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In a previous EduFacts (Volume 3, number 7) we summarized results from the prospective Pathologies Oculaires Liées á l'Age (POLA) Study, which demonstrated a high level of antioxidant enzymes in patients with AMD and cataract. The authors suggested that elevated levels of antioxidant levels may be a marker of oxidative stress in AMD patients. These same investigators recently published an evaluation of the relationship between prevalence of AMD and plasma levels of vitamin E, retinol and
vitamin C to determine if a lower plasma level of these antioxidants was associated with higher risk of AMD.
During 1995 through 1997, participants were recruited in the French city of Séte on the Mediterranean. At the baseline evaluation, presence of AMD was determined by fundus-photograph grading using the Wisconsin system in 2584 patients. Classification was collapsed for analysis into: none, early or late (neovascular) AMD.
Statistical Evaluation: Subjects were divided into groups based on quintile level of the lipid-standardized plasma vitamin E levels. Adjusted Odd's Ratios were computed ( adjusting for age ,sex education, BMI, diabetes, smoking, and various cardiovascular parameters), using the lowest quintile as the reference group. After multivariate adjustment, lipid-standardized vitamin E was inversely associated with risk of late AMD (exudative/ atrophy). The relative risk of late AMD in the highest quintile level was 0.18 (p=0.004). This suggests a decreased risk of late AMD of over 80%. Lipid standardized plasma vitamin E level was also inversely associated with early signs of AMD ( any kind of soft drusen, hyperpigmentation). The Odd's Ratio was 0.72 (28% decreased risk) in the highest vs lowest quintile level.
The authors stated that these results suggest that vitamin E may provide protection against AMD but that randomized interventional studies were necessary to establish such an effect..
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