Cochrane · systematic review · CD000254
Antioxidant vitamin and mineral supplements for slowing the progression of age‐related macular degeneration
Evans, JR, Lawrenson, JG · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
28
current version
GRADE rated
20
No studies
8
Included studies
NR
No studies 8 · 28.6%Ungraded 0 · 0%Very low 4 · 14.3%Low 7 · 25%Moderate 9 · 32.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyAntioxidant multivitamin and mineral supplement versus placebo or no treatment for slowing the progression of age‐related macular degeneration
Population: people with AMD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Progression to late AMD (neovascular AMD, geographic atrophy, or both) Antioxidant multivitamin and mineral supplement vs placebo or no treatment | OR 0.72 [0.58, 0.9] | 3 studies · 2445 participants | Moderate Downgraded: imprecision |
Progression to neovascular AMD Antioxidant multivitamin and mineral supplement vs placebo or no treatment | OR 0.62 [0.47, 0.82] | 1 study · 1206 participants | Moderate Downgraded: imprecision |
Progression to geographic atrophy Antioxidant multivitamin and mineral supplement vs placebo or no treatment | OR 0.75 [0.51, 1.1] | 1 study · 1206 participants | Moderate Downgraded: imprecision |
Progression to visual loss (loss of 3 or more lines on logMAR chart) Antioxidant multivitamin and mineral supplement vs placebo or no treatment | OR 0.77 [0.62, 0.96] | 1 study · 1791 participants | Moderate Downgraded: imprecision |
Quality of life Antioxidant multivitamin and mineral supplement vs placebo or no treatment | no estimate extracted | 1 study · 110 participants | Low Downgraded: risk of bias, imprecision |
Adverse effects Antioxidant multivitamin and mineral supplement vs placebo or no treatment | OR 0.87 | 0 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Resource use and costs Antioxidant multivitamin and mineral supplement vs placebo or no treatment | no estimate extracted | NR | No studies |
Lutein with or without zeaxanthin versus placebo for slowing the progression of age‐related macular degeneration
Population: people with AMD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Progression to late AMD (neovascular AMD, geographic atrophy, or both) Lutein with or without zeaxanthin vs placebo | RR 0.94 [0.87, 1.01] | 1 study · 6891 participants | Low Downgraded: imprecision, indirectness |
Progression to neovascular AMD Lutein with or without zeaxanthin vs placebo | RR 0.92 [0.84, 1.02] | 1 study · 6891 participants | Low Downgraded: imprecision, indirectness |
Progression to geographic atrophy Lutein with or without zeaxanthin vs placebo | RR 0.92 [0.8, 1.05] | 1 study · 6891 participants | Low Downgraded: imprecision, indirectness |
Progression to visual loss (loss of 3 or more lines on logMAR chart) Lutein with or without zeaxanthin vs placebo | RR 0.98 [0.91, 1.05] | 1 study · 6656 participants | Low Downgraded: imprecision, indirectness |
Quality of life Lutein with or without zeaxanthin vs placebo | no estimate extracted | 2 studies · 308 participants | Moderate Downgraded: risk of bias, imprecision |
Adverse effects Lutein with or without zeaxanthin vs placebo | OR 1.06 | NR | Very low Downgraded: imprecision, inconsistency, indirectness |
Resource use and costs Lutein with or without zeaxanthin vs placebo | no estimate extracted | NR | No studies |
Vitamin E versus placebo for slowing the progression of age‐related macular degeneration
Population: people with AMD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Progression to late AMD (neovascular AMD, geographic atrophy or both) Vitamin E vs placebo | RR 1.36 [0.31, 6.05] | 1 study · 998 participants | Very low Downgraded: imprecision, indirectness |
Progression to neovascular AMD Vitamin E vs placebo | no estimate extracted | NR | No studies |
Progression to geographic atrophy Vitamin E vs placebo | no estimate extracted | NR | No studies |
Progression to visual loss (loss of 3 or more lines on logMAR chart) Vitamin E vs placebo | RR 1.04 [0.74, 1.47] | 1 study · 1179 participants | Low Downgraded: imprecision, indirectness |
Quality of life Vitamin E vs placebo | no estimate extracted | NR | No studies |
Adverse effects Vitamin E vs placebo | no estimate extracted | 4 participants | Very low Downgraded: imprecision |
Resource use and costs Vitamin E vs placebo | no estimate extracted | NR | No studies |
Zinc versus placebo for slowing the progression of age‐related macular degeneration
Population: people with AMD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Progression to late AMD (neovascular AMD, geographic atrophy or both) Zinc vs placebo | OR 0.83 [0.7, 0.98] | 3 studies · 3790 participants | Moderate Downgraded: imprecision |
Progression to neovascular AMD Zinc vs placebo | OR 0.76 [0.62, 0.93] | 1 study · 2442 participants | Moderate Downgraded: imprecision |
Progression to geographic atrophy Zinc vs placebo | OR 0.84 [0.64, 1.1] | 1 study · 2442 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Progression to visual loss (loss of 3 or more lines on logMAR chart) Zinc vs placebo | OR 0.87 [0.75, 1] | 2 studies · 3791 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Quality of life Zinc vs placebo | no estimate extracted | NR | No studies |
Adverse effects Zinc vs placebo | no estimate extracted | 286 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Resource use and costs Zinc vs placebo | no estimate extracted | NR | No studies |
Multivitamin versus placebo
Population: people with AMD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Progression to late AMD (neovascular AMD, geographic atrophy or both) Multivitamin vs placebo | OR 0.72 [0.58, 0.9] | 3 studies · 2445 participants | Moderate Downgraded: imprecision |
