0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Clinical Trials |

Age-Related Cataract in a Randomized Trial of Vitamins E and C in Men

William G. Christen, ScD; Robert J. Glynn, ScD; Howard D. Sesso, ScD; Tobias Kurth, MD; Jean MacFadyen, BA; Vadim Bubes, PhD; Julie E. Buring, ScD; JoAnn E. Manson, MD; J. Michael Gaziano, MD
Arch Ophthalmol. 2010;128(11):1397-1405. doi:10.1001/archophthalmol.2010.266.
Text Size: A A A
Published online

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

Figures in this Article

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Figures

Place holder to copy figure label and caption
Figure 1.

Flow diagram of the vitamin E and vitamin C components of the Physicians' Health Study (PHS) II. A total of 3096 participants who had a diagnosis of cataract at baseline were excluded.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Venn diagram showing subtypes for 1160 participants with diagnosed cataract in the Physicians' Health Study II. Excludes 14 participants with missing subtype information. PSC indicates posterior subcapsular.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 3.

Cumulative incidence rates of cataract in the vitamin E (A) and vitamin C (B) groups in the Physicians' Health Study II.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 4.

Hazard ratios and 95% confidence intervals (CIs) of cataract and subtypes comparing the vitamin E alone, vitamin C alone, and vitamin E plus vitamin C groups with placebo (combined vitamin E and vitamin C placebo groups) in the Physicians' Health Study II adjusted for age, Physicians' Health Study cohort, and beta carotene and multivitamin treatment assignment. PSC indicates posterior subcapsular. *Test of the null hypothesis of no difference in treatment effect across treatment combinations. †With or without other subtypes. Dotted vertical line indicates the 1.0 hazard ratio.

Graphic Jump Location

Tables

References

Correspondence

CME


You need to register in order to view this quiz.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 25

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature
Table 9.2-3 Refuted Evidence From Observational Studiesa

brightcove.createExperiences();