title: Vitamins E and C and medical record-confirmed age-related macular degeneration in a randomized trial of male physicians.
abstract: OBJECTIVE
  To test whether supplementation with alternate-day vitamin E or daily vitamin C affects the incidence of the diagnosis of age-related macular degeneration (AMD) in a large-scale randomized trial of male physicians.
  
  
  METHODS
  Randomized, double-masked, placebo-controlled trial.
  
  
  METHODS
  We included 14 236 apparently healthy United States male physicians aged ≥50 years who did not report a diagnosis of AMD at baseline.
  
  
  METHODS
  Participants were randomly assigned to receive 400 international units (IU) of vitamin E or placebo on alternate days, and 500 mg of vitamin C or placebo daily. Participants reported new diagnoses of AMD on annual questionnaires and medical record data were collected to confirm the reports.
  
  
  METHODS
  Incident diagnosis of AMD responsible for a reduction in best-corrected visual acuity to ≤20/30.
  
  
  RESULTS
  After 8 years of treatment and follow-up, a total of 193 incident cases of visually significant AMD were documented. There were 96 cases in the vitamin E group and 97 in the placebo group (hazard ratio [HR], 1.03; 95% confidence interval [CI], 0.78-1.37). For vitamin C, there were 97 cases in the active group and 96 in the placebo group (HR, 0.99; 95% CI, 0.75-1.31).
  
  
  CONCLUSIONS
  In a large-scale, randomized trial of United States male physicians, alternate-day use of 400 IU of vitamin E and/or daily use of 500 mg of vitamin C for 8 years had no appreciable beneficial or harmful effect on risk of incident diagnosis of AMD.
authors.affiliation: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. wchristen@rics.bwh.harvard.edu
authors.forename: William G
authors.initials: WG
authors.lastname: Christen
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Glynn
authors.forename: Howard D
authors.initials: HD
authors.lastname: Sesso
authors.forename: Tobias
authors.initials: T
authors.lastname: Kurth
authors.forename: Jean
authors.initials: J
authors.lastname: Macfadyen
authors.forename: Vadim
authors.initials: V
authors.lastname: Bubes
authors.forename: Julie E
authors.initials: JE
authors.lastname: Buring
authors.forename: Joann E
authors.initials: JE
authors.lastname: Manson
authors.forename: J Michael
authors.initials: JM
authors.lastname: Gaziano
mesh_terms: D000368:Aged; D001205:Ascorbic Acid / Q000008:administration & dosage*; D019587:Dietary Supplements; D004311:Double-Blind Method; D004338:Drug Combinations; D006801:Humans; D015994:Incidence; D008268:Macular Degeneration / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010820:Physicians; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014792:Visual Acuity / Q000502:physiology; D014810:Vitamin E / Q000008:administration & dosage*; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D004338:Drug Combinations; D014815:Vitamins; D014810:Vitamin E; D001205:Ascorbic Acid