The Antioxidants in Prevention of Cataracts Study: effects of antioxidant supplements on cataract progression in South India.
OBJECTIVE
To determine if antioxidant supplements (beta carotene and vitamins C and E) can decrease the progression of cataract in rural South India.


METHODS
The Antioxidants in Prevention of Cataracts (APC) Study was a 5 year, randomised, triple masked, placebo controlled, field based clinical trial to assess the ability of interventional antioxidant supplements to slow cataract progression. The primary outcome variable was change in nuclear opalescence over time. Secondary outcome variables were cortical and posterior subcapsular opacities and nuclear colour changes; best corrected visual acuity change; myopic shift; and failure of treatment. Annual examinations were performed for each subject by three examiners, in a masked fashion. Multivariate modelling using a general estimating equation was used for analysis of results, correcting for multiple measurements over time.


RESULTS
Initial enrolment was 798 subjects. Treatment groups were comparable at baseline. There was high compliance with follow up and study medications. There was progression in cataracts. There was no significant difference between placebo and active treatment groups for either the primary or secondary outcome variables.


CONCLUSIONS
Antioxidant supplementation with beta carotene, vitamins C and E did not affect cataract progression in a population with a high prevalence of cataract whose diet is generally deficient in antioxidants.
Francis I Proctor Foundation for Research in Opthalmology and the Department of Opthalmology, University of California San Francisco, San Francisco, CA, USA. david.gritz@yahoo.com
D C
DC
Gritz
M
M
Srinivasan
S D
SD
Smith
U
U
Kim
T M
TM
Lietman
J H
JH
Wilkins
B
B
Priyadharshini
R K
RK
John
S
S
Aravind
N V
NV
Prajna
R
R
Duraisami Thulasiraj
J P
JP
Whitcher
D000328:Adult; D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use; D002386:Cataract / Q000503:physiopathology / Q000517:prevention & control*; D002387:Cataract Extraction; D003906:Developing Countries; D019587:Dietary Supplements; D004311:Double-Blind Method; D006801:Humans; D007194:India; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D017211:Treatment Failure; D014792:Visual Acuity; D014810:Vitamin E / Q000627:therapeutic use; D014815:Vitamins / Q000627:therapeutic use*
D000975:Antioxidants; D014815:Vitamins; D014810:Vitamin E; D001205:Ascorbic Acid