Now that researchers have finally served up the long-awaited results of the Age-Related Eye Disease Study 2 (AREDS2), it’s going to take quite a while for the eye care community to digest all of this data and determine what impact, if any, it will have on their current practices.
For some, the big reveal was a little anticlimactic. “Although some parts of the study were intriguing—such as the omega-3 arm not showing a statistical improvement—overall, the study results were not too surprising,” says Paul Karpecki, OD, of the Koffler Vision Group in Lexington, Ky.
Others plan to proceed cautiously. “I’m not prepared to make any drastic changes with my AMD patients just yet; I’m interested to see what happens next,” says Benjamin Casella, OD, of Augusta, Ga. “We’ve been hearing about AREDS2 for so many years—you walk into GNC and you see AREDS2 formulations all over the place—but the manufacturers got a little ahead of the science.”
The primary findings indicated that, when added to the original AREDS formula, neither lutein plus zeaxanthin or DHA plus EPA (omega-3 fatty acids), nor all four components combined, further reduced the risk of progression to AMD. However, secondary analyses suggested that the combination of lutein and zeaxanthin may be beneficial in select patient populations. For patients who are at risk for AMD progression, the data suggest a reformulation that removes beta-carotene and adds lutein and zeaxanthin.
“The complexity of the design led to variations in the conclusions about the results,” says Diana Shectman, OD, associate professor at Nova Southeastern University in Ft. Lauderdale. “We couldn’t come up with one simple answer—does it work or not—because there were just too many arms.” In the months and years ahead, it seems the data and trends from these subgroup analyses could provide insights that do actually affect clinical care, she says.
However, many optometrists are waiting for the day when the study design focuses more on the preventive level. “AREDS2 has certainly got some value, but I think it’s still limited,” says Jeffrey Anshel, OD, president and founding director of the Ocular Nutrition Society. “Even before these results were released, I knew they were looking at intermediate and late-stage macular degeneration, which is nice, but it doesn’t say anything about early stage. So even before AREDS2 came out, I was waiting for AREDS3 or 4.”
To read more details about the findings, see “ The Latest on AREDS2 from ARVO 2013."