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Cost Effective Antioxidant - Zinc Supplement To Combat Blindness

Cost Effective Antioxidant - Zinc Supplement To Combat Blindness

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A supplement with zinc and copper given to patients with wet age related macular degeneration slowed down disease progression and vision loss.

Highlights:
  • Age-related macular degeneration (AMD) is an eye disease that may cause irreversible blindness.
  • Abnormal blood vessels grow underneath the retina which can leak fluid and blood, and damage the macula, the part of the retina responsible for central vision.
  • Treatment with zinc and copper might be inexpensive, as well as, effective means of slowing down the progression of age-related macular degeneration.
A combination of antioxidants with zinc and copper might be inexpensive, as well as, effective means of slowing down the progression of age-related macular degeneration (AMD). The disease causes irreversible blindness and calls for immediate treatment.
The current methods to treat the disease are expensive and have an increased risk of side effects. Thus, data from the Age Related Eye Disease Study (AREDS) was used to develop a complimentary treatment.

Age related macular degeneration (AMD)

Age related macular degeneration or age related maculopathy which usually occurs over the age of 50 years, is, the degeneration of the central part of the retina referred to as the macula.

Neovascular maculopathy is often referred to as wet or exudative maculopathy. In wet AMD, detachment, exudation or scarring of retina and abnormal new vessels originating from the choroid are found. The vessels extend forward through a defect in Bruch’s membrane which is the innermost layer of choroid.

AMD accounts for about 8.7 % of the world’s blindness and is more common in developed countries. As the disease is closely related to aging, the number of people affected may increase as the percentage of aging population increases.

Eighty percent of patients diagnosed with AMD have the wet type and it accounts for 90% of severe visual loss.

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Treatment For AMD

One of the mechanisms that cause AMD is the release of Vascular endothelial growth factor (VEGF) in response to oxygen deprivation in tissues. It promotes the growth of new and abnormal blood vessels. These new vessels grow through the breaks in Bruch’s membrane and result in bleeding and protein leak underneath the macula.

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The current treatment involved in AMD is the use of anti-VEGF therapies. They are expensive drugs and may cause inflammation of the inside of the eye (endophthalmitis) and possibly stroke.

Antioxidant Doses For AMD

Two types of supplements were tested in people with early stage disease in one (category 4) or both (category 3) eyes.

The first formulation contained high doses of vitamins C and E, beta carotene, zinc and copper. The second formulation had lutein and zeaxanthin instead of beta carotene but other constituents remained the same.

A daily supplement combining high dose antioxidants and zinc lowered the risk of developing wet AMD.

Statistical analysis showed that both formulations are cost effective for treating patients with early stage wet AMD, but they were more cost effective for those with the condition in just one eye.

Cost Effective - The research team calculated that the patients in the study would need nearly eight fewer injections of anti-VEGF therapies into their eye. This represents a cost saving to the NHS of nearly 3000 pounds per patient, adding up to around 131 million pounds a year.

Vision For Longer Years - The patients would live longer without impaired vision compared to those who did not have the supplements.

"Given the burden and cost of treatment, prevention of nAMD seems, therefore, an attractive strategy to avoid the chronic and costly anti-VEG therapies and preserve visual function," write the researchers.

Better Outcomes

The scientists believe that the reduced cost and improved vision can motivate the people with wet AMD in one eye to take the supplements and stave off vision loss in the second eye.

For those with intermediate stage wet AMD in both eyes, there would still be savings to be made by giving supplements. The NHS currently provide funds for the treatment of wet AMD but the argument for funding those with intermediate stage continues.

"AREDS supplements are a dominant cost-effective intervention for category 4 AREDS patients, as they are both less expensive than standard care and more effective, and therefore should be considered for public funding," they conclude.

Reference:
  1. Aaron Y Lee, Thomas Butt, Emily Chew, Elvira Agron4, Traci E Clemons, Catherine A Egan, Cecilia S Lee, Adnan Tufail. Cost-effectiveness of age-related macular degeneration study supplements in the UK: combined trial and real-world outcomes data, British Journal of Ophthalmology (2017). DOI: 10.1136/bjophthalmol-2017-310939

Source-Medindia


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