A Randomized, Placebo-Controlled, Clinical Trial of High-Dose Supplementation With Vitamins C and E and Beta Carotene for Age-Related Cataract and Vision Loss

The Age-Related Eye Disease Study (AREDS) was a randomized, double-masked, clinical trial with two components, an age-related macular degeneration (AMD) trial and a cataract trial. This paper reports the results of the AMD trial, which was designed to determine the effect of high-dose vitamins C and E, beta carotene, and zinc supplements on the progression of AMD and vision loss. Based on the study findings, the authors recommended that individuals fifty-five years of age and older with extensive intermediate size drusen, at least one large druse, noncentral geographic atrophy in one or both eyes, or advanced AMD or vision loss due to AMD in one eye, and without contraindications such as smoking, should consider taking a supplement of antioxidants (consisting of vitamin C and E and beta carotene) plus zinc.

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High-Dose Supplementation with Vitamins C and E and Beta Carotene for Age-Related Cataract and Vision Loss

50 Studies Every Ophthalmologist Should Know ◽

10.1093/med/9780190050726.003.0007 ◽

2020 ◽

pp. 39-44

Author(s):

Alan D. Penman ◽

Kimberly W. Crowder ◽

William M. Watkins

Keyword(s):

Visual Acuity ◽

Vision Loss ◽

Beta Carotene ◽

High Dose ◽

Age Related ◽

History Of ◽

Visual Acuity Loss ◽

Lens Opacities ◽

Antioxidant Characteristics ◽

Disease Study

The Age-Related Eye Disease Study (AREDS) was a multicenter study of the natural history of age-related cataract and macular degeneration (AMD) in a relatively well-nourished older adult cohort that comprised two clinical trials sharing one pool of participants. The study was designed to determine whether a high-dose antioxidant formulation affected the development and progression of age-related lens opacities and visual acuity loss. The cataract trial showed that use of a high-dose formulation of vitamins having antioxidant characteristics (vitamin C, vitamin E, and beta carotene) had no apparent effect on the 7-year risk of development or progression of age-related lens opacities or visual acuity loss.

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Microvascular abnormalities secondary to radiation therapy in neovascular age-related macular degeneration: findings from the INTREPID clinical trial

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-311865 ◽

2018 ◽

Vol 103 (4) ◽

pp. 469-474 ◽

Cited By ~ 6

Author(s):

Florentina Joyce Freiberg ◽

Stephan Michels ◽

Alyson Muldrew ◽

Jason Slakter ◽

Denis O’Shaughnessy ◽

...

Keyword(s):

Clinical Trial ◽

Macular Degeneration ◽

Vision Loss ◽

Visual Outcome ◽

Retinal Vessel ◽

Age Related Macular Degeneration ◽

Controlled Clinical Trial ◽

Anti Vegf ◽

Age Related ◽

Endothelial Growth Factor

PurposeTo report the incidence and features of retinal microvascular abnormalities (MVAs) occurring secondary to stereotactic radiotherapy (SRT) in a randomised double-masked sham-controlled clinical trial at 21 European sites.MethodsTwo hundred and thirty participants with neovascular age-related macular degeneration (AMD) treated with at least three intravitreal antivascular endothelial growth factor (anti-VEGF) injections prior to enrolment, and demonstrating a continuing need for re-treatment. Interventions: 16 Gy, 24 Gy or sham SRT. All three groups received pro re nata anti-VEGF injections if the lesion was judged to be active at review visits. Colour fundus images from baseline and 6 months and fluorescein angiograms from baseline and annual visits were graded for measures of morphological outcome and safety using a prespecified protocol with accompanying definitions to distinguish RT-related MVA from non-specific retinal vessel abnormalities that are known to occur in neovascular AMD. The main outcome measure was MVA detected by months 12, 24 and 36 after enrolment.ResultsThe frequency of MVAs in the combined SRT arms was 0% in year 1, 13.1% in year 2 and 30.3% in year 3. The area of MVA was small and the mean change in visual acuity in year 2 was similar in a subset of SRT eyes with MVAs, versus those without MVAs. MVA was considered to have possibly contributed to vision loss in 2 of 18 cases with MVA in year 2, and 5 of 37 cases in year 3.ConclusionTreatment with SRT is associated with development of subtle MVAs that have little or no impact on visual outcome. These findings can help clinicians recognise the retinal MVAs that occur in response to SRT.

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