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Antioxidant Status and Neovascular Age-Related Macular Degeneration

Antioxidant Status and Neovascular Age-Related Macular Degeneration Abstract • We evaluated the hypothesis that higher serum levels of micronutrients with antioxidant capabilities may be associated with a decreased risk of neovascular age-related macular degeneration by comparing serum levels of carotenoids, vitamins C and E, and selenium in 421 patients with neovascular age-related macular degeneration and 615 controls. Subjects were classified by blood level of the micronutrient (low, medium, and high). Persons with carotenoid levels in the medium and high groups, compared with those in the low group, had markedly reduced risks of neovascular age-related macular degeneration, with levels of risk reduced to one half and one third, respectively. Although no statistically significant protective effect was found for vitamin C or E or selenium individually, an antioxidant index that combined all four micronutrient measurements showed statistically significant reductions of risk with increasing levels of the index. Although these results suggest that higher blood levels of micronutrients with antioxidant potential, in particular, carotenoids, may be associated with a decreased risk of the most visually disabling form of age-related macular degeneration, it would be premature to translate these findings into nutritional recommendations. References 1. Retinal and Choroidal Diseases Panel, National Advisory Eye Council. Vision Research—a National Plan: 1983-1987 . Bethesda, Md: US Dept of Health and Human Services; 1984. Publication NIH 83-2471. 2. Ferris FL III, Fine SL, Hyman L. Age-related macular degeneration and blindness due to neovascular maculopathy . Arch Ophthalmol . 1984;102:1640-1642.Crossref 3. Hyman LG, Lilienfeld AM, Ferris FL III, Fine SL. Senile macular degeneration: a case-control study . Am J Epidemiol . 1983;118:213-227. 4. The Eye Disease Case-Control Study Group. Risk factors for neovascular age-related macular degeneration. Arch Ophthalmol. In press. 5. Young RW. Solar radiation and age-related macular degeneration . Surv Ophthalmol . 1988;32:252-269.Crossref 6. Sperduto RD, Ferris FL III, Kurinij N. Do we have a nutritional treatment for age-related cataract or macular degeneration? Arch Ophthalmol . 1990;108:1403-1405.Crossref 7. Ferris FL, Kassoff A, Bresnick GH, Bailey I. New visual acuity charts for clinical research . Am J Ophthalmol . 1982;94:91-96. 8. Hyman L, Schachat A, Ferris F, et al. Classification of age-related macular degeneration . Invest Ophthalmol Vis Sci . 1988;29:120. 9. Gunter EW, Turner WE, Neese JW, Bayse DD. Laboratory Methods Used by the Clinical Chemistry Division, Centers for Disease Control, for the Second Health and Nutrition Examination Survey (NHANES II) 1976-1980 . Atlanta, Ga: Centers for Disease Control; 1985:17-20. 