Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 426

There has been considerable study of the potential for micronutrient supplements to slow the progression of established AMD at both early and later stages. A recent Cochrane Review identified 19 RCTs that included studies of MVM supplements, zinc, vitamin E, and lutein and zeaxanthin.²⁵ The MVM supplements in these trials typically contained antioxidant nutrients such as vitamin C, vitamin E, beta‐carotene, lutein and zeaxanthin, and zinc and copper. Nine studies examined MVMs in those with early and moderate AMD, with the result that various AMD‐related outcomes were delayed in the MVM‐treated groups. Six studies examined lutein (with or without zeaxanthin), and there was little to no effect on progression to late AMD and vision loss. Among the five studies that examined zinc, there was evidence that zinc and other antioxidant nutrients (MVM) slow the progression to late AMD and vision loss. The one study that examined vitamin E (without other nutrients) showed no benefit in delaying vision loss. Adverse events were not consistently assessed across these studies. At present, the findings from AREDS and AREDS2 provide much of the evidence for current practices regarding the use of nutrient supplements to delay the progression of AMD.^24,25 As understanding about nutrients and eye disease evolved, the original AREDS formula was modified based on the results of AREDS2 to replace beta‐carotene with lutein and zeaxanthin and to lower the zinc content. The AREDS2 MVM formulation is available commercially.²⁶