Do AREDS Supplements Delay Geographic Atrophy Progression?

AREDS (Age-Related Eye Disease Study) vitamin supplements have long been a mainstay in managing age-related macular degeneration (AMD), but their role in geographic atrophy (GA), the advanced and irreversible form of dry AMD, remains unclear.

New research from Cleveland Clinic Cole Eye Institute adds to that uncertainty. Presented at the 2026 ARVO Annual Meeting, the study found no meaningful link between documented AREDS use and the growth of GA lesions, reinforcing evidence that the supplements may not significantly slow disease progression at this advanced stage.

Interest in AREDS for GA has grown since a 2025 National Eye Institute analysis suggested the supplements might help slow progression. Because current FDA-approved options for GA are limited to repeated intraocular injections, the possibility of a simpler treatment generated optimism in the retina community.

“That study generated a lot of interest because it raised the possibility of a much easier intervention for patients,” says Katherine Talcott, MD, a vitreoretinal surgeon at the Cole Eye Institute. “We wanted to explore whether those findings would hold up in a real-world clinic population using OCT-based imaging. In our cohort, we did not observe a significant difference in GA growth rates between patients taking AREDS and those not.”

What is known about AREDS and advanced AMD

The original AREDS formulation includes high-dose antioxidants and minerals such as vitamin C, vitamin E, beta-carotene, zinc and copper. AREDS2 replaced beta-carotene with lutein and zeaxanthin, which improved safety for people at risk of lung cancer.

The landmark AREDS trial showed a 25% reduction in the risk of progression from intermediate to advanced AMD in selected patients over five years. AREDS2 confirmed its benefit.

“We generally recommend AREDS supplementation for our patients with AMD, but not everyone takes it consistently,” Dr. Talcott notes. “For some, the vitamins are expensive, cause stomach upset or simply add to an already lengthy list of medications. There are also questions about how much benefit they provide once GA is established, making this an especially important area of research.”

Evaluating AREDS in a real-world GA group

The Cole Eye Institute team reviewed electronic health record data from 2017 through 2022 and examined two groups:

• AREDS cohort: 89 eyes in 59 patients with documented AREDS vitamin use, GA lesion size of 1.25-17.5 mm², and OCT scans at baseline and 12 months
• Non-AREDS cohort: 89 eyes in 54 patients not taking AREDS, matched for baseline lesion size and disease duration

After comparing GA lesion growth over one year, the researchers found no significant difference between the groups (P = .52).

A regression model that adjusted for additional health factors also did not identify AREDS use as a significant predictor of GA progression. The model was also limited in its ability to predict outcomes for individual patients.

“One strength of our study is its real-world reflection of clinical practice, leveraging OCT imaging to track GA progression,” Dr. Talcott says. “But we also recognize its limitations. This was a small, retrospective analysis relying on documentation of vitamin use rather than direct verification. Although we matched patients for baseline disease characteristics, factors such as the timing of GA diagnosis or onset of supplementation may not have been perfectly captured.”

What the results may mean for care

The findings suggest that AREDS does not appear to slow lesion progression in GA, despite its broad use in AMD.

“I continue to recommend AREDS for most patients with AMD, particularly before they reach advanced stages, given the original studies’ benefit in slowing vision loss,” Dr. Talcott says. “However, once patients develop GA, the clinical conversation becomes more nuanced.”

She adds that treatment choices in advanced GA often go beyond the available evidence. Many patients see AREDS supplementation as an active way to participate in their care, even when its benefit is uncertain.

“If a patient with advanced GA wishes to remain on AREDS, I support that,” she says. “But if cost, GI side effects or pill burden become significant issues, I feel comfortable counseling patients that discontinuation is reasonable, given our inability to demonstrate a clear benefit at this stage.”

What comes next

The study adds to real-world evidence that may help guide expectations around AREDS use, but important questions remain. Larger and more rigorous studies are still needed to define its role in patients with established GA.

“To truly answer this question, we need prospective trials,” says Dr. Talcott. “And as newer formulations like AREDS3 emerge, it will be interesting to see whether they offer any incremental advantages. For now, though, further data are necessary before making definitive recommendations.”