No Evidence That AREDS Vitamins Slow Geographic Atrophy Progression
Overview
A post hoc analysis of the OAKS and DERBY trials found no evidence that AREDS or AREDS2 vitamin supplements slow the progression of geographic atrophy (GA), including growth towards the fovea or vision loss. This contradicts earlier post hoc findings from the original AREDS and AREDS2 studies suggesting a potential benefit.
Background
Geographic atrophy (GA) is an advanced form of age-related macular degeneration (AMD) characterized by progressive retinal atrophy leading to vision loss. The Age-Related Eye Disease Study (AREDS) and AREDS2 trials originally evaluated vitamin supplements for AMD progression, with a recent post hoc analysis suggesting AREDS vitamins might slow GA growth towards the fovea. The fovea is critical for central vision, making this a clinically important metric. The OAKS and DERBY trials, which focused exclusively on patients with GA and used modern imaging techniques, were analyzed to validate these findings.
Data Highlights
Study
Patient Population
Imaging Method
Sample Size
Effect of AREDS Vitamins on GA Growth
AREDS/AREDS2 (post hoc)
Mixed AMD stages, some GA
Color fundus photography
200-500 patients
Suggested slowing of GA growth towards fovea
OAKS and DERBY (post hoc)
Only GA patients
Fundus autofluorescence
500-1,200 patients
No effect on GA growth or vision loss
Key Findings
Post hoc analysis of OAKS and DERBY trials showed no benefit of AREDS or AREDS2 vitamins on overall GA growth.
No slowing of GA progression towards the fovea was observed with AREDS supplementation in these trials.
AREDS vitamins did not affect vision loss associated with GA in the OAKS and DERBY cohorts.
AREDS supplementation did not enhance or diminish the effect of pegcetacoplan treatment on GA progression.
No impact of AREDS vitamins was found on the development of exudative AMD as a side effect of pegcetacoplan therapy.
Clinical Implications
Clinicians should be cautious in recommending AREDS or AREDS2 vitamin supplements specifically for slowing geographic atrophy progression, as current evidence from OAKS and DERBY does not support this use. Treatment strategies for GA should continue to focus on emerging therapies like pegcetacoplan, while recognizing that oral vitamin supplementation does not appear to modify disease course in this context.
Conclusion
The OAKS and DERBY post hoc analyses do not confirm earlier suggestions that AREDS vitamins slow GA progression, highlighting the need for further research to identify effective oral treatments for geographic atrophy.
References
Hahn P. 2025 ASRS Annual Meeting -- Impact of AREDS Vitamins on Geographic Atrophy Progression
Keenan TDL et al. AREDS and AREDS2 Post Hoc Analysis 2024 -- Vitamin Supplementation and GA Growth
Authors describe both potential retinal benefits and possible rare optic nerve risks, while emphasizing that long-term ocular safety data remain limited as use expands.
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