Antioxidants and Eye Disease: AREDS and AREDS2 Trial Results

What AMD is, and why a diagnosis comes first

AMD affects the middle of your vision and usually first affects people in their 50s. The NHS says the exact cause is unknown and it has been linked to ageing, smoking, high blood pressure, being overweight and family history. [2] Only an eye examination can say whether you have AMD and at what stage. These trials are about people with a diagnosed stage, so do not treat this page as a way to decide for yourself.

The two trials in plain terms

The tested formulas (study amounts, not advice)

These are the amounts in the commercially available versions of the formulas the NEI describes. They are amounts used in trials of people with AMD. They are not recommendations for anyone else. [1]

The NEI table notes that copper was added to avoid zinc-related copper deficiency. [1] Official intake levels for zinc, vitamin C and vitamin E are on their own pages: zinc, vitamin C and vitamin E. We did not read an official level for these on this page, so we do not quote one.

What the trials found

• AREDS. People at high risk (intermediate AMD, or advanced AMD in one eye only) who took the combined antioxidants plus zinc and copper had about 25 percent lower risk of advanced AMD and 19 percent lower risk of central vision loss than placebo. None of the formulations decreased cataract risk. [1]
• AREDS follow-up. Among those at highest risk, 34 percent who had taken the AREDS formula progressed to advanced AMD, compared with 44 percent on placebo. [1]
• AREDS2. Adding lutein plus zeaxanthin did not significantly reduce progression to advanced AMD in the main analyses. [3] The NEI reports no additional overall effect from adding omega-3 or lutein plus zeaxanthin, but a small incremental benefit for the formula with lutein plus zeaxanthin in place of beta-carotene. [1]
• Removing beta-carotene or lowering zinc. The NEI says there were no significant changes in effectiveness. [1]
• Ten-year follow-up. The hazard ratio for late AMD was 0.91 for lutein/zeaxanthin versus none (95% CI 0.84 to 0.99). [4]

Independent reviews

A 2023 Cochrane review concluded that moderate-certainty evidence suggests the AREDS-type combination probably slows progression to late AMD. It also said people with intermediate AMD have a higher chance of benefiting than people with early AMD. [5] For lutein/zeaxanthin on its own, the same review found a similar or slightly reduced risk of progression (risk ratio 0.94, 95% CI 0.87 to 1.01), rated low certainty. [5]

What the trials did not show

• Preventing AMD. A 2017 Cochrane review found vitamin E supplements do not prevent the development of any AMD, and beta-carotene did not prevent any AMD. [6] NCCIH adds that antioxidant supplements have not been shown to prevent AMD in people who do not already have it. [7]
• Cataract. The NEI says AREDS and AREDS2 supplements have no effect on cataract. [1] NCCIH cites a 2012 review of nine high-quality studies that found no effect of vitamin E, vitamin C or beta-carotene on cataract. [7]
• People with no or early AMD. AREDS2 excluded them because AREDS data showed no benefit for these individuals. [1]
• Vitamin E alone. The 2017 prevention review said vitamin E may slightly increase the risk of late AMD (risk ratio 1.22, 95% CI 0.89 to 1.67, moderate certainty). [6] The range includes no effect, so read this as uncertainty rather than proven harm.