American Journal of Epidemiology Vol. 149, No. 5: 476-484
Copyright © 1999 by The Johns Hopkins University School of Hygiene and Public Health
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Prospective Cohort Study of Antioxidant Vitamin Supplement Use and the Risk of Age-related Maculopathy
1Department of Medicine, Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School Boston, MA
2Department of Biostatistics, Harvard School of Public Health Boston, MA
3Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School Boston, MA
4Department of Epidemiology, Harvard School of Public Health Boston, MA
5National Eye Institute Bethesda, MD
6Department of Ambulatory Care and Prevention, Brigham and Women's Hospital and Harvard Medical School Boston, MA
Reprint requests to Dr. William G. Christen, Brigham and Women's Hospital, 900 Commonwealth Avenue East, Boston, MA 02215-1204.
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 participants in the Physicians' Health Study I who did not have a diagnosis of age-related maculopathy at baseline (1982). During an average of 12.5 person-years of follow-up, a total of 279 incident cases of age-related maculopathy with vision loss to 20/30 or worse were confirmed by medical record review. 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 (Cl) 0.53–1.43), while users of multivitamins had a possible but nonsignificant 10% reduced risk (relative risk = 0.90, 95% Cl 0.68–1.19). Users of vitamin C supplements had a relative risk of 1.03 (95% Cl 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. Randomized trial data are accumulating to enable reliable detection of the existence of more plausible small-to-moderate benefits of these agents alone and in combination on age-related maculopathy. Am J Epidemiol 1999; 149:476–84.
antioxidants; maculopathy, age-related; prospective studies; vitamins
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