Lower Risk Of Cataracts Research Articles

Habitual coffee and tea consumption and risk of cataract: A prospective cohort study from the UK Biobank

BackgroundTo study the association of habitual coffee and tea consumption with the risk of cataract. MethodsThis prospective cohort study enrolled UK Biobank participants between 2006 and 2010, and prospectively followed them up for cataract diagnosis. We examined the associations of self-reported intake of tea and coffee and the calculated combined caffeine intake, with the risk of incident cataract. Cox proportional hazards models were analyzed after adjusting for age, sex, race, diabetes, Townsend Index, income, education, smoking and alcohol status. ResultsA total of 444,787 UK Biobank participants aged from 37 to 73 years old who had no cataract at baseline were included. Coffee intake of 2 - 3 cups/day (HR 0.973, 95% CI 0.949–0.998) or tea intake of 4 - 6 cups/day (HR 0.962, 95% CI 0.934–0.990) or combination caffeine intake of 160.0 - 235.0 mg/day (HR 0.950, 95% CI 0.925–0.976) were linked with the lowest risk of incident cataract. Cox models with restricted cubic splines showed J-shaped associations of coffee, tea, and combined caffeine intake with the risk of cataract (all p for nonlinear <0.001). ConclusionsModerate habitual consumption of coffee and tea is associated with a lower risk of cataract. To maximize the protective effect against cataract, it is advisable to control total caffeine intake from coffee and tea within a range of 160.0 - 235.0 mg/day.

Factors Associated with Lower Risk of Cataract in Type 2 Diabetics: National Health Insurance Claims Data Study

Factors Associated with Lower Risk of Cataract in Type 2 Diabetics: National Health Insurance Claims Data Study

Fruit and vegetable intake and the risk of cataract: insights from the UK Biobank study.

A prospective cohort study to investigate the association between fruit and vegetable (F&V) intake and the risk of cataract. We included 72,160 participants who were free of cataract at baseline from the UK Biobank. Frequency and type of F&V intake were assessed using a web-based 24 h dietary questionnaire from 2009 to 2012. Development of cataract during the follow-up was defined by self-report or hospital inpatient records up to 2021. Cox proportional regression models were used to estimate the association between F&V intake and incident cataract. During a mean follow-up of 9.1 years, 5753 participants developed cataract with a corresponding incidence of 8.0%. After adjusting for multiple demographic, medical and lifestyle covariates, higher intake of F&V were associated with a lower risk of cataract (≥6.5 vs. <2 servings/week: hazards ratio [HR]: 0.82, 95% CI: 0.76 to 0.89; P < 0.0001). Regarding specific types, significant reduced risk of cataract was found for higher intake of legumes (P = 0.0016), tomatoes (≥5.2 vs. <1.8 servings/week: HR: 0.94, 95% CI: 0.88 to 1.00), and apple and pear (>7 vs. <3.5 servings/week: 0.89, 95% CI: 0.83 to 0.94; P < 0.0001), but not for cruciferous vegetables, green leafy vegetables, berry, citrus fruit or melon. Smokers were found to benefit more from F&V intake than former and never smokers. Men also could benefit more from higher vegetable intake than women. More F&V intake, especially legumes, tomatoes, apple, and pear, was associated with a lower risk of cataract in this UK Biobank cohort.

Vitamin D Supplementation and the Incidence of Cataract Surgery in Older Australian Adults

