Efficacy of different nutrients in age-related macular degeneration: A systematic review and network meta-analysis

ABSTRACT

Aim

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.

Methods

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).

Results

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.

Conclusion

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.

KEYWORDS:

• carotenoids
• zinc
• Age-related macular degeneration
• Network meta-analysis

AUTHORS’ CONTRIBUTIONS

Data curation, Shan-Shan Li, Hui-Hui Wang; Formal analysis, Shan-Shan Li, Hui-Hui Wang; Methodology, Shan-Shan Li, Hui-Hui Wang; Writing – original draft, Shan-Shan Li; Writing – review & editing, Shan-Shan Li, Da-Wei Zhang.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

LIST OF ABBREVIATIONS

AMD: age-related macular degeneration; NMA: network meta-analysis; MPOD: macular pigment optical density; VA: visual acuity; CIs: confidence intervals; RCTs: randomized controlled trials; VEGF: anti-vascular endothelial growth factor.

DECLARATIONS

Ethics approval and consent to participate: Not applicable.

Consent for publication: Not applicable.

Availability of data and materials: Its supplementary information files.

Competing interests: Li S, None; Wang H, None; Zhang D, None.

Acknowledgements: Not applicable.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China [81870686].