Clinical question
How effective are antioxidant vitamin and mineral supplements (AVMS) on the progression of age-related macular degeneration (AMD)?
Bottom line
Taking antioxidant vitamins plus zinc probably slowed down the progression to late AMD and vision loss (moderate-certainty evidence). This might result in a small improvement in quality of life (low-certainty evidence).
Taking lutein alone (or combined with zeaxanthin) might have little or no effect on progression to late AMD and vision loss (low-certainty evidence).
Taking vitamin E alone might have little or no effect on the progression to late AMD and vision loss (low-certainty evidence).
Duration of supplementation and follow-up ranged from 9 months to 6 years.
Very low-certainty evidence was available on adverse effects because the included studies were underpowered and adverse effects inconsistently reported.
Caveat
These conclusions were largely drawn from a single large trial conducted in a relatively well-nourished US population.
The generalisability of these findings to other populations is not known. Although generally regarded as safe, vitamin supplements may have harmful effects.
Context
It has been proposed that antioxidants may prevent cellular damage in the retina by reacting with free radicals that are produced in the process of light absorption. Higher dietary levels of antioxidant vitamins and minerals may reduce the risk of progression of AMD.
Cochrane Systematic Review
Evans JR and Lawrenson JG. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. Cochrane Reviews, 2017, Issue 9. Art. No.: CD000254.DOI: 10.1002/14651858. CD000254.pub4. This review contains 19 studies involving 11,162 participants.
Cochrane Systematic Reviews for primary care practitioners – developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the Ministry of Health. Brian McAvoy is an honorary/adjunct professor of general practice at the Universities of Auckland, Melbourne, Monash and Queensland. New Zealanders can access the Cochrane Library free via nz.cochrane.org
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