Retinal Conditions

Dry Age-related Macular Degeneration and
AREDS Supplements

The term “dry” AMD may be confusing because it encompasses a wide range of clinical presentations. Early stage AMD is observed without requiring treatment. Intermediate stage AMD can benefit from vitamin supplementation. Atrophic AMD is an advanced form in which patches of tissue slowly lose function and is often associated with significant vision loss. All of these are considered “dry” forms of the disease. In addition, Wet AMD is sometimes referred to as “dry” when it has been controlled with treatment. Ask your BARA doctor about your stage of AMD. The remainder of this handout focuses on the Intermediate stage of AMD, also called Intermediate high risk dry AMD.

What does it mean to have intermediate dry AMD?

Intermediate dry AMD is defined by deposits under the retina called drusen as well as clumping or alterations in the pigmented layer under the retina.
Vision changes in intermediate dry AMD can include the following:

Decreased visual acuity 
(decreased sharpness of small objects or small print)
Decreased contrast sensitivity (difficulty seeing print without good lighting)
Mild distortion  
(waviness of lines or letters)

While distortion and mildly decreased vision are typical in intermediate dry AMD, these symptoms can also be seen in more advanced stages of AMD. Monitoring your vision regularly can be helpful in identifying progression of AMD. Ask your BARA doctor about ways to monitor your vision. 
Conversely, distortion and decreased visual acuity can also be caused by a number of other common retinal conditions. Your BARA doctor will recommend diagnostics as needed to distinguish AMD from other diseases that may be present.

Some patients with age-related macular degeneration (AMD) will benefit from the use of a vitamin supplement available without prescription and taken by mouth. This supplement reduces the chance of future vision loss for some patients. This supplement does not help all patients with AMD, and it is important to understand who benefits from its use.
In recent years, there has been some debate in the retina community about the benefits of AREDS supplements (discussed below); at this time general consensus supports its use.

What research supports the use of supplements in AMD?

The Age-Related Eye Disease Study (AREDS) was a six-year clinical trial of 3,640 participants aged 55 to 80 years old sponsored by the National Eye Institute. Researchers found that a combination of antioxidants prevented progression of intermediate stage AMD. The study helped identify optimal vitamin formulations for both smokers and non-smokers.
The AREDS 2 Study subsequently followed more than 4,000 participants for 5 years to investigate the relative benefits of several variations on the original formulas. This study identified a single vitamin formulation which provides the maximum benefit to patients regardless of prior smoking history. 

The AREDS supplement did not benefit eyes with early stage AMD or eyes that already had advanced AMD with poor vision. The AREDS supplement is recommended for patients with advanced AMD in one eye if the fellow eye has no AMD or AMD with vision of 20/100 or better. This supplement is not a cure for AMD, nor will it restore vision already lost by AMD.

Bay Area Retina Associates has eight offices around the East Bay region of the San Francisco Bay Area.
For billing and insurance questions, please call  (925) 522-8858 or fax to (925) 938-3697. For appointments, please contact the nearest BARA office directly.