AREDS vs AREDS 2 in Advanced Eye Care Strategies

The Age-Related Eye Disease Studies (AREDS and AREDS2) represent hope in the fight against the progressive eye condition Macular degeneration. It is important to understand the comparison of AREDS vs AREDS.

Age-Related Eye Disease Study (AREDS)

Age-Related Eye Disease Study (AREDS) is a pivotal research effort that has significantly influenced our understanding of age-related macular degeneration (AMD) and its management. Sponsored by the National Eye Institute, this study began with the goal of investigating the long-term effects of high-dose antioxidant vitamins and minerals on the progression of AMD and age-related cataracts.

The original AREDS trial, which commenced in 1996 and concluded in 2001, enrolled over 5,000 participants aged 55 to 80 who were at various stages of AMD. From those exhibiting minimal AMD to those with severe disease in one eye, the study aimed to identify whether a specific combination of nutritional supplements could help delay or prevent the progression to advanced AMD, which is a leading cause of vision loss in the elderly.

The History and Objective of AREDS

At the time of its inception, AREDS was groundbreaking. No previous clinical trial had confirmed the effectiveness of nutritional supplements on the ocular health of those with AMD. The study sought to understand not only the natural history and risk factors of AMD but also to rigorously evaluate the role of high-dose antioxidant vitamins and zinc in its treatment.

The AREDS trial acknowledged that while the aging process is irreversible, the risk factors for AMD’s progression, such as oxidative stress and diet, might be mitigable. Thus, its objective crystalized around the hypothesis that bolstering the body’s defense with antioxidants could offer a buffer against AMD’s advancement and, consequently, protect against vision loss.

Key Findings from AREDS

The original AREDS trial had yielded crucial insights. The most significant was that the original AREDS formula, consisting of high doses of antioxidant vitamins and minerals, including 500 mg of Vitamin C, 400 IU of Vitamin E, 15 mg of beta-carotene, 80 mg of zinc oxide, and 2 mg of copper as cupric oxide—could indeed slow down the progression of AMD.

The participants classified under Categories 3 and 4 of AMD, which indicates a more advanced stage of the disease, who took the AREDS formula saw their risk of progressing to advanced AMD decrease by 27% within a five-year period. For individuals with mild AMD (Categories 1 and 2), the supplements showed minimal effect, given their already low risk of progression.

When it came to the real-world impact, these findings represented a beacon of hope: for those at high risk, AREDS supplements effectively reduced the risk of moderate vision loss by 19% across the five-year mark. These studies set the stage for further investigation and refinement of the supplement formulation, which would be carried out in the follow-up AREDS2 study.

As the body of research expanded, so did the recommendations for eye health, particularly for individuals with intermediate AMD or those with advanced AMD in one eye. High-dose supplementation became a key strategy in the secondary prevention of this potentially blinding condition, a testament to the enduring legacy of the AREDS trials.

Continued research would prompt further enhancements to the AREDS formula, addressing specific concerns such as the suitability of beta-carotene use in smokers and the potential synergistic effects of additional antioxidants. This would lead to the development and subsequent testing of the AREDS2 formula.

AREDS 2: Advancements in Supplement Formulation

The inception of the Age-Related Eye Disease Study 2 (AREDS 2) represented a quantum leap in eye health research, particularly for those affected by Age-related Macular Degeneration (AMD). Building on the foundation laid down by the original AREDS study, AREDS 2 aimed to refine and improve the formulation used for nutritional supplements.

A key advancement with AREDS 2 was the removal of beta-carotene from the formula. After the original AREDS trials, evidence emerged linking beta-carotene to an increased risk of lung cancer among former smokers. This finding was significant, as it repositioned the approach to supplementation. As a result, AREDS 2 introduced lutein and zeaxanthin nutrients found in leafy greens and other colorful fruits and vegetables to replace beta-carotene. Clinical trials demonstrated that participants receiving these nutrients without beta-carotene exhibited not just a reduced risk of moderate visual loss and progression to legal blindness but also overall visual acuity improvements.