Observational studies suggest that higher serum 25-hydroxy vitamin D (25(OH)D) concentration may be associated with lower risk of cataract. However, no randomized controlled trials have assessed the effect of vitamin D supplementation on the incidence of cataract. We aimed to assess whether vitamin D supplementation reduces the incidence of cataract surgery. We conducted an ancillary study of the D-Health Trial, a randomized, double-masked, placebo-controlled trial of monthly vitamin D conducted from 2014 through 2020 within the Australian general population. We invited 421 207 men and women 60 to 84 years of age to participate; including an additional 1896 volunteers, 40 824 expressed interest. Those with hypercalcemia, hyperparathyroidism, kidney stones, osteomalacia, or sarcoidosis or those who were taking more than 500 international units (IU) supplemental vitamin D per day were excluded. A total of 21 315 were randomized, and 1390 participants did not fulfil the eligibility criteria for this analysis (linked data available, no cataract within first 6 months), leaving 19 925 included. The median follow-up was 5 years. Participants took 60 000 IU of vitamin D3 (n= 10 662) or placebo (n= 10 653) orally once per month for a maximum of 5 years. The primary outcome for this analysis was the first surgical treatment for cataract, ascertained through linkage to universal health insurance records and hospital data. Among 19 925 participants eligible for this analysis (mean age, 69.3 years; 46% women) 3668 participants (18.4%) underwent cataract surgery during follow-up (vitamin D: n= 1841 [18.5%]; placebo: n= 1827 [18.3%] ). The incidence of cataract surgery was similar between the two groups (incidence rate, 41.6 and 41.1 per 1000 person-years in the vitamin D and placebo groups, respectively; hazard ratio, 1.02; 95% confidence interval, 0.95-1.09). In prespecified subgroup analyses, the effect of vitamin D supplementation on the incidence of cataract surgery was not modified by age, sex, body mass index, predicted serum 25(OH)D concentration, or ambient ultraviolet radiation. Routinely supplementing older adults who live in an area with a low prevalence of vitamin D deficiency with high-dose vitamin D is unlikely to reduce the need for cataract surgery. Proprietary or commercial disclosure may be found after the references.

Relationship between practices of eye protection against solar ultraviolet radiation and cataract in a rural area.

BackgroundCataract is a public health concern worldwide that differentially affects rural residents of outlying islands where ultraviolet radiation (UVR) may have greater penetration because of less shading.ObjectivesTo assess the relationships between attitudes and practices of eye protection and eye diseases for residents of an offshore island of Taiwan.MethodsQuestionnaire survey was administered to local residents (age > 50 years) regarding socio-demographic information, attitudes/practices of eye protection under sun exposure and eye diseases.ResultsA total of 816 participants (response rate 90.7%, 816/900) completed the questionnaires. Mean age was 63.7 (+ 10.8) years. Among these participants, 44.4%, 15.1% and 8.3% had cataract, dry eye and glaucoma, respectively. Although 86.3% and 88.2% of participants agreed that they should avoid outdoor activities and wear glasses/broad-brimmed hats in harsh daylight, 69.4% and 48.3% of participants never/rarely used glasses or hats/umbrellas in harsh daylight, respectively. Predictors of less practices of eye protection against solar UVR included residents who were male, with lower education level, with longer residence and lack of commercial health insurance. Multivariate logistic regression revealed that practices of eye protection under sun exposure were significantly associated with less cataract, but not glaucoma or dry eye. Participants who did not wear glasses, broad-brimmed hats/use umbrellas or both in harsh sunlight (almost) every time were respectively associated with a 57% (P = 0.028), 45% (P = 0.027) or 70% (P = 0.026) increase of cataract than those who did in harsh sunlight (almost) every time.ConclusionsPractices of eye protection under sun exposure is associated with lower risk of cataract.

A Vegetarian Diet Is Associated with a Lower Risk of Cataract, Particularly Among Individuals with Overweight: A Prospective Study

BackgroundCataracts are caused by oxidative stress in the lens of the eyes and plant-based dietary patterns can contain a wide variety of protective antioxidants. However, strict vegetarians with inadequate vitamin B-12 intakes can have elevated homocysteine levels, which could increase the risk of cortical cataracts. Whether the benefits of a vegetarian diet outweigh its risks in the development of cataracts warrants investigation. ObjectiveOur aim was to study the prospective association between a Taiwanese vegetarian dietary pattern and cataract risk. DesignThis was a prospective cohort study. Participants/settingThe Tzu Chi Health Study recruited 6,002 participants from 2007 to 2009 at Dalin Tzu Chi Hospital. Diet was assessed through a validated food frequency questionnaire. Participants 40 years and older and without cataracts at recruitment (3,095 nonvegetarians and 1,341 vegetarians) were followed until the end of 2014, death, or occurrence of cataracts. Main outcome measuresCataract incident cases ((International Classification of Diseases, 9th Revision, Clinical Modification code 366) were identified by linkage to the National Health Insurance Research Database in Taiwan. Statistical analysisCox proportional hazard regression with age as the underlying scale was used to estimate the association between dietary patterns and cataract risk while adjusting for potential confounders. ResultsCompared with nonvegetarians, vegetarians had higher intakes of soy, vegetables, nuts, whole grains, dietary fiber, vitamin C, folate, and vitamin A equivalent. In the 25,103 person-years of follow-up, 476 incident cases of cataracts were identified. A vegetarian diet was associated with a 20% reduced risk of cataracts (hazard ratio 0.80, 95% CI 0.65 to 0.99; P = 0.04) after adjusting for sex, education, smoking, alcohol drinking habits, physical activities, Tzu Chi volunteer status, hypertension, diabetes, hyperlipidemia, corticosteroid prescription, and body mass index (calculated as kg/m2). This association was more pronounced among individuals with overweight (defined as body mass index ≥24 in Taiwan [hazard ratio 0.70, 95% CI 0.50 to 0.99; P = 0.04]). ConclusionsA vegetarian diet was associated with a lower risk of cataracts, particularly in study participants with overweight.

