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For aging eyes, vitamins

THE HEALTHY SKEPTIC

Antioxidant supplements really can slow macular degeneration, the main cause of severe vision loss.

May 14, 2007|Chris Woolston | Special to The Times

The product: Eye supplements are a hot topic of conversation in Kerry Beebe's optometry office in Brainerd, Minn., right up there with the weather and Frances McDormand trivia. "We field questions about vitamins multiple times a day," says Beebe, chairman of the Clinical Care Group for the American Optometric Assn.

Patients mainly want to know if vitamins can help save them from macular degeneration, the leading cause of severe vision loss in America. About 13 million Americans -- mostly people older than 60 -- already have macular degeneration, a disease that breaks down the light-sensitive rods and cones in the center of the retina. Over time, it can blur a person's central field of vision, making tasks such as reading or driving impossible. Treatment options are limited, so it's no wonder many people are interested in vitamins, Beebe says.

Drugstores across the country offer an array of eye supplements, but the market is dominated by Bausch & Lomb products such as PreserVision and several varieties of Ocuvite, including Ocuvite Adult 50 +. All of the Bausch & Lomb supplements combine zinc with large doses of antioxidant vitamins.

PreserVision is especially packed with antioxidants: Two pills (the suggested dose) contain more than 1,000% of the recommended daily allowance of vitamin E and nearly 600% the RDA of beta carotene. The various forms of Ocuvite contain a pigment called lutein but omit beta carotene, a vitamin that can be dangerous to smokers. Ocuvite Adult 50 + combines lutein with omega-3 fatty acids.

Users are instructed to take two pills of PreserVision or one Ocuvite Adult 50 + each day. Prices vary, but a foray into the vitamin aisle found a one-month supply of PreserVision selling for $18. A one-month supply of Ocuvite Adult 50 + costs about $10.

The claims: John Stewart, senior product manager for vitamins at Bausch & Lomb, says there's "gold-standard clinical evidence" that PreserVision and Ocuvite products can slow down macular degeneration.

The evidence comes from the National Eye Institute's Age-Related Eye Disease Study, or AREDS, published in 2001. The six-year study of more than 3,600 people with mild-to-moderate macular degeneration found that the formula in PreserVision slowed vision loss by about 25%. Supplements also cut the risk by about 25% of moderate cases progressing to a more severe form.

Bausch & Lomb has trumpeted the results since. The "AREDS" name is displayed prominently on bottle labels and the Bausch & Lomb website, and labels for PreserVision and varieties of Ocuvite feature the words "clinically proven."

Bottom line: In this case, the "clinically proven" label actually fits, Beebe says. Thanks to AREDS, he says, most eye doctors think that antioxidant supplements really can put the brakes on the disease. "The study had a lot of credibility."

The biology makes sense too, he adds. As he explains, antioxidants should help "gobble up" waste products in the retina. "If we can keep those waste products away, we can keep the rods and cones functioning."

Beebe recommends PreserVision or Ocuvite products to his patients with macular degeneration. Smokers should take Ocuvite Adult 50 + or another variety that contains lutein instead of beta carotene, he says. There's growing evidence that the lutein and omega-3s in Ocuvite Adult 50 + can help slow macular degeneration, he says, but the definitive study -- AREDS II -- is just getting started.

Patients in their 40s and beyond who want to prevent macular degeneration should also consider taking supplements, Beebe says, although "there's no guarantee it will work."

Dr. David Sarraf, an ophthalmologist at UCLA's Jules Stein Eye Institute, also recommends supplements (including less-expensive store brands) to patients, "but I'm not fanatical about it," he says.

Benefits documented by the AREDS trial were fairly modest -- enough to make supplements worth considering, he says, but not enough to make them a can't-miss part of treatment.

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