Mukhtar Sabrina, Ambati Balamurali K
University of Pittsburgh Medical Center, 203 Lothrop Street, Pittsburgh, PA, 15213, USA.
Pacific Clear Vision Institute, 112 Darlene Lane, Eugene, OR, 97401, USA.
Int Ophthalmol. 2019 Dec;39(12):2975-2983. doi: 10.1007/s10792-019-01140-6. Epub 2019 Jul 16.
To describe and evaluate the value of nutritional supplements in the management of age-related macular degeneration (AMD) through a review of the current literature.
An extensive literature search was performed, and key research articles exploring AREDS and AREDS-2 formulations, genetics, omega fatty acids, calcium and folic acid in high-risk women were reviewed. PubMed and Web of Science databases were used for generating articles to review.
The AREDS and AREDS-2 trials, while difficult to validate, show support for antioxidant supplementation in reducing AMD progression in Caucasian populations. While genetic guided personalized medicine has been studied mainly with complement factor H and age-related maculopathy susceptibility 2 risk alleles, the data have not been reproducible. Women at a higher risk of cardiovascular disease may benefit from antioxidant therapies in preventing AMD. Omega 3 fatty acid supplementation has been widely supported through observational studies; however, randomized controlled trials have not shown benefit in disease progression. Calcium exposure has been linked to increased mechanisms in cell death and may be detrimental to older individuals with AMD.
The data regarding nutritional supplements in preventing AMD progression are inconclusive, and therefore recommendations should be based on risk factors and demographic data.
通过回顾当前文献,描述并评估营养补充剂在年龄相关性黄斑变性(AMD)管理中的价值。
进行了广泛的文献检索,并对探索年龄相关性眼病研究组(AREDS)和AREDS-2配方、遗传学、ω脂肪酸、高危女性中的钙和叶酸的关键研究文章进行了综述。使用PubMed和科学网数据库来生成待综述的文章。
AREDS和AREDS-2试验虽然难以验证,但显示补充抗氧化剂对降低白种人群中AMD的进展有支持作用。虽然基因导向的个性化医疗主要针对补体因子H和年龄相关性黄斑病变易感性2风险等位基因进行了研究,但数据尚未得到重复验证。心血管疾病风险较高的女性可能从抗氧化剂疗法预防AMD中获益。通过观察性研究,ω-3脂肪酸补充剂得到了广泛支持;然而,随机对照试验并未显示其对疾病进展有益处。钙暴露与细胞死亡机制增加有关,可能对患有AMD的老年人有害。
关于营养补充剂预防AMD进展的数据尚无定论,因此建议应基于风险因素和人口统计学数据。