Prospective cohort study of antioxidant vitamin supplement use and the risk of age-related maculopathy

In a prospective cohort study, the authors examined whether self-selection for antioxidant vitamin supplement use affects the incidence of age-related maculopathy. The study population consisted of 21,120 US male physician pa rticipants in the Physicians' Health Study I who did not have a diagnosis o f age-related maculopathy at baseline (1982). During an average of 12.5 per son-years of follow-up, a total of 279 incident cases of age-related maculo pathy with vision loss to 20/30 or worse were confirmed by medical record r eview. In multivariate analysis, as compared with nonusers of supplements, persons who used vitamin E supplements had a possible but nonsignificant 13 % reduced risk of age-related maculopathy (relative risk = 0.87, 95 percent confidence interval (CI) 0.53-1.43), while users of multivitamins had a po ssible but nonsignificant 10% reduced risk (relative risk = 0.90, 95% CI 0. 68-1.19), Users of vitamin C supplements had a relative risk of 1.03 (95% C I 0.71-1.50). These observational data suggest that among persons who self- select for supplemental use of antioxidant vitamin C or E or multivitamins, large reductions in the risk of age-related maculopathy are unlikely. Rand omized trial data are accumulating to enable reliable detection of the exis tence of more plausible small-to-moderate benefits of these agents alone an d in combination on age-related maculopathy.