ANTIOXIDANTS AND EYE DISEASE

Oxidative mechanisms are believed to play an important role in the pathogenesis of age-related eye disease, in particular, cataract and macular degeneration, the two most important causes of visual impairment in older adults. For this reason, there is considerable interest in determining whether vitamins and trace minerals with antioxidant properties can be of benefit in preventing the onset or progression of disabling eye disease. Basic research studies have shown that antioxidants can protect against the cumulative effects of oxidative stress in animal models of cataract and macular degeneration. Data from observational epidemiologic studies in humans, however, are inconclusive. While results from several studies, primarily cross-sectional and case-control, are compatible with a possible protective role for micronutrients in cataract and macular degeneration, data for specific nutrients or specific disease types have often been inconsistent. Further, these observational studies are Limited because of the inherent imprecision of dietary exposure data and the likely effects of uncontrolled confounding. Thus, reliable data regarding a potentially important benefit of vitamin supplementation in eye disease will emerge mainly from well-designed, large-scale, randomized trials. Such data are already being collected in the National Eye Institute-sponsored Age Related Eye Disease Study, as well as in the Physicians' Health Study and Women's Health Study.