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Oral Zinc in Macular Degeneration
Abstract
Macular degeneration associated with age and drusen, an important cause of severe visual loss in older persons, is of unknown cause. The sensory retina and retinal pigment epithelium, which are cell layers in zinc, appear to be prominently involved in the disease process. Because zinc plays a role in the metabolic function of several important enzymes in the chorioretinal complex, we undertook a prospective, randomized, double-masked, placebo-controlled investigation of the effects of oral zinc administration on the visual acuity outcome in 151 subjects with drusen or macular degeneration. Although some eyes in the zinc-treated group lost vision, this group had significantly less visual loss than the placebo group after a follow-up of 12 to 24 months. This is the first controlled oral intervention study to show a positive, if limited, treatment effect in macular degeneration, a major public health problem. Because of the pilot nature of the study and the possible toxic effects and complications of oral zinc administration, widespread use of zinc in macular degeneration is not now warranted.
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“One small, randomized, 2-year, placebo-controlled clinical trial of zinc supplementation found a statistically significant reduction in visual acuity loss in the zinc-treated group and recommended a more definitive trial before a general recommendation could be made for zinc supplementation in those at risk of vision loss from advanced AMD. 27”
In the citing paper
“A small randomized trial, completed before AREDS began, suggested a benefit of large doses of zinc on visual acuity in persons with AMD.27”
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“There was significantly less visual loss in the treated group than in the placebo group after a follow-up of 12 to 24 months [46].”
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“Zinc supplementation at a level of 80 mg/d of zinc sulfate was found in a short-term pilot study to reduce the risk of vision loss in persons with age-related macular degeneration (AMD) (17).”
BackgroundInfluentialAge-related Eye Disease Study 2
Aronow, M. E., & Chew, E. Y. (2014) · Current Opinion in Ophthalmology · doi:10.1097/icu.0000000000000046 · Cited by 71
“The reasoning behind lowering zinc levels was that although a dose of 80 mg was used in the original AREDS formulation based on a prior trial suggesting efficacy, there was also evidence to suggest that the maximal level absorbed was closer to 25 mg [25,26].”
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“An earlier clinical trial with a smaller number of patients showed that oral zinc supplementation decreased the risk for visual loss in patients with AMD.(2) It is well known that zinc homeostasis is essential for cellular functions.”
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“This was a randomized, 2-year, placebo-controlled clinical trial involving 151 subjects with drusen or macular degeneration, finding a statistically significant reduction in visual acuity loss in the group treated with zinc [68].”
BackgroundMethodInfluentialOcular Burn: Rinsing and Healing with Ionic Marine Solutions and Vegetable Oils
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Dietary zinc intake is associated with macular fluid in neovascular age‐related macular degeneration
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“In 1988, zinc supplementation was found to be associated with a reduction in visual acuity loss in AMD.(11) Soon thereafter, vitamin formulations containing zinc and antioxidants began to be utilized for AMD, despite the lack of controlled evidence of benefit.”
BackgroundInfluentialAnecortave acetate in the treatment of age-related macular degeneration
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“…large Hamm et al 1976; Taylor et al 1990 quantities of visible spectrum, particularly blue light Nutrition and dietary habits Seddon et al 1994 Zinc Newsome et al 1998 High Intake of dietary fats Seddon et al 2001 Hypertension Abdelsalam et al 1999 Addition of 21-Acetate Removal…”
BackgroundMethodMacular degeneration. Is there a nutritional component?
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Hung, S., & Seddon, J. M. (2001) · Humana Press eBooks · doi:10.1007/978-1-59259-236-4_10 · Cited by 8
Lutein und Antioxidantien zur Prävention der AMD
Rehak, M., Fric, E., & Wiedemann, P. (2007) · Der Ophthalmologe · doi:10.1007/s00347-007-1602-1 · Cited by 11
Mozaffarieh, M., Sacu, S., & Wedrich, A. (2003) · Nutrition Journal · doi:10.1186/1475-2891-2-20 · Cited by 213
“In a small clinical trial, highdose zinc supplementation has been reported to reduce the loss of visual acuity in patients with macular degeneration [55].”
Genetics of age-related macular degeneration
KLEIN, M., & Francis, P. J. (2003) · Ophthalmology Clinics of North America · doi:10.1016/s0896-1549(03)00063-4 · Cited by 26
“deficient choroidal blood flow in the macula [14,15], an abnormal Bruch’s membrane [16,17], and metabolic dysfunction of the retinal pigment epithelium [18,19].”
Gottschall-Pass, K., Grahn, B., Gorecki, D., Semple, H., & Paterson, P. G. (1998) · The Journal of Nutritional Biochemistry · doi:10.1016/s0955-2863(98)00063-1 · Cited by 10
Blood Plasma Levels of Microelements in Patients with History of Optic Neuritis
Kaźmierczak, K., Malukiewicz, G., Lesiewska‐Junk, H., Laudencka, A., Szady-Grad, M., Klawe, J., & Nowicki, K. (2014) · Current Eye Research · doi:10.3109/02713683.2013.833244 · Cited by 9
“Zn and selenium (Se) deficiencies are known to influence retinal function, causing age-related changes such as age-related macular degeneration (AMD).(3,4) Retinal accumulations of Fe are found in the photoreceptors, retinal pigment epithelium (RPE) and drusen of AMD patients.”
BackgroundTamada, Y., Walkup, R. D., Shearer, T., & Azuma, M. (2007) · Current Eye Research · doi:10.1080/02713680701359633 · Cited by 9
Oxidative Stress and Age-Related Macular Degeneration
Bernstein, P. S., Peterman, J. N., Burrows, J., & Askew, E. W. (2003) · Oxidative stress and disease · doi:10.1201/9780203912874.ch16 · Cited by 7
Analysis of the metallothionein gene in age-related macular degeneration.
Sato, M., Abe, T., & Tamai, M. (2000) · Japanese Journal of Ophthalmology · doi:10.1016/s0021-5155(99)00198-7 · Cited by 9
Metadata
- Authors
- Newsome, D. A., Swartz, M., Leone, N. C., Elston, R. C., & Miller, E.
- Affiliations
- Louisiana State University (US)
- University of Utah (US)
- Utah State University (US)
- ORCID
- Elston, R. C.
- Venue
- Archives of Ophthalmology
- Publisher
- American Medical Association (AMA)
- Published
- 1988-02-01
- Volume
- 106
- Issue
- 2
- Pages
- 192-198
- ISSN
- 0003-9950 (ISSN-L)
- OpenAlex
- W2007111898
- Cited by
- 349
- References
- 0
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 2 · 2023: 5 · 2022: 6 · 2021: 5 · 2020: 4 · 2019: 4 · 2018: 6 · 2017: 8 · 2016: 6 · 2015: 9 · 2014: 7 · 2013: 13 · 2012: 14
- FWCI
- 14.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Ophthalmology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Nursing › Nutrition and Dietetics › Trace Elements in Health
- Health Sciences › Medicine › Ophthalmology › Retinal Development and Disorders
- Keywords
- macular degeneration, oral zinc supplementation, drusen, age-related macular degeneration, visual acuity, retinal pigment epithelium, zinc toxicity, blindness prevention
- MeSH terms
- Administration, Oral, Adult, Aged, Aged, 80 and over, Clinical Trials as Topic, Double-Blind Method, Female, Fluorescein Angiography, Humans, Macular Degeneration, Male, Middle Aged, Prospective Studies, Random Allocation, Zinc
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