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OSN Retina 150 Survey

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Do you already recommend a supplement formulation that includes lutein and zeaxanthin in patients with macular degeneration?

Perspective

Timothy W. Olsen

I have recommended the AREDS formulation that includes lutein (10 mg) and zeaxanthin (2 mg) without beta carotene for approximately 6 years. This formulation is also referred to as the “smoker’s version” of the AREDS supplement, with rationale based on a Danish meta-analysis that associated a higher mortality when supplements contained either vitamin A or beta carotene supplementation. In addition, lutein and zeaxanthin are associated with a healthy diet and have antioxidant properties. A direct nutritional association was being measured in the macular pigmentation in primate studies. The AREDS2 data confirm the use of these supplements for AMD patients who have high-risk features.

Timothy W. Olsen, MD
Disclosure: Olsen receives no industry support.

Do you or would you recommend supplements that contain omega-3 fatty acids in patients with macular degeneration, even though AREDS2 results do not generally support their use in that population?

Perspective

Timothy W. Olsen

No, not specifically using a supplement for AMD. My recommendation is based on the results of AREDS2. However, I do still recommend eating fish rich in omega-3 (ie, salmon) and, specifically, not deep-fried preparation of the fish (it destroys the omega-3). One should discuss proper food preparation with patients. Grilled or broiled fish, such as salmon, is an excellent dietary source of omega-3 fatty acid. Importantly, the dietary questionnaire survey from AREDS indicated that the highest quartile for dietary intake of omega-3 had an approximately 30% lower risk of developing advanced forms of AMD at 12 years. There is also evidence in the cardiac literature of the benefits of omega-3 for reducing myocardial death by optimizing cardiac conduction. Therefore, I defer supplementation use to the cardiologist.

Timothy W. Olsen, MD
Disclosure: Olsen receives no industry support.