Abstract
Age-related macular degeneration (AMD) is a multifactorial disease associated with anatomical changes in the inner retina. Despite tremendous advances in clinical care, there is currently no cure for AMD. This review aims to evaluate the published literature on the therapeutic roles of natural antioxidants in AMD. A literature search of PubMed, Web of Science and Google Scholar for peer-reviewed articles published between 1 January 2011 and 31 October 2021 was undertaken. A total of 82 preclinical and 18 clinical studies were eligible for inclusion in this review. We identified active compounds, carotenoids, extracts and polysaccharides, flavonoids, formulations, vitamins and whole foods with potential therapeutic roles in AMD. We evaluated the integral cellular signaling pathways including the activation of antioxidant pathways and angiogenesis pathways orchestrating their mode of action. In conclusion, we examined the therapeutic roles of natural antioxidants in AMD which warrant further study for application in clinical practice. Our current understanding is that natural antioxidants have the potential to improve or halt the progression of AMD, and tailoring therapeutics to the specific disease stages may be the key to preventing irreversible vision loss.
Highlights
Age-related macular degeneration (AMD) is a progressive disease affecting the macular region of the retina
The Singapore Epidemiology of Eye Disease (SEED) Study reported that the prevalence of early-stage AMD in Singapore was similar to that of Australia, Singaporeans had a milder spectrum of early AMD lesions compared to Australians [4]
According to a population-based cross-sectional study conducted by Cheung et al [5], early-stage AMD is more common in Chinese and Indians than in Malays, whereas no apparent racial differences were observed in the prevalence of late-stage AMD
Summary
Age-related macular degeneration (AMD) is a progressive disease affecting the macular region of the retina. 290 million individuals are predicted to be affected with AMD by 2040, with 110 million in Asia [1]. It was one of the major causes of blindness globally in 2020 [2] among individuals aged 50 and older, after cataract and glaucoma. The population-based longitudinal Beijing Eye Study revealed that visual impairment due to AMD was relatively uncommon in the adult Chinese population in rural and urban regions [3]. According to a population-based cross-sectional study conducted by Cheung et al [5], early-stage AMD is more common in Chinese and Indians than in Malays, whereas no apparent racial differences were observed in the prevalence of late-stage AMD
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