Effects of AREDS Vitamins on Geographic Atrophy Lesions with Roger Goldberg, MD, MBA

At the 2025 Association for Research in Vision and Ophthalmology (ARVO) annual meeting, Roger Goldberg, MD, MBA, cofounder of Emmetrope Ophthalmics and a practicing vitreoretinal surgeon at Bay Area Retina Associates, presented the results from his post hoc analysis of the OAKS and DERBY phase 3 trials testing micronutrient supplements AREDS and AREDS2 in reducing nonsubfoveal (NSF) geographic atrophy (GA) lesions toward the fovea.1

A previous post hoc analysis indicated AREDS and AREDS2 could potentially slow down GA lesion progression without affecting overall GA area growth. Goldberg and colleagues analyzed whether the OAKS and DERBY trial populations exhibited similar effects.1

“We actually had quite a large population of patients with untreated geographic atrophy, of whom about half were on AREDS vitamins,” Goldberg told HCPLive. “So we had a great comparison between patients on vitamins and patients not on vitamins.”

During the study, eyes were grouped by AREDS micronutrients use (AREDS, AREDS2, or no micronutrients); sham observed NSF GA eyes and fellow eyes with NSF GA that met study inclusion criteria from subjects in the modified intent-to-treat population were pooled and included in the analysis.1

Changes in GA distance to foveal centerpoint from baseline and changes in square root transformed total GA lesion size, measured by reading center assessments on fundus autofluorescence (FAF) images over 24 months. For analyses of distance to foveal centerpoint, if it was reached or an event of exudative AMD occurred, the data from subsequent timepoints were excluded.1

A total of 516 eyes with NSF GA were included – 226 of these were on micronutrients and 290 were not. Participants exhibited no meaningful difference in progression towards the fovea between the sham and fellow eyes between micronutrient supplementation compared to those not (13 µm faster growth, P = .5). There was also no meaningful difference in area-based GA progression between eyes on and not on oral supplementation (.07 mm more progression, P = .08).1

Ultimately, Goldberg and colleagues noted that this analysis found no evidence that oral micronutrient supplements slow GA progression towards the fovea or overall GA growth. Goldberg also acknowledged the limited ability of post hoc analyses to fully guide clinical practice, justifying the study’s departure from previous findings.1

“I think AREDS are safe, so if patients want to take them, I think that’s fine,” Goldberg said. “Do I think it’s a substitute for either considering one of the FDA approved medicines, or that it should impact or impede our development of new agents? No. But lots of therapies are in development across all stages, some still targeting a compliment cascade, some targeting totally new pathways. I’m excited and optimistic for what the next decade or two will bring.”

Goldberg reports the following disclosures: Regeneron, Alimera, EyePoint, Cognition, 4DMT, and others

References

1. Goldberg, R, Saperstein, D, Do, D, et al. Analysis of AREDS oral micronutrients supplementation on geographic atrophy growth: Insights from the OAKS and DERBY studies. Abstract presented at Association for Research in Vision and Ophthalmology in Salt Lake City, UT, from May 3 – May 8, 2025.