Age-Related Cataract in a Randomized Trial of Vitamins E and C in Men

Christen, William G.; Glynn, Robert J.; Sesso, Howard D.; Kurth, Tobias; MacFadyen, Jean; Bubes, Vadim; Buring, Julie E.; Manson, JoAnn E.; Gaziano, J. Michael

doi:10.1001/archophthalmol.2010.266

Cited by 70 publications

(47 citation statements)

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“…15 After 8 years of treatment and follow-up, there were no beneficial or harmful effects of this treatment regimen of vitamins E and C on the development of incident cataract in comparison of those treated versus the placebo group. The hazard ratios (HRs; 95% confidence intervals [CI]) were 0.99 (95% CI, 0.88-1.11) for vitamin E versus placebo and 1.02 (95% CI, 0.91-1.14) for vitamin C versus placebo.…”

Section: Physicians' Health Studymentioning

confidence: 85%

Nutrition Effects on Ocular Diseases in the Aging Eye

Chew¹

2013

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. We reviewed the data from the clinical trials of nutritional supplements for the treatment of age-related cataract and age-related macular degeneration (AMD) to determine future directions of research and treatment.METHODS. Data from the controlled clinical trials are presented and reviewed for potential opportunities for further research into the treatment of cataracts and AMD.RESULTS. Two trials using daily multivitamins/minerals demonstrated a reduction in the progression of nuclear cataract, but increased the risk of posterior subcapsular cataract. For AMD, the Age-Related Eye Disease Study (AREDS) formulation (vitamins C, E, beta-carotene, zinc, and copper) reduced the risk of progression to advanced AMD by 25% at 5 years. Because beta-carotene is associated with increased lung cancer in former smokers, lutein/ zeaxanthin could replace beta-carotene and provide an incremental increase in the beneficial effects beyond the effects of the AREDS formulation. In addition, a randomized clinical trial of B vitamins demonstrated a beneficial effect for AMD with the vitamin B complex.CONCLUSIONS. Future evaluation may include additional assessments of nutrients for the treatment of progression of cataract and AMD. A modest reduction would have significant impact as the numbers of persons affected with these two leading causes of blindness are projected to double in the next decade. An important step would be to develop surrogate outcomes to increase efficiency in clinical trials. More detailed phenotyping, especially of AMD, is required as it appears to be not one disease, but a group of diseases. Genotypephenotype analyses may help to target pathways that are important in AMD.Keywords: age-related macular degeneration, cataract type, antioxidants A ge-related cataract and macular degeneration (AMD), two leading causes of blindness in the United States, are agerelated ocular conditions in which nutritional risk factors have been evaluated extensively with observational and interventional studies. The results of a number of observational studies have provided the hypotheses and rationale for the interventional studies. The results of these interventional trials will be presented to identify potential opportunities for further research in these ocular conditions of significant public health importance. The Table gives a compilation of randomized controlled clinical trials for age-related cataract and AMD, including the nutrients evaluated and the study results. AGE-RELATED CATARACTSAge-related cataract is the leading cause of vision loss in the United States and its prevalence is rising; an estimated 30.1 million Americans will be affected by 2020. 1 Treatments that can delay the progression of lens opacities likely would reduce the burden of disease markedly. Numerous observational epidemiologic studies have demonstrated inverse relationships between dietary micronutrients and the development of age-related cataract or cataract surgery.2-7 These studies have generated interest in micronutrients with antioxid...

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Section: Physicians' Health Studymentioning

confidence: 85%

Nutrition Effects on Ocular Diseases in the Aging Eye

Chew¹

2013

Invest. Ophthalmol. Vis. Sci.

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“…The Women's Health Study (WHS), a randomized double-masked placebo controlled trial, gave 39,421 women either 600 IU vitamin E every other day or placebo for 10 years. After adjusting for age, aspirin intake and beta-carotene, vitamin E had no effect on risk for visually significant AMD (RR = 0.93; 95% CI: 0.72, 1.19), late AMD (RR = 1.13; 95% CI: 0.67, 1.92) or AMD with or without vision loss (RR = 0.90; 95% CI: 0.77, 1.06) [114]. The ATBC Study gave subjects either daily supplements of 50 mg vitamin E, 20 mg beta-carotene, both or placebo, and after five to eight years of intervention, alpha-tocopherol supplementation alone had no effect on risk for AMD (OR = 1.13; 95% CI: 0.81, 1.59) [101].…”

Section: Vitamin Ementioning

confidence: 95%

“…Excessive vitamin A uptake can lead to severe toxicity in humans [109,[111][112][113]. Water-miscible, emulsified, and solid forms of retinol are much more toxic than oil-based retinol preparations [114]. Excessive retinoic acid is even more toxic than retinol, consistent with the fact that retinoic acid is more biologically active [115].…”

Section: Retinoid Toxicity Associated With the Evolution Of Vitamin Amentioning

confidence: 99%

Nutrition and the Eye

2015

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“…A large randomized, double-masked, placebo-controlled clinical trial failed to demonstrate prophylactic effect of vitamins E and C on age-related cataract (Christen et al 2010). AREDS did not demonstrate any influence of antioxidant formulation on the progression of age-related lens opacities (AREDS 2001).…”

Section: Antioxidantsmentioning

confidence: 98%