Efficacy and Safety of Corticosteroid Implants in Non-infectious Uveitis: A Systematic Review with Network Meta-analysis

ABSTRACT Background/aims To compare different existent implants for noninfectious uveitis. Methods We performed a systematic review of randomized clinical trials (RCTs), searching in five electronic databases and screening reference lists of included studies and relevant reviews. We performed network meta-analysis to compare 0.18 mg fluocinolone acetonide implants, 0.70 mg and 0.35 mg dexamethasone implants, and sham procedures. Results Eight RCTs were included in this systematic review, of which three articles from two studies (n = 358 patients) were included in network meta-analysis. The 0.70 mg dexamethasone implant (at 1.5 months) was associated with better results than the 0.18 mg fluocinolone acetonide implant (at 1 month) at improving vitreous haze grading (RR = 2.96; 95%CI = 1.23–7.07), and with less frequently development of cataracts at 12 (RR = 0.36; 95%CI = 0.17; 0.79) and 36 months (RR = 0.37; 95%CI = 0.20; 0.71). Conclusions In the short term, the 0.70 mg dexamethasone implant is superior at improving vitreous haze, and shows lower risk of cataracts. However, additional RCTs with standardized outcomes are needed.

Impact of Myeloablative Total Body Irradiation Versus Chemotherapy on Late Effects and Survival Among Adolescent and Young Adult Survivors of Hematopoietic Cell Transplantation for Acute Leukemia: A Center for International Blood and Marrow Transplant Research (CIBMTR) Analysis

