Research Article| Volume 97, ISSUE 3, SUPPLEMENT 1, S14-S17, September 26, 1994

Antioxidants and eye disease

  • William Gerard Christen Jr
    Requests for reprints should be addressed to William Gerard Christen, Jr, Ph.D., Sc.D., Brigham and Women's Hospital, 900 Commonwealth Avenue East, Boston, Massachusetts 02215.
    Division of Preventive Medicine, Department of Medicine, Harvard Medical School, and Brigham and Women's Hospital, Boston, Massachusetts USA
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.


      Oxidative mechanisms are believed to play an important role in the pathogenesis of age-related eye disease, in particular, cataract and macular degeneration, the two most important causes of visual impairment in older adults. For this reason, there is considerable interest in determining whether vitamins and trace minerals with antioxidant properties can be of benefit in preventing the onset or progression of disabling eye disease. Basic research studies have shown that antioxidants can protect against the cumulative effects of oxidative stress in animal models of cataract and macular degeneration. Data from observational epidemiologic studies in humans, however, are inconclusive. While results from several studies, primarily cross-sectional and case-control, are compatible with a possible protective role for micronutrients in cataract and macular degeneration, data for specific nutrients or specific disease types have often been inconsistent. Further, these observational studies are limited because of the inherent imprecision of dietary exposure data and the likely effects of uncontrolled confounding. Thus, reliable data regarding a potentially important benefit of vitamin supplementation in eye disease will emerge mainly from well-designed, large-scale, randomized trials. Such data are already being collected in the National Eye Institute-sponsored Age Related Eye Disease Study, as well as in the Physicians' Health Study and Women's Health Study.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. National Advisory Eye Council. Vision Research, a National Plan, 1994–1998. NIH Publication No. 93-3186, Bethesda, Maryland.

        • Kahn HA
        • Leibowitz HM
        • Ganley JP
        • et al.
        The Framingham Eye Study. I. Outline and major prevalence findings.
        Am J Epidemiol. 1977; 106: 17-32
        • Stark WJ
        • Sommer A
        • Smith RE
        Changing trends in intraocular lens implantation.
        Arch Ophthalmol. 1989; 107: 1441-1444
        • Bressler NM
        • Bressler SB
        • Fine SL
        Age-related macular degeneration.
        Surv Ophthalmol. 1988; 32: 375-413
        • Bunce GE
        • Kinoshita J
        • Horwitz J
        Nutritional factors in cataract.
        Ann Rev Nutr. 1990; 10: 233-254
        • Gerster H
        Antioxidant vitamins in cataract prevention.
        Z. Ernahrungswiss. 1989; 28: 56-75
        • Jacques PF
        • Taylor A
        Micronutrients and age-related cataracts.
        in: Bendich A Butterworth CE Micronutrients in Health and in Disease Prevention. Marcel Dekker, New York1991: 359-379
        • Taylor A
        • Jahngen JH
        • Blondin J
        • Jahngen Jr., EGE
        Ascorbate delays ultraviolet-induced, age-related damage to lens protease and the effect of maturation and aging on the function of the ubiquitin-lens protein conjugation apparatus.
        Proteases Biol Control Biotechnol. 1987; : 283-293
        • Young RW
        Solar radiation and age-related macular degeneration.
        Surv Ophthalmol. 1988; 32: 252-269
        • Hayes KC
        Retinal degeneration in monkeys induced by deficiencies of vitamin E or A.
        Invest Ophthalmol Vis Sci. 1974; 13: 499-510
        • Katz ML
        • Stone WL
        • Dratz EA
        Fluorescent pigment accumulation in retinal pigment epithelium of antioxidant-deficient rats.
        Invest Ophthalmol Vis Sci. 1978; 17: 1049-1058
        • Organisciak DT
        • Wang HM
        • Li Z-Y
        • Tso MOM
        The protective effect of ascorbate in retinal light damage of rats.
        Invest Ophthalmol Vis Sci. 1985; 26: 1580-1588
        • Jacques PF
        • Hartz SC
        • Chylack LT
        • McGandy RB
        • Sadowski JA
        Nutritional status in persons with and without senile cataract: blood vitamin and mineral levels.
        Am J Clin Nutr. 1988; 48: 152-158
        • Robertson J McD
        • Donner AP
        • Trevithick JR
        Vitamin E intake and risk of cataracts in humans.
        Ann NY Acad Sci. 1989; 570: 372-382
        • Schoenfeld ER
        • Leske MC
        • Wu S-Y
        Recent epidemiologic studies on nutrition and cataract in India, Italy and the United States.
        J Am Coll Nutr. 1993; 12: 521-526
        • Mohan M
        • Sperduto RD
        • Angra SK
        • et al.
        India-US case-control study of age-related cataracts.
        Arch Ophthalmol. 1989; 107: 670-676
        • Leske MC
        • Chylack LT
        • Wu S-Y
        The lens opacities case-control study: risk factors for cataract.
        Arch Ophthalmol. 1991; 109: 244-251
        • The Italian-American Cataract Study Group
        Risk factors for age-related cortical, nuclear, and posterio subcapsular cataracts.
        Am J Epidemiol. 1991; 133: 541-553
        • Vitale S
        • West S
        • Hallfrisch J
        • et al.
        Plasma antioxidants and risk of cortical and nuclear cataract.
        Epidemiology. 1993; 4: 195-203
        • Mares-Perlman JA
        • Klein BEK
        • Klein R
        • Ritter LL
        Relation between lens opacities and vitamin and mineral supplement use.
        Ophthalmol. 1994; 101: 315-325
        • Sperduto RD
        • Hu T-S
        • Milton RC
        • et al.
        The Linxian Cataract Studies: two nutrition intervention trials.
        Arch Ophthalmol. 1993; 111: 1246-1253
        • Knekt P
        • Heliovaata M
        • Rissanen A
        • Aromaa A
        • Aaran R-K
        Serum antioxidant vitamins and risk of cataract.
        Br Med J. 1992; 305: 1392-1394
        • Hankinson SE
        • Stampfer MJ
        • Seddon JM
        • et al.
        Nutrient intake and cataract extraction in women: a prospective study.
        Br. Med J. 1992; 305: 335-339
        • 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
        • West S
        • Vitale S
        • Hallfrisch J
        • et al.
        Are antioxidants or supplements protective for age-related macular degeneration?.
        Arch Ophthalmol. 1994; 112: 222-227
        • Blumenkranz MS
        • Russell SR
        • Robey MG
        • Kott-Blumenkranz R
        • Penneys N
        Risk factors in age-related maculopathy complicated by choroidal neovascularization.
        Ophthalmol. 1986; 93: 552-557
        • Eye Disease Case-Control Study Group
        Antioxidant status and neovascular age-related macular degeneration.
        Arch Ophthalmol. 1993; 111: 104-109
        • Newsome DA
        • Swartz M
        • Leone NC
        • Elston RC
        • Miller E
        Oral zinc in macular degeneration.
        Arch Ophthalmol. 1988; 106: 192-198
      2. Manual of procedures. National Eye Institute, Bethesda, Md1991
        • Steering Committee of the Physicians' Health Study Research Group
        Final report on the aspirin component of the ongoing Physicians' Health Study.
        New Engl J Med. 1989; 321: 129-135
        • Buring JE
        • Hennekens CH
        The Women's Health Study: summary of the study design.
        J Myocardial Ischemia. 1992; 4: 27-29