Eye Blog

Date: 29/10/2016
Category: Nutritional Supplements
Tags: Lutein, Omega 3, Macular Degeneration

I was recently asked to comment on the feasibility of keeping nutritional supplements for macular degeneration drug on the NHS formulary. Its removal would mean that it would no longer be available on prescription. I was told that there was no clear evidence of its usefulness and it would save the NHS money.

This is how I responded:
'The drug Preservision Lutein is clearly supported by evidence from the AREDS trial which is considered to be landmark trial of its kind. It enrolled 4757participants and the key finding was that in patients with a high risk of developing advanced macular degeneration there was a 25% reduction in moderate vision loss over a 5 year period.

Wet macular degeneration is the commonest cause of blindness in the elderly population of the UK and the disease has a significant public health and socio-economic impact. The annual cost of the AREDS drug per patient is £180, the annual cost of treating wet macular degeneration with anti-VEGF therapy is significantly higher (approx £4000 in drug costs alone for treating one eye of a patient for one year). A healthy diet while advisable cannot provide the recommended levels of vitamins and anti-oxidants.'

In lay terms, the use of Preservision Lutein or any other AREDS drug, will reduce your risk of developing wet macular degeneration if you have certain high risk clinical features. These features are best assessed by a retinal specialist. Recent reports from the AREDS 2 study confirm that the protective effect lasts for up to 10 years.

For further information look up https://www.nei.nih.gov/areds2/ This leaves us with one final question: What is the role of omega 3 fatty acids in the management of wet macular degeneration?
The AREDS 2 study found no additional benefit to adding omega 3 fatty acids to the formulation.