Background. Increasing numbers of adolescent and young adult (AYA) with acute leukemia (AL; acute myeloid leukemia [AML] and acute lymphoblastic leukemia [ALL]) are transitioning to long-term survivorship following allogeneic hematopoietic cell transplantation (HCT) and are at risk for certain morbidities after HCT due to myeloablative conditioning (MAC) with total body irradiation (TBI) or non-TBI-based chemotherapy (CT). Using data from the Center for International Blood and Marrow Transplantation Research (CIBMTR), we evaluated late effects (LEs) following MAC HCT and furthermore compared the effect of TBI vs. CT-based MAC on LEs and overall survival (OS) in a large cohort of one-year disease-free AYA survivors following HCT for AL. We hypothesized that the use of TBI, relative to CT-based MAC, would lead to equivalent long-term survival in this population but that TBI conditioning would be associated with significantly increased LEs following HCT.Methods. AYAs (ages 15-39 years at HCT) with AL who received first MAC HCT between 2000-2014 from a HLA matched sibling or 8/8 matched unrelated donor (MUD) and were alive and disease-free at one year following HCT were included. The cumulative incidence (CI) of LEs (avascular necrosis [AN], cataracts, congestive heart failure, myocardial infarction, diabetes [DM], gonadal dysfunction, growth disturbance, hypothyroidism, pancreatitis, renal failure requiring hemodialysis, and strokes/seizures) was estimated at 2, 5 and 10 years after HCT, with death as a competing risk. Multivariable Cox proportional hazard models evaluated patient and HCT risk factors, including the main effect of TBI vs. CT-based MAC, for the most frequently occurring LEs (limited to AML cohort only as majority of ALL patients received TBI) and for OS.Results. The study population included 1,578 one-year disease-free AYA survivors of AML (n=936) or ALL (n=642) who received first MAC HCT with TBI (AML: 449; ALL: 607) or CT (AML: 487; ALL: 35). The median TBI dose was 1200 cGy (range, 550 - 1800). The median age at HCT for AML and ALL was 29 and 26 years, respectively. The majority were male (AML: 54%; ALL: 67%), transplanted in first complete remission (AML: 62%; ALL 59%) with MUD donors (AML: 56%; ALL 55%), and had GVHD prophylaxis consisting of a calcineurin inhibitor and methotrexate (AML: 83%; ALL 83%) without T-cell depletion. The most common TBI and CT-based MAC regimens were TBI/cytoxan and busulfan/cytoxan, respectively. Median follow-up (months) of survivors was 82 (range, 12-194) for AML and 92 (range, 12-194) for ALL. The estimated CI of LEs in AML and ALL patients are shown in Table 1. Multivariable analyses for individual LEs in the AML cohort showed that CT- based MAC was independently associated with a lower risk of cataracts (HR 0.19, 95% CI 0.10 - 0.37). There was no significant association between TBI and secondary malignancies, DM, gonadal dysfunction, or hypothyroidism. cGVHD was independently associated with significantly increased risk of cataracts (HR 2.88, 95% CI 1.58 -5.24), AN (HR 2.55, 95% CI 1.25 - 4.07), and DM (HR 2.85, 95% CI 1.05 - 7.73). Unadjusted long-term HCT survival outcomes for AYAs with AML and ALL did not significantly differ based upon TBI vs. CT-based MAC (Table 2) despite significantly higher disease relapse among the CT cohort (AML only). Limited and severe cGVHD occurred in 12% and 51% of AML patients, respectively, and 13% and 53% of ALL patients, respectively, and did not differ by conditioning. In multivariable analyses for OS, HCT in relapse (HR 2.40, 95% CI 1.59 - 3.63), poor-risk cytogenetics (HR 2.09, 95% CI 1.24 - 3.52), peripheral blood stem cell graft (HR 1.46, 95% CI 1.07 - 1.97), cGVHD (HR 1.36, 95% CI 1.04 - 1.80), and a new malignancy post-HCT (HR 4.40, 95% CI 2.21 - 8.74) were associated with significantly inferior OS in AML. Undergoing HCT in CR2 (HR 1.50, 95% CI 1.09 - 2.07) or in relapse (HR 3.67, 95% CI 2.31 - 5.82), and a new malignancy post-HCT (HR 3.11, 95% CI 1.26 - 7.68) were associated with significantly inferior OS in ALL.Conclusion. AYAs with AL who are disease-free survivors at one-year have favorable long-term HCT outcomes. Long-term survival in this population appears unrelated to a TBI vs. CT-based MAC regimen. Development of cataracts is increased in long-term AYA AML HCT survivors receiving TBI-based MAC. Screening for LEs is important in survivors of AYA HCT for AL, regardless of the use of TBI or CT- based MAC regimens. [Display omitted] DisclosuresMuffly:Shire Pharmaceuticals: Research Funding; Adaptive Biotechnologies: Research Funding.

Risk factors for nuclear and cortical cataracts: A hospital based study

Purpose:To evaluate risk factors associated with nuclear and cortical cataracts among a hospital based sample of subjects in Southern India.Methods:In this hospital-based study, 3,549 subjects including 2,090 male and 1,459 female individuals aged 45 years and over were randomly screened for nuclear and cortical cataracts. Lens opacity was graded and classified after pupil dilation using the lens opacities classification system (LOCS) III at the slit lamp. Furthermore, participants were interviewed for lifestyle variables and dietary intake of carotenoids using a structured food frequency questionnaire.Results:Demographic risk factors for cataracts included older age and lower socioeconomic status. Nuclear cataracts were associated with diabetes (OR = 6.34; 95% CI: 2.34-8.92%), tobacco chewing (moderate, OR = 3.04; heavy, OR = 4.62), cigarette smoking (moderate, OR = 1.58; heavy, OR = 1.87) and hypertension (OR = 1.56; 95% CI: 1.25-2.78%). Cortical cataracts were associated with diabetes (OR = 15.03; 95% CI: 7.72-29.2%), tobacco chewing (moderate, OR = 2.16; heavy, OR = 2.32) and cigarette smoking (moderate, OR = 2.20; heavy, OR = 2.97). Higher dietary intake of lutein/zeaxanthin (L/Z) and β-carotene was associated (P < 0.001) with a lower risk of nuclear and cortical cataracts.Conclusion:Higher dietary intake of carotenoids is associated with a lower risk of cataracts. Nuclear and cortical cataracts are associated with various risk factors such as diabetes, hypertension, cigarette smoking and tobacco, similar to studies conducted in other Asian and European populations, irrespective of ethnic origin.

