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Randomized Controlled Trial
. 2010 Nov;128(11):1397-405.
doi: 10.1001/archophthalmol.2010.266.

Age-related cataract in a randomized trial of vitamins E and C in men

William G Christen  1 , Robert J Glynn, Howard D Sesso, Tobias Kurth, Jean MacFadyen, Vadim Bubes, Julie E Buring, JoAnn E Manson, J Michael Gaziano
Affiliations
Randomized Controlled Trial

Age-related cataract in a randomized trial of vitamins E and C in men

William G Christen et al. Arch Ophthalmol. 2010 Nov.

Abstract

Objective: To test whether supplementation with alternate-day vitamin E or daily vitamin C affects the incidence of age-related cataract in a large cohort of men.

Methods: In a randomized, double-masked, placebo-controlled trial, 11,545 apparently healthy US male physicians 50 years or older without a diagnosis of cataract at baseline were randomly assigned to receive 400 IU of vitamin E or placebo on alternate days and 500 mg of vitamin C or placebo daily.

Main outcome measure: Incident cataract responsible for a reduction in best-corrected visual acuity to 20/30 or worse based on self-report confirmed by medical record review.

Application to clinical practice: Long-term use of vitamin E and C supplements has no appreciable effect on cataract.

Results: After 8 years of treatment and follow-up, 1174 incident cataracts were confirmed. There were 579 cataracts in the vitamin E-treated group and 595 in the vitamin E placebo group (hazard ratio, 0.99; 95% confidence interval, 0.88-1.11). For vitamin C, there were 593 cataracts in the treated group and 581 in the placebo group (hazard ratio, 1.02; 95% confidence interval, 0.91-1.14).

Conclusion: Long-term alternate-day use of 400 IU of vitamin E and daily use of 500 mg of vitamin C had no notable beneficial or harmful effect on the risk of cataract.

Trial registration: clinicaltrials.gov Identifier: NCT00270647.

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Figures

Figure 1
Figure 1
Flow diagram of the Vitamin E and Vitamin C components of the Physicians' Health Study II. A total of 3,096 participants who had a diagnosis of cataract at baseline were excluded.
Figure 2
Figure 2
Venn diagram showing subtypes for 1,160 participants with diagnosed cataract in Physicians' Health Study II. Excludes 14 participants with missing subtype information. NS, nuclear sclerosis; PSC, posterior subcapsular.
Figure 3
Figure 3
Cumulative incidence rates of cataract in the vitamin E and vitamin C groups in the Physicians' Health Study II.
Figure 4
Figure 4
Hazard ratios and 95% confidence intervals of cataract and subtypes comparing vitamin E alone, vitamin C alone, and vitamin E plus C groups with placebo (combined vitamin E and C placebo groups) in the Physicians' Health Study II. Adjusted for age, PHS cohort, and beta-carotene and multivitamin treatment assignment. NS, nuclear sclerosis; PSC, posterior subcapsular. a With or without other subtypes; b Test of the null hypothesis of no difference in treatment effect across treatment combinations.
See this image and copyright information in PMC

Comment in

  • Vitamin E and age-related cataracts.
    Roberts LJ 2nd. Roberts LJ 2nd. Arch Ophthalmol. 2011 Jun;129(6):815; author reply 815-6. doi: 10.1001/archophthalmol.2011.106. Arch Ophthalmol. 2011. PMID: 21670360 No abstract available.

References

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