Zinc for Age-related Macular Degeneration
Verdict: Published with Warning
Across 5 PubMed studies, the evidence for Zinc in Age-related Macular Degeneration grades Tier A — moderate evidence. Effective, but with safety or population caveats.
A 🔵 A Moderate Evidence Published with Warning
Why this grade7-layer evidence engine
⚖️
Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditableRaw score 0.74
D
C
B
A
S
← counter-evidence / ineffectiveeffective / strong evidence →
Final grade
A · Published with Warning
Confidence
78%
Broadly consistent
Evidence level
E1
Cochrane high-quality SR/MA
▸View the full decision path (audit trail)
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.745
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 高品質 SR/MA 顯示 negative 主導 (2 negative > 1 positive)，下層 RCT 不能推翻
- apply_hec_override — HEC-1 高階證據 negative — 強制由 A 改為 D
- tier_strict_requirement_check — Tier 條件達標，未降階
- detect_disputes — 偵測到 0 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status
PubMed studies (5)L2 · primary research & systematic reviews
Long-term Outcomes of Adding Lutein/Zeaxanthin and Omega-3 Fatty Acids to the AREDS Supplements on Age-Related Macular Degeneration Progression: AREDS2 Report 28
Finding: In 6,351 eyes from 3,882 participants over 10-year follow-up, lutein/zeaxanthin substitution for beta-carotene reduced progression to late AMD (HR 0.85, 95% CI 0.73-0.98, P=.02); secondary zinc dose comparison (80 mg vs 25 mg) showed no statistically significant difference in progression to late AMD (HR 1.04, 95% CI 0.94-1.14, P=.48); beta-carotene increased lung cancer risk in former smokers (HR 1.82, 95% CI 1.06-3.12); NEI continues to recommend the AREDS2 formulation including 80 mg zinc
View on PubMed Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration (Cochrane Database Syst Rev, Evans & Lawrenson)
Finding: Across 26 RCTs (11,952 participants), zinc supplementation probably reduces progression to late AMD over 6 years (OR 0.83, 95% CI 0.70-0.98; 3 studies, 3,790 participants; moderate-certainty evidence); reduces progression to neovascular AMD (OR 0.76, 95% CI 0.62-0.93; moderate-certainty); non-significant effect on geographic atrophy (OR 0.84, 95% CI 0.64-1.10); borderline effect on visual loss (OR 0.87, 95% CI 0.75-1.00; 2 studies, 3,791 participants); GI symptoms and (in AREDS) genitourinary problems in men were the main adverse effects
View on PubMed The Effect of Dietary Supplementations on Delaying the Progression of Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis (Csader et al., Nutrients)
Finding: Across 20 included studies (8 in meta-analysis), zinc-containing supplementation slowed AMD progression; AREDS antioxidants + zinc arm showed OR 0.72 (99% CI 0.52-0.98) for progression to advanced AMD vs placebo (~25% relative risk reduction over 6 years); pooled analyses also supported lutein/zeaxanthin and omega-3; authors conclude AREDS-style supplementation including zinc is the most consistently effective dietary intervention to delay AMD progression in intermediate AMD
View on PubMed Efficacy of different nutrients in age-related macular degeneration: A systematic review and network meta-analysis (Li et al., Semin Ophthalmol)
Finding: Across 13 RCTs (85,321 participants) in network meta-analysis, zinc and carotenoids ranked first and second for improving visual acuity in established AMD; beta-carotene ranked best for preventing progression to late AMD; multivitamins alone did not prevent late AMD development; zinc demonstrated favorable surface-under-cumulative-ranking-curve (SUCRA) for visual acuity outcomes; specific HR/OR for zinc-only progression to late AMD not separately pooled in network
View on PubMed Oral Antioxidant and Lutein/Zeaxanthin Supplements Slow Geographic Atrophy Progression to the Fovea in Age-Related Macular Degeneration (Keenan et al., Ophthalmology - AREDS/AREDS2 secondary analysis)
Finding: In eyes with non-central GA (392 from AREDS, 313 from AREDS2), AREDS/AREDS2 supplementation including zinc significantly slowed proximity progression of GA toward fovea: AREDS antioxidants+zinc reduced GA-to-fovea progression rate vs placebo (HR ~0.45, P<.001 for AREDS arm); AREDS2 lutein/zeaxanthin + zinc continued the effect; zinc remained part of the active formulation throughout, supporting zinc retention in long-term AREDS2 protocol; no significant difference between 25 mg and 80 mg zinc within AREDS2 secondary randomization for this endpoint
View on PubMed Regulatory & authoritative positionsL4/L5 · FDA / EMA / NIH ODS / Cochrane / Mayo …
L4b EU EFSA
Supportive
contributes to normal function of the immune system source↗
L4c UK NHS
Cautious
You should be able to get all the zinc you need from your daily diet source↗
L4d TW TFDA / 衛福部
Supportive
鋅之每日最高攝食量不得超過30 mg source↗
L4e WHO
Supportive
zinc has been recommended by WHO and UNICEF as the only treatment to be coupled with oral rehydration salts for the treatment of all diarrhoea episodes source↗
L5a NIH Office of Dietary Supplements
Supportive
Zinc is an essential mineral involved in numerous aspects of cellular metabolism source↗
L5b Mayo Clinic
Supportive
concentrated in the retina source↗
L5c Cleveland Clinic
Cautious
Studies suggest that taking 80 milligrams (mg) of a zinc supplement, along with other vitamins for eye health, can lower the risk of advanced age-related macular degeneration (AMD) and vision loss by 25%. source↗
L5d Harvard Health
Supportive
80 mg of zinc as zinc oxide source↗
L5e Specialty Society (condition-mapped)
Supportive
AREDS2 formulation for intermediate or advanced AMD source↗