August 10, 2014 SAN DIEGO (August 10, 2014) – New research shows that supplementation with nutritional supplements that slow age-related macular degeneration (AMD) in some genotypes of patients may not only be unhelpful but may accelerate disease progression. Professor Carl Awh of Nashville, Tennessee, believes the study has tremendous public health implications, and the results of a randomized, controlled study of age-related eye disease (AREDS) in which supplementation slowed the progression of AMD were published in Arch Ophthalmol 2001, and since then the National Eye Institute has recommended supplementation for patients with moderate AMD. supplements. Patients with certain genes are known to be at high risk for macular degeneration, and Professor Awh sampled the DNA of AREDS participants and found that patients with certain genotypes benefited more with nutritional supplements, the results of which were published in Ophthalmology 2013, but the findings are somewhat controversial. More recent research supported by the National Eye Institute found no effect of genotype on the amount of benefit from AREDS supplementation and was shared in the June 2014 issue of Ophthalmology. Dr. Awh, on the other hand, argues that the recent study is flawed because it divided 1200 study subjects into 27 genotype groups, each so small that the sample size was too small for statistical differences to emerge. professor Awh found the opposite result in their current study. They divided the risk of patients with 9 genotypes into 4 groups based on complement factor H (CFH), age-related macular degeneration susceptibility 2 (ARMS2): high CFH high ARMS2, high CFH low ARMS2, low CFH high ARMS2, low CFH low ARMS2. Each group had a larger sample size and could therefore show statistical differences. Those with high CFH low ARMS2 accounted for 13% of the total, and the risk of progression to advanced macular degeneration was 135% times higher in patients on nutrients for 7 years than in controls. Low CFH high ARMS2 patients accounted for 35% of the total and the risk of progression was 37% lower in patients using nutritional agents for 7 years than in the control group. In contrast, patients with high CFH and high ARMS2 and low CFH and low ARMS2 had no benefit or harm. Awh cautions that we must keep this in mind when recommending nutritional supplements for patients with macular degeneration, as we cannot double the risk of disease progression in patients with confirmed deleterious phenotypes; I usually genetically test patients before recommending nutritional supplements. Professor Eugene from the University of California, San Francisco’s ophthalmology department is very concerned about the study, and he thinks the results are important but controversial because if they are, then the implications are significant, so the field needs further study. However, he said he would perform the genetic test himself if he had AMD, and more experimental evidence is needed before clinical guidelines can be developed.