American Board of Internal Medicine (ABIM) Certification Practice Exam

To prevent the progression of moderate dry age-related macular degeneration, patients should be treated with:

1. Low-dose steroids

2. High-dose antioxidants

3. Dietary changes only

4. Vitamin A supplements

The correct answer is: High-dose antioxidants

The use of high-dose antioxidants is supported by evidence from clinical trials, particularly the Age-Related Eye Disease Study (AREDS) and its follow-up study (AREDS2). These studies demonstrated that specific combinations of antioxidants and zinc can significantly reduce the risk of progression to advanced stages of age-related macular degeneration (AMD), particularly in patients with moderate dry AMD. Antioxidants like vitamins C and E, beta-carotene, and zinc work synergistically to combat oxidative stress and support retinal health. The formulation recommended in the AREDS trials includes a combination that has been shown to slow the progression of AMD in individuals at high risk. Other options, such as low-dose steroids and vitamin A supplements, have not shown a significant impact on the progression of dry AMD. Dietary changes, while important for overall health, do not provide the specific protective effect demonstrated by high-dose antioxidants in this context. Therefore, high-dose antioxidants are the primary intervention recommended to prevent the progression of moderate dry age-related macular degeneration.