10. Roe JH, Kuether CA. The determination of ascorbic acid in whole blood and urine through the 2,4-dinitrophenyl-hydrazine derivative of dehydroascorbic acid . J Biol Chem . 1943;147:399-407. 11. Sowell AL, Huff DL, Gunter EW, Driskell WJ. Identification of cis-carotenoids in human sera analyzed by reversed-phase high-performance liquid chromatography with diode array detection . J Chromatogr . 1988;431:424-430.Crossref 12. Lewis SA, Hardison NW, Veillon C. Comparison of isotope dilution mass spectrometry and graphite furnace atomic absorption spectrometry with Zeeman background correction for determination of plasma selenium . Anal Chem . 1986;58:1272-1273.Crossref 13. Paschal DC, Kimberly MM. Automated direct determination of selenium in serum by electrothermal atomic absorption spectroscopy . Atomic Spectroscopy . 1986;7:75-78. 14. Stryker WS, Kaplan LA, Stein EA, Stampfer MJ, Sober A, Willet WC. The relation of diet, cigarette smoking, and alcohol consumption to plasma beta-carotene and alpha-tocopherol levels . Am J Epidemiol . 1988;127:283-296. 15. Russell-Briefel R, Bates MW, Kuller LH. The relationship of plasma carotenoids to health and biochemical factors in middle-aged men . Am J Epidemiol . 1985;122:741-749. 16. Comstock GW, Menkes MS, Schober SE, Vuilleumier J-P, Helsing KJ. Serum levels of retinol, beta-carotene, and alpha-tocopherol in older adults . Am J Epidemiol . 1987;127:114-123. 17. Nierenberg DW, Stukel TA, Baron JA, Dain BJ, Greenberg ER, the Skin Cancer Prevention Study Group. Determinants of plasma levels of beta-carotene and retinol . Am J Epidemiol . 1989;130:511-521. 18. Hayes KC. Retinal degeneration in monkeys induced by deficiencies of vitamin E or A . Invest Ophthalmol . 1974;13:499-510. 19. Organisciak DT, Wang HM, Li ZY, Tso MOM. The protective effect of ascorbate in retinal light damage of rats . Invest Ophthalmol Vis Sci . 1985;26:1580-1588. 20. Weiter JJ. Macular degeneration: is there a nutritional component? Arch Ophthalmol . 1988;106:183-184.Crossref 21. Gottsch JD, Pou S, Bynoe LA, Rosen GM. Hematogenous photosensitization: a mechanism for the development of age-related macular degeneration . Invest Ophthalmol Vis Sci . 1990;31:1674-1682. 22. Handelman GJ, Dratz EA, Reay CC, van Kuijk FJGM. Carotenoids in the human macular and whole retina . Invest Ophthalmol Vis Sci . 1988;29:850-855. 23. Krinsky NI. Antioxidant functions of carotenoids . Free Radic Biol Med . 1989;7:617-635.Crossref 24. Goldberg J, Flowerdew G, Smith E, Brody JA, Tso MOM. Factors associated with age-related macular degeneration: an analysis of data from the First National Health and Nutrition Examination Survey . Am J Epidemiol . 1988;128:700-710. 25. Blumenkranz MS, Russell SR, Robey MG, Kott-Blumenkranz R, Penneys N. Risk factors in age-related maculopathy complicated by choroidal neovascularization . Ophthalmology . 1986;93:552-557.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Antioxidant Status and Neovascular Age-Related Macular Degeneration

