AREDS2 Study: Which Supplements Really Help for AMD

Why Supplementation for AMD?

Age-related macular degeneration is a disease in which oxidative stress plays a central role. The macula—the area of the retina responsible for sharp, central vision—is particularly susceptible to damage from free radicals due to its high metabolic activity and constant light exposure. These reactive oxygen species are byproducts of normal cell metabolism but are exacerbated by factors like UV radiation, smoking, and increasing age. Over time, they can damage the sensitive cells of the macula and contribute to the progression of AMD.

Antioxidants—substances that can neutralize free radicals—therefore play a crucial role in protecting the retina. Certain carotenoids like lutein and zeaxanthin are of particular importance as they naturally accumulate in the macula, acting as a kind of biological light filter. They absorb high-energy blue light and protect the underlying photoreceptors from oxidative damage. This insight led to the question of whether targeted supplementation with antioxidants and minerals could influence the course of AMD—a question systematically investigated by the National Eye Institute (NEI) in the US in two large-scale clinical trials.

Beyond Supplementation: Complementary Therapeutic Approaches

AREDS2 supplementation is an important component in managing dry AMD, but it is not the only one. The basic therapy for dry AMD includes lifestyle adjustments in addition to supplementation: a balanced, vegetable-rich diet with regular fish consumption, strict avoidance of smoking, UV protection with suitable sunglasses, and regular ophthalmological check-ups. These measures form the foundation upon which all other therapeutic approaches are built.

In recent years, Photobiomodulation (PBM) has emerged as a promising complementary therapy that goes beyond mere supplementation. PBM involves irradiating the retina with defined wavelengths in the red and near-infrared parts of the light spectrum. At a cellular level, this stimulates the mitochondria—the powerhouses of the cells—potentially improving the energy supply to damaged retinal cells and triggering anti-inflammatory processes. Clinical trials like the LIGHTSITE series have shown improvements in visual acuity and contrast sensitivity in patients with intermediate dry AMD.

In Germany, PBM is currently being scientifically investigated as part of the nationwide MACULIGHT study—for the first time also for home use. This approach could meaningfully complement AREDS2 supplementation as it is based on a different mechanism of action: while supplementation reduces oxidative stress, PBM aims to improve cellular energy production.

Conclusion: Evidence Over Promises

The AREDS2 study has created a clear, evidence-based foundation for the question of which supplements actually provide a benefit for AMD. The answer is nuanced: for patients with intermediate AMD, daily intake of the AREDS2 formula—Vitamin C, Vitamin E, zinc, copper, lutein, and zeaxanthin in the defined dosages—can significantly reduce the risk of progression to advanced AMD. No additional benefit was demonstrated for omega-3 fatty acids as a supplement, and supplementation is not indicated for patients with early AMD.

Do not be misled by exaggerated advertising claims. No supplement can cure AMD or restore vision. What the AREDS2 formula can demonstrably do is slow the progression of the disease—and for a chronic, progressive condition like AMD, that is a significant gain. Talk to your ophthalmologist about whether AREDS2 supplementation is appropriate for your individual stage of the disease, and pay attention to the exact composition of the formula when purchasing.

Research into the treatment of dry AMD is constantly evolving. Alongside the proven AREDS2 supplementation, new therapeutic approaches such as Photobiomodulation and complement inhibitors are being investigated in clinical trials. Stay informed, take advantage of regular check-ups with your ophthalmologist, and supplement this with daily self-monitoring using the Amsler grid self-check. This way, you give your vision the best possible support.

Sources and Further Information

1. Age-Related Eye Disease Study Research Group. A Randomized, Placebo-Controlled, Clinical Trial of High-Dose Supplementation With Vitamins C and E, Beta Carotene, and Zinc for Age-Related Macular Degeneration and Vision Loss. Archives of Ophthalmology. 2001;119(10):1417–1436.
2. Age-Related Eye Disease Study 2 (AREDS2) Research Group. Lutein + Zeaxanthin and Omega-3 Fatty Acids for Age-Related Macular Degeneration. JAMA. 2013;309(19):2005–2015.
3. Chew EY, Clemons TE, Agrón E et al. Long-term Outcomes of Adding Lutein/Zeaxanthin and ω-3 Fatty Acids to the AREDS Supplements on Age-Related Macular Degeneration Progression: AREDS2 Report 28. JAMA Ophthalmology. 2022;140(7):692–698. doi:10.1001/jamaophthalmol.2022.1640
4. National Eye Institute. AREDS 2 Supplements for Age-Related Macular Degeneration (AMD). Juni 2021. nei.nih.gov
5. Cochrane Library. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. September 2023. cochranelibrary.com
6. Beckers D et al. AREDS2 Under Scrutiny: Advocating Unified Regulations. Klinische Monatsblätter für Augenheilkunde. 2025. PubMed: 40719090
7. Macular Society. AREDS2 supplements slow sight loss in late-stage dry AMD. Juli 2024. macularsociety.org