Primary prevention of age related macular degeneration

doi:10.1136/bmj.39351.478924.BE

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Jennifer Evans, lecturer

International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT

jennifer.evans{at}lshtm.ac.uk

Current evidence does not support a protective role for dietary antioxidant vitamins

In this week's BMJ, Chong and colleagues present a systematic review and meta-analysis of the effectiveness of dietary antioxidants, including supplements, in the primary prevention of age related macular degeneration.1

Age related macular degeneration is one of the most important causes of visual loss in older people. The number of people affected will increase as populations age.2 Two types of age related macular degeneration exist. Geographic atrophy is a sharply demarcated area of depigmentation caused by atrophy of the retinal pigment epithelium; neovascular degeneration occurs when new blood vessels grow under the retinal pigment epithelium leading to haemorrhage and scarring. Age related macular degeneration is diagnosed in people aged 50 or more when no other obvious cause for degeneration exists.

New treatments are being developed rapidly. In the past two years, intraocular injections of agents that interfere with angiogenesis have been licensed for use in this condition.3 These …