ARE ANTIOXIDANTS OR SUPPLEMENTS PROTECTIVE FOR AGE-RELATED MACULAR DEGENERATION

Objectives: The relationships between fasting plasma levels of retinol , ascorbic acid, alpha-tochopherol, and beta-carotene and age-related macular degeneration (AMD) were studied in a population enrolled in th e Baltimore longitudinal Study of Aging (BLSA), in which most of the d ata were collected 2 or more years before assessment of macular status . Design: A total of 976 participants in the study were scheduled for a biennial examination from January 1988 through January 1, 1990, whic h included taking lens and macular photographs. A total of 827 (85%) o f the participants had fundus photographs taken, and most plasma data were available for 82% of those subjects with fundus photographs. Age- related macular degeneration was defined as neovascular changes, geogr aphic and nongeographic atrophy, large or confluent drusen, or hyperpi gmentation. A total of 226 cases of AMD were available for analysis. R esults: Logistic regression analyses suggested that alpha-tocopherol w as associated with a protective effect for AMD, adjusted for age, sex, and nuclear opacity. An antioxidant index, including ascorbic acid, a lpha-tocopherol, and beta-carotene, was also protective for AMD. Our c onclusions must be tempered with the knowledge that the population und er study was basically well nourished, and few individuals had any cli nically deficient status. The study cannot exclude the possibility tha t quite low levels of micronutrients, lower than those observed in thi s study, might be risk factors for AMD. Conclusions: The data suggest a protective effect for AMD of high plasma values of alpha-tocopherol. An antioxidant index, composed of plasma ascorbic acid, alpha-tocophe rol, and beta-carotene, was also protective. The use of vitamin supple ments to prevent AMD is not supported by these data, which showed no p rotective effect of vitamin use.