Visual Outcome After Antioxidant Supplementation

In 2001, the National Eye Institute–funded Age-related Eye Disease Study (AREDS) published its findings. The AREDS was a double-masked, randomized, placebo-controlled trial of 4757 subjects over a period of 5 years that showed that supplementation with antioxidants vitamins C and E, β-carotene, and zinc in combination resulted in a 25% relative reduction in the risk of progression from intermediate to advanced and visually consequential age-related macular degeneration (AMD). The AREDS supplement did not contain the macular pigment carotenoids lutein and zeaxanthin, compounds believed to confer protection against development and/or progression of AMD because of their antioxidant and/or optical (blue light-filtering) properties. There is an emerging body of opinion that deficiency of macular pigment might play an etiological role in the development of AMD. We report the results of the Carotenoids in Age-related Maculopathy study (ISRCTN number 94557601), a randomized, double-blind, placebo-controlled clinical trial of lutein and zeaxanthin with co-antioxidants versus placebo in persons at high risk of progression to late AMD.