Dietary interventions for AMD

Have you ever stopped to think about the evidence behind the treatments you offer your patients? 

How do you know that the treatment is right for them? Our Using evidence in practice series sets out a summary of that evidence for you, so that you know that there is a solid foundation behind the recommendations you make. 

There are three Cochrane systematic reviews that have investigated whether nutritional supplements prevent or slow the progression of age-related macular degeneration (AMD). 

Dr Jennifer R Evans and Professor John Lawrenson FCOptom have written an explanation of the evidence behind the use of nutritional supplements to prevent or slow the progression of age-related macular degeneration (AMD).

What you should know

There is no good evidence from randomised controlled trials that the general population should be taking antioxidant vitamin supplements to reduce their risk of developing AMD later on in life.

There is moderate quality evidence that people with AMD may experience a delay in progression by taking specific antioxidant vitamin and mineral supplements. This finding is drawn from one large randomised controlled trial conducted in the USA. The 2018 NICE guideline on the Diagnosis and Management of AMD in Adults does not contain any recommendations on dietary interventions or nutritional supplementation for AMD.

There is an increased risk of lung cancer associated with beta-carotene supplementation in people who smoke. There may be a small increased risk of mortality associated with taking betacarotene and vitamin E supplements.

Although observational studies have shown that the consumption of dietary omega 3 long chain polyunsaturated fatty acids may reduce the risk of progression to advanced AMD, two randomised controlled trials failed to show any benefit of omega 3 supplements on AMD progression.

There is a need for a regularly updated systematic review of the evidence on diet and AMD from good quality prospective cohort studies, where researchers have attempted to control for known confounders, to add to the evidence base for the association between diet and AMD.