BMJ 2002;325:11 ( 6 July )

Papers

Vitamin E supplementation and macular degeneration: randomised controlled trial

Hugh R Taylor, professor, ^a Gabriella Tikellis, research fellow, ^a Luba D Robman, senior research fellow, ^a Catherine A McCarty, associate professor, ^a John J McNeil, professor. ^b

^a Centre for Eye Research Australia, University of Melbourne, Locked Bag 8, East Melbourne, Victoria, Australia, 8002, ^b Department of Epidemiology and Preventive Medicine, Monash University, Room 306, Building ALF, Alfred Hospital, Caulfield, Victoria, Australia, 3145

Correspondence to: H R Taylor h.taylor{at}unimelb.edu.au

Objective: To determine whether vitamin E supplementation influences the incidence or rate of progression of age related maculopathy (AMD).
Design: Prospective randomised placebo controlled clinical trial.
Setting: An urban study centre in a residential area supervised by university research staff.
Participants: 1193 healthy volunteers aged between 55 and 80 years; 73% completed the trial on full protocol.
Interventions: Vitamin E 500 IU or placebo daily for four years.
Main outcome measures: Primary outcome: development of early age related macular degeneration in retinal photographs. Other measures included alternative definitions of age related macular degeneration, progression, changes in component features, visual acuity, and visual function
Results: The incidence of early age related macular degeneration (early AMD 3) was 8.6% in those receiving vitamin E versus 8.1% in those on placebo (relative risk 1.05, 95% confidence interval 0.69 to 1.61). For late disease the incidence was 0.8% versus 0.6% (1.36, 0.67 to 2.77). Further analysis showed no consistent differences in secondary outcomes.
Conclusion: Daily supplement with vitamin E supplement does not prevent the development or progression of early or later stages of age related macular degeneration.

What is already known on this topic Age related macular degeneration is the leading cause of loss of vision and blindness in elderly people; for people aged 90 years, two out of every three will be affected and one in four will become blind Currently, there are no methods of prevention or treatment in most cases, though a third of cases are due to cigarette smoking Antioxidant vitamins have been suggested as a possible prevention What this study adds Daily supplementation with 500 mg vitamin E for four years did not alter the incidence or progression of AMD

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Rapid Responses:

Read all Rapid Responses

Comment on use of Vitamin E

David Potterton
bmj.com, 8 Jul 2002 [Full text]

Re: Comment on use of Vitamin E

Hugh R Taylor
bmj.com, 9 Jul 2002 [Full text]