In case you missed it: Bausch + Lomb officially released PreserVision AREDS3 eye vitamins in the United States earlier this week. Read up on this here.
And with this launch in mind: We’re taking a closer look at one of the key ingredients in the AREDS3 formulation—B vitamins—by exploring a recent analysis published in Ophthalmology and Therapy on the current and emerging research on the role and potential impact of these vitamins for both reducing the risk of AMD development and slowing its progression.
Where to start?
Let’s hone in on one notable study we’re all familiar with: the Age-Related Eye Disease Study (AREDS).
What to know: This randomized, placebo-controlled clinical trial demonstrated that supplementation and a combination of antioxidant vitamins and minerals—Vitamins C and E, beta-carotene, zinc, and copper—led to a reduced risk for AMD to progress from the intermediate to advanced stage.
- To be specific: A 25% reduction was observed over a 5-year period.
And then?
There was the subsequent AREDS2 trial.
What to know: This randomized, placebo-controlled study treated patients with a modified formulation of the original AREDS supplement—but minus beta-cartone and plus lutein and zeaxanthin).
- The result: Patients demonstrated an 18% lower risk of progressing to late-stage AMD—and a 22% lower risk of wet AMD —compared with those receiving the original AREDs-formulated supplement.
And now?
We have PreserVision AREDS3 eye vitamins. The body of clinical evidence that helped shape the inclusion of B vitamins will also support ongoing research in this area, including plans for a future long-term clinical trial evaluating the formulation.
- This newly-launched supplement is referred to as “the most advanced PreserVision formula” intended to support a broader population—including those in earlier stages (but more on that later).
What to know (about the formula): It includes a more B vitamin complex-heavy ingredient list: B1, B2, B3, B5, B6, B7, B9, and B12, in addition to the nutrients found in AREDS2.
What to know (about the trial): Plans for a future long-term clinical trial evaluating the formulation are in discussion.
So I have to ask—why B vitamins?
They support essential functions such as:
- Energy metabolism
- DNA synthesis and methylation
- Energy production and antioxidant reactions
What to know: Many adults, up to 20% of the population, have a vitamin B deficiency. The population particularly at risk is older adults, people on plant-based diets, metformin-induced deficiency, and bariatric surgery.
Multiple studies support the role of B vitamins in reducing the incidence and progression of AMD by lowering homocysteine levels, a potential contributor to AMD. Targeting homocysteine in early AMD provides an opportunity to intervene at an upstream biological level.
They may also play a role in OSD, diabetic retinopathy, optic neuropathy, and glaucoma.
Gotcha. And are B vitamins considered safe?
Yes! They are water-soluble and deemed safe. There have been trials showing no ocular adverse events with supplementation.
Note: At-risk population includes those with liver disease and neuropathy at a higher risk of developing niacin toxicity and B6 toxicity, respectively.
Ok. So what are the theoretical benefits of AREDS2 nutrients and B vitamins?
A combination of the two will support the body’s natural response to oxidative stress.
- Reduce risk of visually significant AMD
- Reduced risk of early AMD
- Lower risk in moderate-to-advanced AMD
- Lower risk of neovascular AMD
And in real-world application?
That’s where clinical expert feedback comes in.
Cecelia Koetting, OD, FAAO, Dipl ABO, associate professor of Ophthalmology at the University of Colorado, has already begun using b-vitamin supplementation as part of her patients’ routine AMD management.
In speaking with Glance President Jackie, OD, FAAO, Dr. Koetting explained how b vitamins are shifting the AMD management paradigm—and the role AREDS3 will play.
Is there any clinical trial data yet?
As Dr. Koetting noted, that’s currently in progress.
The PreserVision AREDS3 formula will be studied in a long-term trial including patients with all stages of AMD, from early to geographic atrophy.
But in the meantime: “There’s enough data that shows B vitamins’ impact in supporting the body’s natural response to oxidative stress and cellular metabolism with homocysteine levels—both of which we know are issues in macular degeneration,” Dr. Koetting said.
- She added: “I feel comfortable adding in B-vitamin supplementation for these patients because we actually have more data behind the vitamins themselves to show that we do see decreased risk of progression into mild, from mild to moderate, intermediate, and even severe AMD.”
So … when might we see results from the long-term AREDS3 trial?
That’s currently to be determined.
In the meantime, however, that research published in Ophthalmology and Therapy earlier this year offers an extensive body of scientific data to back up the use of B vitamins for AMD management.