New York: Smoking is one of the strongest risk factors for developing age-related macular degeneration (AMD). But smokers may not benefit from antioxidant vitamin supplements, say experts.

Emily Chew, MD, Deputy Director, Division of Epidemiology and Clinical Research, National Eye Institute, Bethesda, Maryland, United States, said patients who smoke and take beta carotene supplements have an increased risk of developing lung cancer.

In a presentation to the American Academy of Ophthalmology (AAO), Dr Chew outlined which patients should and should not take supplements. In a recent study more than 4,700 patients who received supplements of vitamin C and E, beta carotene, zinc and copper and were followed for 6.3 years.

The results of the study showed that while there was a protective benefit for patients with large bilateral macular drusen and those with advanced AMD in one eye, there was no protective benefit for patients with mild and moderate AMD. The supplements did not prevent progression to severe AMD in these patients.

Dr Chew pointed out, however, that the risk of developing AMD in these patients is “exceedingly low,” and therefore, it is unlikely that they would progress to severe AMD.

According to Dr Chew, patients who still smoke, or quit smoking within the past year should avoid the supplements because of the increased risk of cancer. Nor should the offspring of patients with AMD take the supplements, unless they too have AMD in one eye, or large bilateral drusen.

But for most individuals, the benefits of the supplements seem to outweigh any risks. Recently, a meta-analysis of 68 trials reported no significant impact associated with a wide variety of antioxidant supplements. More study is needed, Dr Chew said
Dr Chew concluded that the public health impact of this supplementation regimen could prevent 300,000 people over the next 5 years from either developing advanced macular degeneration or experiencing significant loss of vision as a result of progressive disease.