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Editorial
Dietary interventions for AMD: what do we know and what do we not know?
  1. Jennifer R Evans1,
  2. John G Lawrenson2
  1. 1Clinical Research Department, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
  2. 2Division of Optometry and Visual Science, City University, London, UK
  1. Correspondence to Dr Jennifer R Evans, Clinical Research Department, International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; jennifer.evans{at}lshtm.ac.uk

https://doi.org/10.1136/bjophthalmol-2013-303134

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    Dietary supplements are marketed to people worried about their eyes, and recommended by eye healthcare professionals for people who have signs of age-related macular degeneration (AMD). But how much do we actually know about which dietary interventions prevent or slow down the progression of AMD? And what do we know about the adverse effects of supplements? This article summarises the Cochrane reviews on nutritional supplementation in AMD.

    There are three relevant reviews on The Cochrane Library.1–3 Overall the reviews include a total of 16 trials. Two reviews focus on the role of antioxidant supplementation in the prevention1 and progression2 of AMD and one review focuses on the role of omega 3 fatty acid (ω-3) supplementation.3 The reviews are slightly different in scope: the antioxidant reviews are restricted to dietary supplements (pills containing vitamin/mineral supplements alone or in combination); the ω-3 review also considers dietary sources, for example, fish consumption. All three reviews focus on intervention studies, specifically experimental studies where participants have been randomly allocated to dietary supplement or placebo/no intervention.

    The Cochrane review on antioxidant vitamin and mineral supplements to prevent AMD includes four trials.1 The searches for trials were last done in January 2012. This review provides high quality evidence that people aged 40 years and above in the general population are unlikely to prevent the development of AMD by taking vitamin E or β-carotene supplements. …

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    Footnotes

    • This is the first in a series of short articles summarising the results of Cochrane reviews.

    • Contributors JE and JL made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data of the Cochrane reviews on which this summary is based. JE drafted this summary and JL revised it critically for important intellectual content. Both JE and JL approved the version to be published.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • ↵i AMD was defined as extensive small drusen, intermediate drusen, large drusen, non-central geographic atrophy, or pigment abnormalities in one or both eyes, or advanced AMD/vision loss due to AMD in one eye.

    • ↵ii AREDS formula (per day): vitamin C (500 g), vitamin E (400 IU), β-carotene (15 mg), zinc oxide (80 mg).