Resveratrol Oral Supplement Associated With Lower Rates of Intravitreal Aflibercept Injections

Patients with wet age-related macular degeneration (AMD) had lower rates of intravitreal aflibercept injections when using the resveratrol oral supplement, according to a study published in Clinical Ophthalmology.¹ Lower rates of progression of macular fibrosis were also found.

AMD is the leading cause of vision impairment and blindness in older adults, as it can lead to the blurring of central vision.² AMD has been defined through 2 different forms of the condition: dry and wet. Late AMD is always classified as wet AMD, which leads to irreversible damage. Wet AMD can be treated with aflibercept, but overall treatment of wet AMD can be suboptimal. Resveratrol (RSV) is a polyphenolic phytoalexin that has significant benefits, including antioxidant and anti-inflammatory effects. The current study aimed to assess how the daily intake of an oral supplement containing RSV could have a beneficial effect in patients living with wet AMD.

The study took place at the Ophthalmological Institute in Athens, Greece. Participants had wet AMD and were treatment naïve. All participants were assigned to 2 groups matched by age and sex. Optical coherence tomography (OCT) was used to determine the use of reinjection in the first group, who had 3 monthly injections of 2.0 mg of aflibercept. The second group had the same treatment but added the daily consumption of 60 mg of RSV per day. All participants had an ocular exam at baseline.

Aflibercept plus resveratrol helps in reducing the number of injections for treatment in patients with macular degeneration | Image credit: RFBSIP - stock.adobe.com

Participants were excluded if they had previously been treated for wet AMD or if they had any other macular disorder. The primary outcomes of the study included change in best corrected visual acuity (BCVA), number of injections of aflibercept, expansion or new onset of fibrosis, and change in central foveal thickness (CFT).

There were no significant differences in age and sex between the 2 groups, with the aflibercept group being 52% men and having a mean (SD) age of 75.72 (5.49) years whereas the aflibercept plus RSV group was 48% men and had a mean age of 75.24 (5.72) years. There were no significant differences between the groups in mean logMAR BCVA or mean CFT at the end of the study period, and mean changes in these values did not differ between the groups during the study period. Both treatment groups had significant improvements in logMAR BCVA (–0.10 [0.17] in aflibercept group; –0.07 [0.16] in aflibercept plus RSV group) and in CFT value (–64.00 [20.21] μm in the aflibercept group; –62.80 [38.46] μm in the aflibercept plus RSV group).

Patients who took RSV had less of a need for injections throughout the 2-year period than those just taking aflibercept (7.40 [1.87] vs 9.32 [1.38]). Injections did not differ significantly after 12 months (5.16 [0.85] vs 5.60 [1.00]) but were significantly different at 18 months (6.48 [1.56] vs 7.68 [1.11]).

There were some limitations to this study. The efficacy of RSV may not have been fully assessed in only 24 months. The effect of RSV on visual outcomes was not evaluated in this study. The generalizability of the study is limited due to the smaller sample size. The high frequency of fibrosis in the cohort could have affected the findings of the study. The study did not evaluate the efficacy of other anti–vascular endothelial growth factor agents, which should be the focus of future study.

The researchers concluded that “the daily oral consumption of [RSV] in patients suffering from wet AMD could be identified as a useful supplementary aid to the established treatment.” Future studies could look to establish RSV as an effective addition to therapy for patients living with wet AMD.

References

1. Datseris I, Rouvas A, Tzanidaki ME, Kardara M, Geros V, Gouliopoulos N. Resveratrol supplementation in wet AMD: association with fewer intravitreal injections and reduced macular fibrosis. Clin Ophthalmol. 2025;19:217-225. doi:10.2147/OPTH.S494595
2. Age-related macular degeneration. National Institutes of Health. Updated June 22, 2021. Accessed January 27, 2025. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/age-related-macular-degeneration