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Xavier Valldeperas, Pau Romera, Rafael Abos-Herrandiz, Antoni Sabala; Drusen morphology changes in nonexudative age-related degeneration using spectral domain optical coherence tomography after oral antioxidants supplementation: one-year results.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5157.
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To determine drusen morphology (volume and area) changes in nonexudative age-related macular degeneration (AMD) after one year of oral supplementation with AREDS-like formulation.
Patients with AREDS category 2 and 3 AMD were prospectively enrolled in this study, and were randomized to receive daily oral supplementation with lutein (12mg) + zeaxanthin (2mg) + astaxanthin (8mg) + omega-3 fatty acids (docosahexaenoic acid [DHA] 540mg + eicosapentaenoic acid [EPA] 360mg) + vitamin C (40mg) + vitamin E (20mg) + zinc (16mg) + copper (2mg), or observation during one year. ETDRS vision, biomicroscopy, intraocular pressure (IOP), color fundus photography and automatic measurement of drusen with Topcon 3D-OCT 2000 (Topcon, Tokyo, Japan) using the 6 x 6 mm 3D cube scan protocol, were performed in all patients, at baseline and 12 months after. Automated delineation of macular drusen was modified by the investigators when evident segmentation errors occurred.
Seventy eyes of 35 patients were included: 18 patients received oral supplementation and the rest were observed. Visual acuity and IOP did not significantly change in either group after 12 months. In the treatment group, drusen count did not significantly change (p=0.715) and increase in drusen area and volume was not statistically significant (p=0.304 and p=0.085, respectively). In the observed group, drusen count significantly increased after 12 months from 13.9±14.1 to 15.5±15.1 (p=0.045), as well as drusen volume (p=0.038). Drusen area in this group remained unchanged during the study period.
Patients with oral supplementation with the AREDS-like formulation show a tendency to slow drusen increase, measured with SD-OCT. The clinical relevance of these findings is still unclear and need further comparison with natural history in larger population and longer duration.
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