Antioxidant supplements to prevent or slow down the progression of AMD: A systematic review and meta-analysis


Evans, J; (2008) Antioxidant supplements to prevent or slow down the progression of AMD: A systematic review and meta-analysis. Eye (London, England), 22 (6). pp. 751-760. ISSN 0950-222X DOI: https://doi.org/10.1038/eye.2008.100

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Abstract

Introduction The aim of this review was to examine the evidence as to whether antioxidant vitamin or mineral supplements prevent the development of AMD or slow down its progression. Methods Randomised trials comparing antioxidant vitamin and/or mineral supplement to control were identified by systematic electronic searches (updated August 2007) and contact with investigators. Data were pooled after investigating clinical and statistical heterogeneity. Results There was no evidence that antioxidant (vitamin E or beta-carotene) supplementation prevented AMD. A total of 23 099 people were randomised in three trials with treatment duration of 4-12 years; pooled risk ratio 1.03 (95% CI, 0.74-1.43). There was evidence that antioxidant (beta-carotene, vitamin C, and vitamin E) and zinc supplementation slowed down the progression to advanced AMD and visual acuity loss in people with signs of the disease (adjusted odds ratio = 0.68, 95% CI, 0.53-0.87 and 0.77, 95% CI, 0.62-0.96, respectively). The majority of people were randomised in one trial (AREDS, 3640 people randomised). There were seven other small trials ( total randomised 525). Conclusions Current evidence does not support the use of antioxidant vitamin supplements to prevent AMD. People with AMD, or early signs of the disease, may experience some benefit from taking supplements as used in the AREDS trial. Potential harms of high-dose antioxidant supplementation must be considered. These may include an increased risk of lung cancer in smokers (beta-carotene), heart failure in people with vascular disease or diabetes (vitamin E) and hospitalisation for genitourinary conditions (zinc).

Item Type: Article
Keywords: age-related macular degeneration, antioxidant supplements, systematic, review, AGE-RELATED MACULOPATHY, MACULAR DEGENERATION, BETA-CAROTENE, VITAMIN-E, RANDOMIZED-TRIAL, LUNG-CANCER, ORAL ZINC, PHYSICIANS, DISEASE, EYE
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: The International Centre for Evidence in Disability
PubMed ID: 18425071
Web of Science ID: 256659800003
URI: http://researchonline.lshtm.ac.uk/id/eprint/6447

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