Retina and AMD · Nutrition evidence
AREDS2 Supplement Guide what the trials showed and who qualifies.
Two National Eye Institute trials define which AMD patients benefit from high-dose supplements and which formula they should take. This guide condenses the evidence into a chairside protocol, then points you to the product shelf.
Quick answer
Intermediate AMD or one-eye late AMD.
AREDS found that a high-dose antioxidant, zinc and copper formula cut progression to advanced AMD by 25 percent in people with intermediate AMD or late AMD in one eye. AREDS2 then replaced beta-carotene with lutein and zeaxanthin. People without those findings were not shown to benefit, so the exam, not the patient request, decides who starts.
Key takeaways
- AREDS enrolled 4,757 people aged 55 to 80 and followed them for 5 years.
- The full formula lowered progression to advanced AMD by 25 percent and central vision loss by 19 percent.
- AREDS2 enrolled 4,203 people at 82 sites and tested lutein, zeaxanthin and omega-3s.
- Omega-3s added no benefit; lutein and zeaxanthin safely replaced beta-carotene.
- Current and former smokers should take the AREDS2 formula, never the original.
The AREDS2 formula, ingredient by ingredient.
Daily amounts as published by the National Eye Institute.
Vitamin C
500 mg a day, unchanged from the original AREDS formula.
Vitamin E
400 IU a day, unchanged from the original formula.
Zinc and copper
Zinc 80 mg with copper 2 mg. AREDS2 also tested a lower zinc dose and saw no significant change in effect.
Lutein and zeaxanthin
Lutein 10 mg and zeaxanthin 2 mg, added in AREDS2 in place of beta-carotene.
Beta-carotene
Removed. Former smokers on beta-carotene had more lung cancers, and removing it cost no measurable benefit.
Omega-3s
Tested in AREDS2 and found to add no effect on progression to advanced AMD.
Who qualifies, from the exam.
Map each AMD stage to the action the evidence supports.
| Exam finding | Supplement evidence | What to do |
|---|---|---|
| No AMD or early AMD only | No benefit shown in AREDS | Diet, smoking cessation and routine monitoring |
| Intermediate AMD in one or both eyes | AREDS2 formula lowers risk of progression | Start the AREDS2 formula and document the stage |
| Late AMD in one eye | Formula may slow AMD in the fellow eye | Start the formula and monitor the fellow eye closely |
| Late AMD in both eyes | Not the population the trials were built to protect | Retina care plus low vision support |
| Current or former smoker | Beta-carotene linked to more lung cancers | AREDS2 formula only |
Ten-year AREDS follow-up found that those originally assigned the formula were 25 to 30 percent less likely to develop advanced AMD than placebo recipients. Use that number to set expectations: the goal is a lower chance of progression over years of daily use, not better vision next month.
RescueLink
Keep the daily supplement daily.
The trials only help patients who keep taking the formula. Send the exact product through RescueLink with refills on auto-ship, and the practice earns a 15% participation credit on eligible OTC orders placed on VisionRescue.com.
- One-tap ordering for the patient
- Auto-ship keeps the supply continuous
- The recommendation stays with your practice
- No setup fee or quota
Frequently asked questions
Should every patient over 55 take AREDS2?
No. The benefit was shown for intermediate AMD and for late AMD in one eye. People without those findings were not shown to benefit.
What is the difference between AREDS and AREDS2?
AREDS2 removes the 15 mg of beta-carotene and adds lutein 10 mg and zeaxanthin 2 mg. Vitamin C, vitamin E, zinc and copper stay the same.
Why do smokers need the AREDS2 version?
Former smokers taking beta-carotene had a higher rate of lung cancer in the trials, and the NEI advises current and former smokers to avoid the original formula.
Do omega-3s help AMD?
Adding omega-3s to the AREDS formula had no overall effect on progression to advanced AMD in AREDS2.
Is a lower zinc dose acceptable?
AREDS2 tested a lower zinc dose and found no significant change in effectiveness. Some formulas use 25 mg; check the label.
Does the formula prevent cataracts?
No. None of the AREDS formulations reduced cataract risk.
References
- National Eye Institute. About AREDS and AREDS2. NEI
- AREDS2 Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration. JAMA. 2013;309(19):2005-2015. PubMed
- National Eye Institute. Age-related macular degeneration. NEI
- Every source used across these guides is listed on the Vision Rescue sources page.
About this guide
Written for licensed eye care practices by the Vision Rescue team. Questions: providers@visionrescue.com or 1-855-692-8024.
Important notes and disclosures
Information only, not clinical advice. Supplement statements have not been evaluated by the Food and Drug Administration, and these products are not intended to diagnose, treat, cure, or prevent any disease. Use each product according to its current label. Clinical decisions rest with the treating eye doctor.
Stock the formula the trials support.
Compare AREDS2-based formulas, carotenoids and eye multivitamins at wholesale, and route refills through RescueLink.