Bausch + Lomb Publishes Review on B Vitamins and Their Role in Reducing Risk and Progression of Age-Related Macular Degeneration
Bausch + Lomb Corporation has announced the publication of a major scientific narrative review in the peer-reviewed journal Ophthalmology and Therapy, further strengthening the growing body of evidence linking B vitamins to reduced risk of age-related macular degeneration (AMD). AMD remains one of the leading causes of irreversible vision loss in adults aged 50 and older, particularly in developed countries, making it a major public health concern.
The newly published review brings together more than two decades of research on the relationship between B vitamins and ocular health. It synthesizes findings from over 20 human studies involving nearly 30,000 participants, including randomized clinical trials, large-scale observational cohorts, mechanistic laboratory studies, and biomarker analyses. By integrating this diverse evidence base, the publication provides one of the most comprehensive assessments to date of how B-vitamin status may influence the development and progression of AMD.
A complex biological link between nutrition and retinal health
The review explores the biological mechanisms that connect nutritional status—particularly B-vitamin levels—with retinal degeneration. AMD is a multifactorial disease driven by a combination of oxidative stress, mitochondrial dysfunction, chronic inflammation, and metabolic imbalance within retinal cells. According to the authors, deficiencies in certain B vitamins may exacerbate these processes by disrupting homocysteine metabolism, increasing oxidative damage, and impairing cellular energy production in retinal tissues.
Elevated homocysteine levels, in particular, have been identified as a potential risk factor for retinal damage. Homocysteine is an amino acid that, when present in excess, is associated with vascular dysfunction and increased oxidative stress. Several B vitamins—most notably B6, B9 (folate), and B12—play essential roles in regulating homocysteine levels. The review suggests that maintaining adequate intake of these vitamins may help reduce biochemical stressors that contribute to AMD progression.
Julie Poteet, OD, MS, CNS, FOWNS, and co-author of the paper, emphasized that AMD is not caused by a single factor but rather develops through interconnected biological pathways. She noted that oxidative stress, mitochondrial dysfunction, and chronic inflammation are central drivers of the disease. In this context, B vitamins may serve a protective role by supporting metabolic balance and reducing homocysteine accumulation, thereby potentially lowering the risk of retinal damage. She also highlighted that these findings are particularly relevant for patients in the early stages of AMD, where intervention may help slow disease progression.
Evidence from large-scale clinical studies
One of the strengths of the review lies in its analysis of several landmark clinical studies. Among the most notable is the Women’s Antioxidant and Folic Acid Cardiovascular Study (WAFACS), which demonstrated a 34% reduction in overall AMD risk and a 41% reduction in visually significant AMD among participants receiving daily supplementation of vitamin B6 (50 mg), vitamin B9 (2.5 mg), and vitamin B12 (1 mg). These results provide strong clinical evidence supporting the protective role of B vitamins in eye health.
Additional insights come from post-hoc analyses of the Age-Related Eye Disease Study (AREDS) and AREDS2 trials. These studies, originally designed to evaluate antioxidant supplementation in AMD, later revealed that higher dietary intake of vitamins B6 and B9 was associated with a reduced risk of progression to advanced forms of the disease, including geographic atrophy and neovascular AMD. These findings further reinforce the importance of adequate B-vitamin status in maintaining retinal health.
Observational cohort studies also support this relationship. The Blue Mountains Eye Study and the Alienor Study both found that low serum levels of vitamins B9 and B12 were associated with an increased incidence of AMD and faster disease progression. These population-based findings complement randomized trial data by demonstrating consistent associations across different study designs and populations.
Collectively, the review concludes that evidence from epidemiological, mechanistic, and clinical trial research consistently points to a strong association between B-vitamin levels and both the risk and progression of AMD.
Industry response and translation into clinical products
John Ferris, President of Consumer at Bausch + Lomb, emphasized that the publication reinforces the company’s commitment to science-driven innovation in eye health. He noted that nutritional supplementation is increasingly recognized as an important component of AMD risk reduction strategies. According to Ferris, the company is actively translating this scientific evidence into practical solutions for patients.
As part of this effort, Bausch + Lomb has introduced PreserVision AREDS3 eye vitamins, a next-generation formulation designed to support ocular cellular metabolism, maintain healthy homocysteine levels, and help protect against oxidative stress. The formulation builds upon the established AREDS2 vitamin combination by incorporating additional B vitamins based on emerging scientific evidence.
Ferris explained that the inclusion of B vitamins in the new formulation reflects both clinical research and evolving understanding of AMD biology. He also highlighted that the company is committed to ensuring that patients and eye care professionals have access to evidence-based nutritional options that may help reduce the risk of disease progression in individuals with early-stage AMD.
Mechanistic insights and emerging science
Beyond clinical data, the review also discusses emerging mechanistic and genetic research. Laboratory studies suggest that combining AREDS2 nutrients with B vitamins may produce synergistic effects on gene expression pathways involved in oxidative stress response and cellular repair. These findings indicate that B vitamins may enhance the biological activity of other antioxidants used in AMD prevention strategies.
Recent genetic studies have further strengthened the rationale for B-vitamin inclusion in eye health formulations. Variations in genes related to homocysteine metabolism and mitochondrial function have been linked to increased AMD susceptibility, suggesting that nutritional modulation of these pathways could have therapeutic relevance.
Together, these mechanistic insights provide a biological framework that helps explain the clinical associations observed in human studies. They also support the hypothesis that AMD progression can be influenced by modifiable nutritional factors, particularly those involved in one-carbon metabolism and oxidative stress regulation.
Toward future clinical validation
While existing evidence is compelling, Bausch + Lomb has indicated that further research is needed to fully establish the long-term benefits of B-vitamin supplementation in AMD management. Ferris noted that the company is currently finalizing plans for a long-term clinical trial to evaluate the new B-vitamin-enriched formulation in patients with early and intermediate AMD.
This planned study aims to provide definitive prospective data on whether targeted B-vitamin supplementation can slow disease progression, preserve visual function, and improve patient outcomes over extended periods. Importantly, the trial is designed to build on existing evidence while addressing remaining gaps in long-term clinical validation.
Broader implications for eye health
AMD represents a growing global health burden due to aging populations and increased life expectancy. As treatment options remain limited, especially in early stages of disease, preventive strategies are becoming increasingly important. Nutritional interventions, including antioxidant and vitamin supplementation, are emerging as accessible and non-invasive approaches to support long-term eye health.
The findings highlighted in this review suggest that B vitamins may play a more significant role in ocular health than previously recognized. By influencing metabolic pathways, reducing homocysteine levels, and supporting cellular resilience, these nutrients could help slow or reduce the risk of AMD development in susceptible populations.
The publication in Ophthalmology and Therapy represents an important milestone in understanding the relationship between nutrition and age-related macular degeneration. By integrating extensive clinical, observational, and mechanistic evidence, the review strengthens the scientific rationale for incorporating B vitamins into AMD prevention strategies.
For Bausch + Lomb, the findings not only validate ongoing research efforts but also support the development of next-generation nutritional solutions such as PreserVision AREDS3. As further clinical trials are planned, the company aims to continue advancing evidence-based innovations that may help preserve vision and improve quality of life for millions of individuals at risk of AMD worldwide.
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