Table 3.
Nutritional recommendations for primary prevention of age-related macular degeneration (AMD).
| Clinical Guideline | Dietary Advice | Use of Antioxidant or Mineral Supplements | Use of Omega-3 Fatty Acid Supplements | Contraindications or Side Effects of Supplements | Systematic Review Cited with Recommendation |
|---|---|---|---|---|---|
| American Optical Association 2004 | NR | ✓ 4 | NR | ✓ | None |
| International Council of Ophthalmology 2007 | NR | NR | NR | N/A | N/A |
| Spanish Retina and Vitreous Society 2009 | NR | NR | NR | N/A | N/A |
| Canadian Expert Consensus 2012 | NR | NR | NR | N/A | N/A |
| German Ophthalmological Society 2014 | ✓ 1 | ✓ 5 | NR | N/A | Yes |
| Eye Health Council of Ontario (Canada) 2015 | ✓ 2 | ✓ 5 | NR | N/A | None |
| National Health Committee (New Zealand) 2015 | NR | NR | NR | N/A | N/A |
| American Academy of Ophthalmology 2015 | NR | ✓ 5 | NR | N/A | None |
| Vitreo-Retinal Society of the Philippines 2016 | NR | ✓ 5 | NR | N/A | None |
| NICE Clinical Knowledge Summary (CKS) 2016 | NR | ✓ 5 | NR | N/A | Yes |
| Clinical Advisory Committee (United States) 2017 | NR | ✓ 6 | NR | NR | None |
| NICE Guideline (NG82) 2018 | NR | NR | NR | N/A | N/A |
| Optometry Australia 2019 | ✓ 3 | ✓ 7 | NR | NR | None |
Abbreviations: ✓, recommendation included; NICE, National Institute for Health and Care Excellence; NR, no recommendation. Guideline recommendations: 1 Balanced diet; 2 A diet high in green, leafy vegetables (rich in antioxidants and carotenoids); 3 A diet high in macular carotenoids (zeaxanthin and lutein) and omega-3 fatty acids; 4 Antioxidant nutrient supplements (particularly for nutritionally deficient); 5 Evidence of no benefit for antioxidant vitamin and/or mineral supplements for primary prevention; 6 Supplement containing xanthophylls (lutein, zeaxanthin, meso-zeaxanthin) for ‘sub-clinical’ AMD. 7 Supplements not currently recommended for people with normal ageing changes.