Eye vitamins did not slow late dry macular degeneration in clinic study

Eye doctors at Cleveland Clinic have found no sign that the popular AREDS eye vitamins slow the late stage of dry macular degeneration, a common cause of vision loss in older adults. In a look back at patient records, the damaged areas at the back of the eye grew at a similar pace over one year whether or not patients took the vitamins.¹ The work, led by the Cole Eye Institute and presented at the 2026 ARVO Annual Meeting, was described by Cleveland Clinic on October 28.¹

The question matters because the late stage, called geographic atrophy, has few treatment options. The only therapies approved by the US Food and Drug Administration (FDA) for it are injections into the eye that have to be repeated.¹ A daily pill would be far easier, which is why earlier hints that the vitamins might help drew so much attention.¹

What the Cleveland Clinic team did

Age-related macular degeneration (AMD) damages the macula, the part of the retina used for sharp central vision. In the dry form, patches of light-sensing cells can waste away. These patches, called geographic atrophy, slowly grow over time and can take away central vision.² Cleveland Clinic calls geographic atrophy the advanced, irreversible stage of dry AMD.¹

The researchers used electronic health records from 2017 to 2022. They compared two groups:¹

• Vitamin group: 89 eyes in 59 patients whose records showed they took AREDS vitamins, with damaged areas between 1.25 and 17.5 square millimeters and eye scans at the start and 12 months later.¹
• Comparison group: 89 eyes in 54 patients not taking AREDS vitamins, matched for the starting size of the damage and how long they had had the disease.¹

The scans used optical coherence tomography (OCT), a standard eye-imaging method that shows the layers of the retina.¹

What they found

Over one year, the damaged areas grew by about the same amount in both groups. The difference was not statistically significant (P = .52), meaning it could easily be due to chance.¹ A second analysis that adjusted for other health factors also did not find vitamin use to be a meaningful predictor of how fast the damage spread.¹ The researchers added that this model was poor at predicting how any single patient would do.¹

“In our cohort, we did not observe a significant difference in GA growth rates between patients taking AREDS and those not.”

That was how Katherine Talcott, a retina surgeon at the Cole Eye Institute, summed up the result.¹

What the study cannot show

The researchers point out the study’s limits themselves. Talcott called it “a small, retrospective analysis,” meaning it looked backward at existing records rather than assigning people to take vitamins or not.¹ It relied on what was written in the records about vitamin use, not on checking whether patients actually took the pills.¹ Although the two groups were matched on how advanced their disease was, details such as when the atrophy was diagnosed or when patients started the vitamins may not have been fully captured.¹

The study also followed patients for only one year. It does not say whether a small effect might appear over a longer time, and it was not built to test whether the vitamins slow damage moving toward the very center of vision, the specific effect an earlier analysis reported.¹² The source does not say who funded the work.

How it fits with earlier research

The vitamins come from two large government trials run by the National Eye Institute (NEI). The first, AREDS, enrolled 4,757 people and tested antioxidants and zinc.³ The second, AREDS2, enrolled 4,203 people and tested adding lutein, zeaxanthin and omega-3 fats, and removing beta-carotene.⁴ The original formula combines vitamin C, vitamin E, beta-carotene, zinc and copper; AREDS2 swapped beta-carotene for lutein and zeaxanthin, which is safer for people at risk of lung cancer.¹ The first trial found a 25% reduction in the risk of moving from intermediate to advanced AMD over five years in certain patients.¹

Those trials did not find a benefit once people already had late-stage disease.² That changed in July 2024, when NEI researchers re-read old retinal images from 318 AREDS participants (392 eyes) and 891 AREDS2 participants (1,210 eyes).² They reported that, in people whose damage started away from the fovea (the spot for the sharpest vision), the supplements slowed spread toward it by about 55% over an average of three years. For people whose damage was already in the center, the supplements had little benefit.² That was a “post hoc” analysis, meaning it asked a new question of data collected for another purpose.⁵ Lead author Tiarnan Keenan said the team planned to confirm the findings in a dedicated trial.²

A year later, a second group tried to repeat that finding in different data. Paul Hahn of NJ Retina analyzed 1,259 untreated eyes from OAKS and DERBY, two late-stage trials of an eye-injection drug called pegcetacoplan. Of those eyes, 518 were on AREDS or AREDS2 vitamins and 741 were not.⁶ He found no significant difference in spread toward the fovea or in overall growth (P = .12).⁶ A summary in Retinal Physician also reported that the vitamins did not change how well pegcetacoplan worked.⁷ “Unfortunately, we did not find any effect of AREDS on any of our metrics or endpoints,” Hahn told HCPLive.⁶

The Cleveland Clinic team describes its result as adding to “mounting evidence” that the vitamins may not meaningfully slow damage at this stage.¹ All three analyses, the one that found a benefit and the two that did not, looked back at existing data rather than testing the vitamins in a new trial designed for this question.¹⁶⁵

Who is behind the research

The new study comes from Cleveland Clinic’s Cole Eye Institute, a non-profit academic medical center.¹ The 2024 analysis that suggested a benefit was supported by the NEI’s own research program.² Hahn reports financial ties to several drug companies, including Apellis, Genentech, Eyepoint, Alexion, OcuTerra and Regeneron.⁶

AREDS-style vitamins are also a commercial product. Bausch + Lomb sells PreserVision AREDS 2 Formula eye vitamins and has promoted NEI data supporting the formula; a 2021 company release quoted another Cole Eye Institute doctor, Rishi Singh, speaking in favor of the AREDS2 formula for appropriate patients.⁸

What the doctors involved say it means

Talcott said she still recommends the vitamins for most people with AMD, especially before they reach the advanced stage, because of the original trials’ results.¹ Once geographic atrophy has developed, she said, “the clinical conversation becomes more nuanced.”¹ She noted that some patients find the vitamins costly, get stomach upset from them, or struggle with the number of pills they already take.¹ She said she supports patients who want to stay on them, and is comfortable telling patients that stopping is reasonable when those problems become significant.¹

Hahn made a broader point: analyses that look back at old data “should be hypothesis-generating and need validation in either further studies or, ideally, prospective studies.”⁶

What to watch next

• A dedicated trial. Both camps call for one. Keenan’s NEI team said it planned a trial to confirm its finding, and Talcott said, “To truly answer this question, we need prospective trials.”²¹
• Newer formulas. Talcott mentioned that newer versions such as AREDS3 are emerging and said it will be worth seeing whether they offer any added benefit.¹
• A full paper. The Cleveland Clinic results were presented at a meeting; a peer-reviewed paper would give more detail on the methods and patients.¹