Progression to neovascular AMD Multivitamin vs placebo | OR 0.62 [0.47, 0.82] | 1 study · 1206 participants | Moderate Downgraded: imprecision |
Progression to geographic atrophy Multivitamin vs placebo | OR 0.75 [0.51, 1.1] | 1 study · 1206 participants | Moderate Downgraded: imprecision |
Progression to visual loss (loss of 3 or more lines on logMAR chart) Multivitamin vs placebo | OR 0.77 [0.62, 0.96] | 1 study · 1791 participants | Moderate Downgraded: imprecision |
Quality of life Multivitamin vs placebo | no estimate extracted | 1 study · 110 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Adverse effects Multivitamin vs placebo | no estimate extracted | 0 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Resource use and costs Multivitamin vs placebo | no estimate extracted | NR | No studies |
Lutein or zeaxanthin versus placebo
Population: people with AMD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Progression to late AMD (neovascular AMD, geographic atrophy, or both) Lutein or zeaxanthin vs placebo | RR 0.94 [0.87, 1.01] | 1 study · 6891 participants | Low Downgraded: indirectness |
Progression to neovascular AMD Lutein or zeaxanthin vs placebo | RR 0.92 [0.84, 1.02] | 1 study · 6891 participants | Low Downgraded: indirectness |
Progression to geographic atrophy Lutein or zeaxanthin vs placebo | RR 0.92 [0.8, 1.05] | 1 study · 6891 participants | Low Downgraded: indirectness |
Progression to visual loss (loss of 3 or more lines on logMAR chart) Lutein or zeaxanthin vs placebo | RR 0.98 [0.91, 1.05] | 1 study · 6656 participants | Low Downgraded: indirectness |
Quality of life Lutein or zeaxanthin vs placebo | no estimate extracted | 1 study · 108 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Adverse effects Lutein or zeaxanthin vs placebo | no estimate extracted | 2 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Resource use and costs Lutein or zeaxanthin vs placebo | no estimate extracted | NR | No studies |
Vitamin E versus placebo
Population: people with AMD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Progression to late AMD (neovascular AMD, geographic atrophy or both) Vitamin E vs placebo | RR 1.36 | 1 study · 998 participants | Very low Downgraded: imprecision |
Progression to neovascular AMD Vitamin E vs placebo | no estimate extracted | NR | No studies |
Progression to geographic atrophy Vitamin E vs placebo | no estimate extracted | NR | No studies |
Progression to visual loss (loss of 3 or more lines on logMAR chart) Vitamin E vs placebo | RR 1.04 [0.74, 1.47] | 1 study · 1179 participants | Low Downgraded: imprecision |
Quality of life Vitamin E vs placebo | no estimate extracted | NR | No studies |
Adverse effects Vitamin E vs placebo | no estimate extracted | 91 participants | Very low Downgraded: imprecision, indirectness |
Resource use and costs Vitamin E vs placebo | no estimate extracted | NR | No studies |
Zinc versus placebo
Population: people with AMD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Progression to late AMD (neovascular AMD, geographic atrophy or both) Zinc vs placebo | OR 0.83 [0.7, 0.98] | 3 studies · 3790 participants | Low Downgraded: inconsistency |
Progression to neovascular AMD Zinc vs placebo | OR 0.76 [0.62, 0.93] | 1 study · 2442 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Progression to geographic atrophy Zinc vs placebo | OR 0.84 [0.64, 1.1] | 1 study · 2442 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Progression to visual loss (loss of 3 or more lines on logMAR chart) Zinc vs placebo | OR 0.87 [0.75, 1] | 2 studies · 3791 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Quality of life Zinc vs placebo | no estimate extracted | NR | No studies |
Adverse effects Zinc vs placebo | no estimate extracted | 286 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Resource use and costs Zinc vs placebo | no estimate extracted | NR | No studies |
Multivitamin antioxidant vitamin or mineral supplement for age‐related macular degeneration
Population: patients with age‐related macular degeneration
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Distance visual acuity (loss of 3 or more lines) LogMAR | OR 0.77 [0.62, 0.96] | 1 study · 3640 participants | Moderate Downgraded: imprecision, inconsistency |
Progression to advanced AMD Grading of fundus photographs | OR 0.68 [0.53, 0.87] | 1 study · 3640 participants | Moderate Downgraded: imprecision, inconsistency |
Zinc for age‐related macular degeneration
Population: patients with age‐related macular degeneration
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Distance visual acuity (loss of 3 or more lines) LogMAR | OR 0.81 [0.66, 0.99] | 2 studies · 1942 participants | Moderate Downgraded: imprecision |
Progression to advanced AMD Grading of fundus photographs | OR 0.73 [0.58, 0.93] | 3 studies · 1943 participants | Moderate Downgraded: imprecision, inconsistency |
Vitamin E for age‐related macular degeneration
Population: patients with age‐related macular degeneration
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Distance visual acuity (loss of 2 or more lines) LogMAR | OR 1.05 [0.71, 1.54] | 1 study · 1179 participants | Low Downgraded: imprecision, inconsistency |
Progression of AMD (dichotomous) Grading of fundus photographs | OR 1.11 [0.81, 1.53] | 1 study · 997 participants | Low Downgraded: imprecision, inconsistency |
Lutein for age‐related macular degeneration
Population: patients with age‐related macular degeneration
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Distance visual acuity (loss of 3 or more lines) | no estimate extracted | NR | No studies |
Progression of AMD (dichotomous) | no estimate extracted | NR | No studies |