Age-related macular degeneration
Macular degeneration in older adults. For dry AMD, evidence-based intervention is the AREDS2 supplement (vitamins C, E, zinc, copper, lutein, zeaxanthin) in intermediate-to-late disease. For wet AMD – intravitreal anti-VEGF. AAO 2024 PPP and EURETINA do not include systemic peptide 'neuroprotectors'.
ICD-10 H35.34 drugs
Also known as: AMD, ARMD, Dry AMD, Wet AMD, Neovascular AMD
Drugs used for this condition
- BLuteinAdd-on therapy · Xanthophyll carotenoid, supplement marketed for vision and skin supportLutein is part of the AREDS2 formula together with zeaxanthin, vitamins C and E, zinc and copper. The AREDS2 RCT (NEI, 2013) in 4203 patients with intermediate or late AMD in one eye showed that replacing beta-carotene with lutein 10 mg plus zeaxanthin 2 mg cut the risk of progression to late AMD by 18% in participants with low baseline dietary carotenoid intake. The 10-year follow-up (JAMA Ophthalmol 2022) confirmed durable benefit. AAO PPP 2024 and Spanish SERV recommend the AREDS2 formula in patients with intermediate AMD or late AMD in one eye. In early AMD and healthy adults lutein has not lowered AMD incidence in RCTs. If an ophthalmologist prescribed it with a documented intermediate or late AMD diagnosis, the supplement is justified. If it was recommended just-in-case and you do not have a confirmed AMD diagnosis, consider seeking a second opinion.
- BLutein + zeaxanthinAdd-on therapy · Carotenoids. Antioxidants for visionLutein 10 mg + zeaxanthin 2 mg combination as part of the AREDS2 formula (with vitamins C, E, zinc, copper) is recommended in intermediate and late dry age-related macular degeneration in adults from age 50. AAO 2020 classifies this as a level II recommendation (moderate-quality evidence). Reduces the risk of progression to late AMD by 25% over 5 years per the AREDS2 RCT (3,036 participants). Isolated lutein without the complete AREDS2 formula has not shown efficacy.
- BZeaxanthinAdd-on therapy · Xanthophyll carotenoid, supplement marketed for retinal blue-light protectionZeaxanthin 2 mg is part of the AREDS2 formula together with lutein 10 mg, vitamins C and E, zinc and copper. The AREDS2 RCT (NEI, 2013) in 4203 patients with intermediate or late AMD in one eye showed an 18% reduction in progression to late AMD with low baseline dietary carotenoid intake. The benefit persisted at 10-year follow-up. AAO PPP 2024 and Spanish SERV recommend the AREDS2 formula with lutein and zeaxanthin for intermediate AMD or late AMD in one eye. In healthy people and early AMD stand-alone zeaxanthin does not prevent disease onset. If zeaxanthin is part of a product prescribed by an ophthalmologist with a documented AMD diagnosis, the supplement is justified. If it was recommended without an eye exam, consider seeking a second opinion.
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit