations might delay the progression of...