The updated formula ascertained with AREDS 2 encompasses vital ingredients like vitamin C, vitamin E, copper, Zinc, alongside the newly added lutein and Zeaxanthin, while decisively omitting beta-carotene. These enhancements make the AREDS 2 formula 18% more effective than its predecessor, making it a landmark in the ongoing fight against vision loss due to AMD.

Introduction to AREDS 2

The original AREDS study and subsequent formulation marked a cornerstone in AMD management with its combination of high doses of antioxidant vitamins, copper, and zinc. This original blend was shown to cut the risk of progressing to advanced AMD by about 30% in individuals with moderate to advanced stages of the disease. However, AREDS2 sought to refine this approach by adding omega-3 fatty acids and lutein/zeaxanthin while eliminating beta-carotene, largely in an effort to mitigate the increased risk of lung cancer in smokers indicated by the prior findings.

The AREDS2 study, which was a comprehensive randomized, double-masked, placebo-controlled trial, assessed the effects of the adjustments made to the original formula. The findings indicated an absence of impact by omega-3 fatty acids on the formula’s effectiveness, but lutein and Zeaxanthin emerged as promising replacements for beta-carotene. Lutein/Zeaxanthin was tied to a 10% average risk decrease in progressing to AMD, and in certain groups, the risk reduction of advanced AMD reached up to 18%.

The National Eye Institute’s dedication to unveiling these nuanced interactions between nutrients and eye health underscored the importance of tailoring preventive strategies to individual patient needs and risk profiles, incorporating factors such as dietary intake, age, and smoking status.

Findings and Implications of AREDS 2

The transition to the AREDS2 formula marked a significant step forward in the clinical approach to AMD. The recalibrated formulation showed superior efficacy in reducing the progression of macular degeneration and carried the added benefit of lowering the risk of lung cancer an issue previously associated with the beta-carotene component in the original AREDS supplement.

Research led by the National Eye Institute highlighted the advantage of substituting beta-carotene with lutein and zeaxanthin, showing these nutrients not only provided incremental visual benefits but did so without elevating cancer risks in smokers or former smokers. With these enhancements, AREDS2 supplements are now commonly recommended for individuals who have late-stage AMD in one eye to potentially decelerate the disease’s advancement in the other eye.

The AREDS2 supplements, deemed safer and more efficient, endorse a nuanced approach to eye health, signifying an era where high-dose nutritional supplementation is increasingly personalized. The introduction of lutein and zeaxanthin in the formula and the deliberate exclusion of beta-carotene embodies the critical balance of optimizing benefits while reducing potential harm, thereby offering a refined strategy for the management of AMD.

Comparing AREDS and AREDS 2

When exploring the world of ocular nutritional supplements, two significant formulations surface in the discourse against Age-related Macular Degeneration (AMD): AREDS vs AREDS 2. Through years of research and clinical trials, the scientific community has observed that both AREDS and AREDS 2 cater to individuals with intermediate AMD, with the primary aim of slowing the progression to advanced stages of the disease, such as wet AMD.

Detailed comparison of the ingredients in AREDS and AREDS 2

The groundbreaking AREDS study brought forward a supplement packed with 500 mg of vitamin C, 400 IU of vitamin E, 15 mg of beta-carotene (a form of vitamin A), 80 mg of zinc as zinc oxide, and 2 mg of copper as cupric oxide. However, subsequent research led to the evolution of AREDS 2, which embraced a revised composition to enhance safety and efficacy. While retaining the same levels of vitamin C, vitamin E, zinc, and copper, AREDS 2 notably replaced beta-carotene with 10 mg of Lutein and 2 mg of Zeaxanthin in light of the associated lung cancer risk for smokers with the former ingredient.

