Department of Ophthalmology, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Semin Ophthalmol. 2022 May 19;37(4):515-523. doi: 10.1080/08820538.2021.2022165. Epub 2022 Jan 7.
Age-related macular degeneration (AMD) has become a predominant global health concern. The visual function of individuals with AMD seems to improve with dietary antioxidants. We assessed the efficacy of different antioxidants (carotenoids, zinc, vitamin E, and multivitamin) on visual function and the incidence of developing late AMD.
We searched PubMed, EMBASE, and Cochrane Central Register of Controlled Trials for related published studies. We considered randomized controlled trials (RCTs) comparing different nutrients. The main outcomes measurements included changes in visual acuity (VA), and the rate of developing late AMD. The network meta-analysis was registered on PROSPERO (CRD42020171288).
We identified 13 studies, including 85321 individuals randomly assigned to different nutrients or placebo groups. In the network meta-analysis, we found that there was more risk of progression to late AMD in the multivitamin group than carotenoids and vitamin E groups (RR 0.45, 95% CI 0.32 to 0.65; RR 0.56, 95% CI 0.40 to 0.79; RR 0.42, 95% CI 0.26 to 0.67). The nutrients of zinc and carotenoids (Lutein/Zeaxanthin) ranked first and second and showed better improvement in VA. The efficacy of carotenoids (β-carotene) ranked first for delaying the progress of AMD among all of the four treatments.
Taking multivitamin supplementation may not prevent the development of late AMD. The nutrient of zinc and carotenoids (lutein/zeaxanthin) supplementation were associated with better improvement in VA. Carotenoids (β-carotene) were the most likely to prevent the progression of late AMD.
年龄相关性黄斑变性（AMD）已成为全球主要的健康关注点。AMD 患者的视觉功能似乎可以通过膳食抗氧化剂得到改善。我们评估了不同抗氧化剂（类胡萝卜素、锌、维生素 E 和多种维生素）对视觉功能和发展为晚期 AMD 的影响。
我们在 PubMed、EMBASE 和 Cochrane 对照试验中心注册库中搜索了相关的已发表研究。我们考虑了比较不同营养素的随机对照试验（RCT）。主要结局测量包括视力（VA）变化和发展为晚期 AMD 的速度。网络荟萃分析在 PROSPERO（CRD42020171288）上进行了注册。
我们确定了 13 项研究，共纳入 85321 名随机分配至不同营养素或安慰剂组的个体。在网络荟萃分析中，我们发现与类胡萝卜素和维生素 E 组相比，多种维生素组发展为晚期 AMD 的风险更高（RR 0.45，95%CI 0.32 至 0.65；RR 0.56，95%CI 0.40 至 0.79；RR 0.42，95%CI 0.26 至 0.67）。锌和类胡萝卜素（叶黄素/玉米黄质）的营养素排名第一和第二，VA 改善效果更好。在所有四种治疗方法中，类胡萝卜素（β-胡萝卜素）对延缓 AMD 进展的疗效排名第一。
服用多种维生素补充剂可能无法预防晚期 AMD 的发生。锌和类胡萝卜素（叶黄素/玉米黄质）的营养素补充与 VA 改善有关。类胡萝卜素（β-胡萝卜素）最有可能阻止晚期 AMD 的进展。
