A single solid study suggests that zinc, or a mixture of zinc and antioxidants can prevent or slow the progression of early macular degeneration. However it is not clear whether the antioxidant portion of this mixture added any additional benefit.
Note that it’s not clear how much the antioxidants in the mixture contributed to the benefits. In fact, there is no convincing evidence that antioxidants alone are effective for preventing or delaying the onset of macular degeneration. A 4-year, double-blind, placebo-controlled trial of 1,193 people with macular degeneration failed to find vitamin E alone helpful for preventing or treating macular degeneration.16 An even larger and longer study, following over 20,000 people for over 10 years, failed to find that beta-carotene alone reduced the incidence of macular degeneration.23 A mixture of beta-carotene, vitamin E, and vitamin C has also failed to prove beneficial.15 And, a review of 3 randomized controlled trials involving a total of 23,099 subjects found no evidence of benefit for vitamin E and beta-carotene.24
As noted above, in one very large study, beta-carotene failed to prove effective for preventing macular degeneration. However, the less well-known carotenoids lutein and zeaxanthin might be more promising.7,8 These carotenoids, principally found in corn and dark green leafy vegetables, are found in high concentrations in the eye. It has been suggested that they may protect the macula from light-induced damage by dyeing it yellow, thereby acting as a kind of natural sunglasses. They also act in the usual antioxidant fashion by neutralizing free radicals.9
Like carotenoids, flavonoids are found in many plants and may offer a variety of beneficial effects. Weak but interesting evidence suggests that bilberry and oligomeric proanthocyanidins (OPCs), both rich in flavonoids, may prevent or treat macular degeneration.11-13
Weak evidence hints that moderate wine consumption might help prevent macular degeneration.14 Similarly weak evidence suggests possible benefit with a low glycemic index diet.19
1. Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS Report no.8. Arch Ophthalmol. 2001;119:1417-1436.
3. Newsome DA, Swartz M, Leone NC, et al. Oral zinc in macular degeneration. Arch Ophthalmol. 1988;106:192-198.
4. Stur M, Tittl M, Reitner A, et al. Oral zinc and the second eye in age-related macular degeneration. Invest Ophthalmol Vis Sci. 1996;37:1225-1235.
5. Seddon JM, Ajani UA, Sperduto RD, et al. Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group. JAMA. 1994;272:1413-1420.
6. Mares-Perlman JA, Brady WE, Klein R, et al. Serum antioxidants and age-related macular degeneration in a population-based case-control study. Arch Ophthalmol. 1995;113:1518-1523.
7. Landrum JT, Bone RA, Kilburn MD. The macular pigment: a possible role in protection from age-related macular degeneration. Adv Pharmacol. 1997;38:537-556.
8. Hammond BR Jr, Wooten BR, Snodderly DM. Density of the human crystalline lens is related to the macular pigment carotenoids, lutein and zeaxanthin. Optom Vis Sci. 1997;74:499-504.
9. Snodderly DM. Evidence for protection against age-related macular degeneration by carotenoids and antioxidant vitamins. Am J Clin Nutr. 1995;62:1448S-1461S.
10. Mares-Perlman JA, Fisher AI, Klein R, et al. Lutein and zeaxanthin in the diet and serum and their relation to age-related maculopathy in the Third National Health and Nutrition Examination Survey. Am J Epidemiol. 2001;153:424-432.
11. Scharrer A, Ober M. Anthocyanosides in the treatment of retinopathies [translated from German]. Klin Monatsbl Augenheilkd. 1981;178:386-389.
12. Lebuisson DA, Leroy L, Rigal G. Treatment of senile macular degeneration with Ginkgo biloba extract. A preliminary double-blind, drug versus placebo study [translated from French]. Presse Med. 1986;15:1556-1558.
13. Caselli L. Clinical and electroretinographic study on activity of anthocyanosides [in Italian; English abstract]. Arch Med Intern (Parma). 1985;37:29-35.
14. Watson V. Wine consumption decreases risk of age-related blindness. Medical Tribune. 1997 June 5.
15. Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled clinical trial of high-dose supplementation with vitamins C and E and beta carotene for age-related cataract and vision loss: AREDS report no. 9. Arch Ophthalmol. 2001;119:1439-1452.
16. Taylor HR, Tikellis G, Robman LD, et al. Vitamin E supplementation and macular degeneration: randomised controlled trial. BMJ. 2002;325:11.
17. Fies P, Dienel A. Ginkgo extract in impaired vision—treatment with special extract EGb 761 of impaired vision due to dry senile macular degeneration. Wien Med Wochenschr. 2002;152:423-426.
18. Richer S, Stiles W, Statkute L, et al. Double-masked, placebo-controlled, randomized trial of lutein and antioxidant supplementation in the intervention of atrophic age-related macular degeneration: the Veterans LAST study (Lutein Antioxidant Supplementation Trial). Optometry. 2004;75:216-230.
19. Chiu CJ, Hubbard LD, Armstrong J et al. Dietary glycemic index and carbohydrate in relation to early age-related macular degeneration. Am J Clin Nutr. 2006;83:880-886.
20. Feher J, Kovacs B, Kovacs I, et al. Improvement of Visual Functions and Fundus Alterations in Early Age-Related Macular Degeneration Treated with a Combination of Acetyl-L-Carnitine, n-3 Fatty Acids, and Coenzyme Q10. Ophthalmologica. 2005;219:154-166.
21. Bartlett HE, Eperjesi F. Effect of lutein and antioxidant dietary supplementation on contrast sensitivity in age-related macular disease: a randomized controlled trial. Eur J Clin Nutr. 2007 Jan 31. [Epub ahead of print]
22. Wimpissinger B, Berisha F, Garhoefer G, et al. Influence of ginkgo biloba on ocular blood flow. Acta Ophthalmol Scand. 2007 Feb 26. [Epub ahead of print]
23. Christen WG, Manson JE, Glynn RJ, et al. Beta-carotene supplementation and age-related maculopathy in a randomized trial of US physicians. Arch Ophthalmol. 2007;125:333-339.
24. Evans J, Henshaw K. Antioxidant vitamin and mineral supplements for preventing age-related macular degeneration. Cochrane Database Syst Rev. 2008;1:CD000253
25. Chong EW, Kreis AJ, Wong TY, et al. Dietary omega-3 fatty acid and fish intake in the primary prevention of age-related macular degeneration: a systematic review and meta-analysis. Arch Ophthalmol. 2008;126:826-833.