Table 4.
Nutritional recommendations for secondary prevention (i.e., slowing the progression) 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 a Recommendation |
|---|---|---|---|---|---|
| American Optical Association 2004 | NR | ✓ 6 | NR | ✓ | None |
| International Council of Ophthalmology 2007 | NR | ✓ 7a | NR | NR | None |
| Spanish Retina and Vitreous Society 2009 | ✓ 1 | ✓ 7a | NR | ✓ | None |
| Canadian Expert Consensus 2012 | ✓ 2 | ✓ 7a | NR | ✓ | Yes |
| German Ophthalmological Society 2014 | NR | ✓ 7a | ✓ 10 | ✓ | Yes |
| Eye Health Council of Ontario (Canada) 2015 | ✓ 3 | ✓ 7a | ✓ 10 | ✓ | None |
| National Health Committee (New Zealand) 2015 | NR | ✓ 7a | NR | NR | None |
| American Academy of Ophthalmology 2015 | NR | ✓ 7a | NR | ✓ | None |
| Vitreo-Retina Society of the Philippines 2016 | NR | ✓ 7a | NR | ✓ | None |
| NICE Clinical Knowledge Summary (CKS) 2016 | ✓ 3 | ✓ 7a | NR | ✓ | Yes |
| Clinical Advisory Committee (United States) 2017 | ✓ 4 | ✓ 7a | ✓ 9 | NR | None |
| NICE Guideline (NG82) 2018 | NR | ✓ 8 | ✓ 10 | ✓ | Yes |
| Optometry Australia 2019 | ✓ 5 | ✓ 7b | NR | NR | None |
Abbreviations: ✓, recommendation included; NICE, National Institute for Health and Care Excellence; NR, no recommendation. Guideline recommendations: 1 Diet rich in carotenoids (lutein and zeaxanthin) and omega-3 fatty acids; 2 Dietary intake of antioxidants, docosahexaenoic acid, and omega-3 fatty acids; 3 Diet high in fresh fruit and green, leafy vegetables (rich in antioxidants and carotenoids); 4 Consume oily fish rich in DHA and follow healthier eating styles e.g., Mediterranean diet; 5 A diet rich in green leafy vegetables, fish and antioxidants should be encouraged; 6 Antioxidant nutrient supplements; 7a Age-Related Eye Disease Studies (AREDS) or AREDS2 supplement recommended; 7b AREDS or AREDS2 supplement may be beneficial, and should be discussed in conjunction with the patient’s general medical practitioner. 8 No evidence that benefit of AREDS supplement outweighs the risk; 9 Omega-3 fatty acid supplement recommended; 10 No evidence for benefit of omega-3 fatty acid supplements.