Archives of Ophthalmology , Volume 111 (1) – Jan 1, 1993

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Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1993.01090010108035
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Abstract

Abstract • We evaluated the hypothesis that higher serum levels of micronutrients with antioxidant capabilities may be associated with a decreased risk of neovascular age-related macular degeneration by comparing serum levels of carotenoids, vitamins C and E, and selenium in 421 patients with neovascular age-related macular degeneration and 615 controls. Subjects were classified by blood level of the micronutrient (low, medium, and high). Persons with carotenoid levels in the medium and high groups, compared with those in the low group, had markedly reduced risks of neovascular age-related macular degeneration, with levels of risk reduced to one half and one third, respectively. Although no statistically significant protective effect was found for vitamin C or E or selenium individually, an antioxidant index that combined all four micronutrient measurements showed statistically significant reductions of risk with increasing levels of the index. Although these results suggest that higher blood levels of micronutrients with antioxidant potential, in particular, carotenoids, may be associated with a decreased risk of the most visually disabling form of age-related macular degeneration, it would be premature to translate these findings into nutritional recommendations. References 1. Retinal and Choroidal Diseases Panel, National Advisory Eye Council. Vision Research—a National Plan: 1983-1987 . Bethesda, Md: US Dept of Health and Human Services; 1984. Publication NIH 83-2471. 2. Ferris FL III, Fine SL, Hyman L. Age-related macular degeneration and blindness due to neovascular maculopathy . Arch Ophthalmol . 1984;102:1640-1642.Crossref 3. Hyman LG, Lilienfeld AM, Ferris FL III, Fine SL. Senile macular degeneration: a case-control study . Am J Epidemiol . 1983;118:213-227. 4. The Eye Disease Case-Control Study Group. Risk factors for neovascular age-related macular degeneration. Arch Ophthalmol. In press. 5. Young RW. Solar radiation and age-related macular degeneration . Surv Ophthalmol . 1988;32:252-269.Crossref 6. Sperduto RD, Ferris FL III, Kurinij N. Do we have a nutritional treatment for age-related cataract or macular degeneration? Arch Ophthalmol . 1990;108:1403-1405.Crossref 7. Ferris FL, Kassoff A, Bresnick GH, Bailey I. New visual acuity charts for clinical research . Am J Ophthalmol . 1982;94:91-96. 8. Hyman L, Schachat A, Ferris F, et al. Classification of age-related macular degeneration . Invest Ophthalmol Vis Sci . 1988;29:120. 9. Gunter EW, Turner WE, Neese JW, Bayse DD. Laboratory Methods Used by the Clinical Chemistry Division, Centers for Disease Control, for the Second Health and Nutrition Examination Survey (NHANES II) 1976-1980 . Atlanta, Ga: Centers for Disease Control; 1985:17-20. 10. Roe JH, Kuether CA. The determination of ascorbic acid in whole blood and urine through the 2,4-dinitrophenyl-hydrazine derivative of dehydroascorbic acid . J Biol Chem . 1943;147:399-407. 11. Sowell AL, Huff DL, Gunter EW, Driskell WJ. Identification of cis-carotenoids in human sera analyzed by reversed-phase high-performance liquid chromatography with diode array detection . J Chromatogr . 1988;431:424-430.Crossref 12. Lewis SA, Hardison NW, Veillon C. Comparison of isotope dilution mass spectrometry and graphite furnace atomic absorption spectrometry with Zeeman background correction for determination of plasma selenium . Anal Chem . 1986;58:1272-1273.Crossref 13. Paschal DC, Kimberly MM. Automated direct determination of selenium in serum by electrothermal atomic absorption spectroscopy . Atomic Spectroscopy . 1986;7:75-78. 14. Stryker WS, Kaplan LA, Stein EA, Stampfer MJ, Sober A, Willet WC. The relation of diet, cigarette smoking, and alcohol consumption to plasma beta-carotene and alpha-tocopherol levels . Am J Epidemiol . 1988;127:283-296. 15. Russell-Briefel R, Bates MW, Kuller LH. The relationship of plasma carotenoids to health and biochemical factors in middle-aged men . Am J Epidemiol . 1985;122:741-749. 16. Comstock GW, Menkes MS, Schober SE, Vuilleumier J-P, Helsing KJ. Serum levels of retinol, beta-carotene, and alpha-tocopherol in older adults . Am J Epidemiol . 1987;127:114-123. 17. Nierenberg DW, Stukel TA, Baron JA, Dain BJ, Greenberg ER, the Skin Cancer Prevention Study Group. Determinants of plasma levels of beta-carotene and retinol . Am J Epidemiol . 1989;130:511-521. 18. Hayes KC. Retinal degeneration in monkeys induced by deficiencies of vitamin E or A . Invest Ophthalmol . 1974;13:499-510. 19. Organisciak DT, Wang HM, Li ZY, Tso MOM. The protective effect of ascorbate in retinal light damage of rats . Invest Ophthalmol Vis Sci . 1985;26:1580-1588. 20. Weiter JJ. Macular degeneration: is there a nutritional component? Arch Ophthalmol . 1988;106:183-184.Crossref 21. Gottsch JD, Pou S, Bynoe LA, Rosen GM. Hematogenous photosensitization: a mechanism for the development of age-related macular degeneration . Invest Ophthalmol Vis Sci . 1990;31:1674-1682. 22. Handelman GJ, Dratz EA, Reay CC, van Kuijk FJGM. Carotenoids in the human macular and whole retina . Invest Ophthalmol Vis Sci . 1988;29:850-855. 23. Krinsky NI. Antioxidant functions of carotenoids . Free Radic Biol Med . 1989;7:617-635.Crossref 24. Goldberg J, Flowerdew G, Smith E, Brody JA, Tso MOM. Factors associated with age-related macular degeneration: an analysis of data from the First National Health and Nutrition Examination Survey . Am J Epidemiol . 1988;128:700-710. 25. Blumenkranz MS, Russell SR, Robey MG, Kott-Blumenkranz R, Penneys N. Risk factors in age-related maculopathy complicated by choroidal neovascularization . Ophthalmology . 1986;93:552-557.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Jan 1, 1993

References