This table highlights the key differences:

IngredientAREDS FormulaAREDS2 Formula
Vitamin C500 mg500 mg
Vitamin E400 IU400 IU
Beta-Carotene15 mgNone
Zinc80 mg as zinc oxide80 mg as zinc oxide
Copper2 mg as cupric oxide2 mg as cupric oxide
LuteinNone10 mg
ZeaxanthinNone2 mg

The effectiveness of AREDS vs AREDS 2 in preventing the progression of AMD.

In the realm of effectiveness, AREDS set the stage by demonstrating a risk reduction of about 25% for the progression from intermediate to advanced AMD. AREDS 2 built on this foundation and displayed an 18% increase in efficacy over its predecessor by integrating lutein and zeaxanthin, excluding beta-carotene. Importantly, it’s crucial to acknowledge that neither AREDS nor AREDS 2 supplements prevent the onset of AMD or affect the development of cataracts. AREDS 2 stands as the recommended choice, especially for current and former smokers, due to its safety profile.

The safety profile and potential side effects of each formulation

Safety is paramount when considering long-term supplementation. The initial AREDS formula, though beneficial, presented a risk conundrum for smokers and former smokers because of the inclusion of beta-carotene, which is linked to an increased risk of lung cancer. AREDS 2 addressed this by expunging beta-carotene and instead, incorporating lutein and zeaxanthin, which bear no such risks and are therefore suitable for a broader demographic. Omega-3 fatty acids included in the AREDS 2 formulation were shown to have no significant impact on AMD or cataract progression, upholding the formulation’s robustness.

Both AREDS and AREDS 2 supplements are considered generally safe. Side effects are uncommon but can include stomach upset, decreased appetite, and in the case of high zinc intake, potential urinary and kidney problems. It’s important for potential users to consult with their healthcare provider to weigh the benefits and risks based on individual health profiles and needs.

Both AREDS and AREDS 2 formulations play a critical role in managing AMD, AREDS 2 has emerged as the formulation of choice due to its improved safety and efficacy profile. The informed use of these supplements can offer hope to those seeking to preserve their sight in the face of AMD.

The Future of Eye Health Supplements

The landscape of managing conditions like age-related macular degeneration (AMD), a leading cause of vision loss, is evolving. Antioxidant supplementation’s role in combating AMD is a hotbed for ongoing research, with clinical trials like the Age-Related Eye Disease Study (AREDS) providing pivotal insights. As the number of advanced AMD cases rises, the urgency for improved eye health strategies escalates.

Current findings hint at a future where eye health supplements are personalized, perhaps guided by genetic testing and individual analysis. Proactive patient management, integrating dietary counseling and targeted supplementation, is becoming increasingly key to preserving vision.

Data from studies such as AREDS2 will further refine these approaches, moving toward customized treatments. High-dose nutritional supplements, formerly based on the AREDS formula, are likely to adapt as knowledge expands. Researchers anticipate more granular directives from ongoing studies that will influence the composition and recommendation of these supplements.


  1. National Eye Institute (NEI): Overview and results of the AREDS and AREDS2 studies provided by the NEI, a part of the National Institutes of Health (NIH) that conducts and supports research on eye diseases. NEI – AREDS/AREDS2 Study Results
  2. PubMed: Access to scientific publications and clinical trial results on the efficacy of the AREDS and AREDS2 formulations. PubMed Database
  3. American Academy of Ophthalmology (AAO): Provides a detailed analysis of the impact of AREDS and AREDS2 studies on the management of age-related macular degeneration. AAO – AREDS/AREDS2 Resource Center
  4. Mayo Clinic: Information on the management of macular degeneration, including discussions on the benefits and risks of AREDS and AREDS2 supplements. Mayo Clinic – Macular Degeneration
  5. ClinicalTrials.gov: Database of privately and publicly funded clinical studies conducted around the world, including detailed study protocols for AREDS and AREDS2. ClinicalTrials.gov
  6. Centers for Disease Control and Prevention (CDC): Provides general information on vision health and prevention strategies, including the use of nutritional supplements in the prevention of AMD. CDC – Vision Health Initiative

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