Sunlight exposure, antioxidants, and age-related macular degeneration.
OBJECTIVE
To examine the association of sunlight exposure and antioxidant level with age-related macular degeneration (AMD).


METHODS
Four thousand seven hundred fifty-three participants aged 65 years or older in the European Eye Study underwent fundus photography, were interviewed for adult lifetime sunlight exposure, and gave blood for antioxidant analysis. Blue light exposure was estimated by combining meteorologic and questionnaire data.


RESULTS
Data on sunlight exposure and antioxidants were available in 101 individuals with neovascular AMD, 2182 with early AMD, and 2117 controls. No association was found between blue light exposure and neovascular or early AMD. Significant associations were found between blue light exposure and neovascular AMD in individuals in the quartile of lowest antioxidant level-vitamin C, zeaxanthin, vitamin E, and dietary zinc-with an odds ratio of about 1.4 for 1 standard deviation unit increase in blue light exposure. Higher odds ratios for blue light were observed with combined low antioxidant levels, especially vitamin C, zeaxanthin, and vitamin E (odds ratio, 3.7; 95% confidence interval, 1.6-8.9), which were also associated with early stages of AMD.


CONCLUSIONS
Although it is not possible to establish causality between sunlight exposure and neovascular AMD, our results suggest that people in the general population should use ocular protection and follow dietary recommendations for the key antioxidant nutrients.
Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, England. astrid.fletcher@lshtm.ac.uk
Astrid E
AE
Fletcher
Graham C
GC
Bentham
Maureen
M
Agnew
Ian S
IS
Young
Cristina
C
Augood
Usha
U
Chakravarthy
Paulus T V M
PT
de Jong
Mati
M
Rahu
Johan
J
Seland
Gisele
G
Soubrane
Laura
L
Tomazzoli
Fotis
F
Topouzis
Johannes R
JR
Vingerling
Jesus
J
Vioque
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000378:metabolism*; D001205:Ascorbic Acid / Q000097:blood; D016022:Case-Control Studies; D015331:Cohort Studies; D019587:Dietary Supplements; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008268:Macular Degeneration / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D015999:Multivariate Analysis; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013472:Sunlight; D011795:Surveys and Questionnaires; D014810:Vitamin E / Q000097:blood; D024341:Xanthophylls / Q000097:blood; D065146:Zeaxanthins; D015032:Zinc / Q000097:blood
D000975:Antioxidants; D024341:Xanthophylls; D065146:Zeaxanthins; D014810:Vitamin E; D015032:Zinc; D001205:Ascorbic Acid