Risk of Cataract among Subjects with Acquired Immune Deficiency Syndrome Free of Ocular Opportunistic Infections

To evaluate the risk of cataract in the setting of AIDS. Prospective cohort study. Subjects with AIDS free of ocular opportunistic infections throughout catamnesis. From 1998 through 2008, subjects 13 years of age or older were enrolled. Demographic characteristics and clinical characteristics were documented at enrollment and semiannually. Cataract was defined as high-grade lens opacity observed by biomicroscopy judged to be the cause of a best-corrected visual acuity worse than 20/40. Eyes that underwent cataract surgery during follow-up were considered to have developed cataract before the first visit when pseudophakia or aphakia was observed. Among 1606 participants (3212 eyes) at enrollment, 1.9% (95% confidence interval [CI]: 1.3%-2.7%) were observed to have cataract or prior cataract surgery. Among the 2812 eyes initially free of cataract and followed longitudinally (median follow-up, 4.6 years), the incidence of cataract was 0.37%/eye-year (95% CI: 0.26%-0.53%). In addition to age, significant cataract risk factors included prior cataract in the contralateral eye (adjusted hazard ratio [aHR], 21.6; 95% CI: 10.4-44.8), anterior segment inflammation (aHR, 4.40; 95% CI: 1.64-11.9), prior retinal detachment (aHR, 4.94; 95% CI: 2.21-11.0), and vitreous inflammation (aHR, 7.12; 95% CI: 2.02-25.0), each studied as a time-updated characteristic. Detectable human immunodeficiency virus RNA in peripheral blood was associated with lower risk of cataract at enrollment (adjusted odds ratio, 0.32; 95% CI: 0.12-0.80) but not of incident cataract (aHR, 1.58; 95% CI: 0.90-2.76). After adjustment for other factors, neither the then-current absolute CD4+ T-cell count nor antiretroviral therapy status showed consistent association with cataract risk, nor did an additive diagnosis of other comorbidities. Compared with the available population-based studies that used similar definitions of cataract, the age-specific prevalence of cataract in our cohort was higher than in 1 of 2 such studies, and the age-specific incidence of cataract surgery was higher. Our results suggest cataract may occur earlier among patients with AIDS free of ocular opportunistic infections than in the general population. Cataract risk was associated most strongly with age and with other ocular morbidity in this population. With improved survival, the burden of cataract likely will increase for persons with the human immunodeficiency virus or AIDS.

Diet, vegetarianism, and cataract risk

Age-related cataract is a major cause of morbidity. Previous studies of diet and cataract risk have focused on specific nutrients or healthy eating indexes but not on identifiable dietary groups such as vegetarians. We investigated the association between diet and cataract risk in a population that has a wide range of diets and includes a high proportion of vegetarians. We used Cox proportional hazards regression to study cataract risk in relation to baseline dietary and lifestyle characteristics of 27,670 self-reported nondiabetic participants aged ≥40 y at recruitment in the Oxford (United Kingdom) arm of the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford) by using data from the Hospital Episode Statistics in England and Scottish Morbidity Records. There was a strong relation between cataract risk and diet group, with a progressive decrease in risk of cataract in high meat eaters to low meat eaters, fish eaters (participants who ate fish but not meat), vegetarians, and vegans. After multivariable adjustment, incidence rate ratios (95% CIs) for moderate meat eaters (50-99 g meat/d), low meat eaters (<50 g meat/d), fish eaters, vegetarians, and vegans compared with high-meat eaters (≥100 g meat/d) were 0.96 (0.84, 1.11), 0.85 (0.72, 0.99), 0.79 (0.65, 0.97), 0.70 (0.58, 0.84), and 0.60 (0.38, 0.96), respectively (P < 0.001 for heterogeneity). Associations between cataract risk and intakes of selected nutrients and foods generally reflected the strong association with diet group. Vegetarians were at lower risk of cataract than were meat eaters in this cohort of health-conscious British residents.

Biomedicine: Statins might lower risk of cataracts

Biomedicine: Statins might lower risk of cataracts

Ocular complications of pediatric uveitis

To determine the cumulative proportion and the visual significance of ocular complications of pediatric uveitis. Cohort study. Patients with onset of endogenous or infectious uveitis before or at age 16 years. Retrospective review of existing records at a university-based uveitis clinic. Type and prevalence of complications related to uveitis, time to development of complications, and vision loss after initial diagnosis. There were 148 patients, 71 males and 77 females, with a mean age of 10.4+/-4.9 years (median, 10.3 years) for an estimated prevalence of pediatric uveitis of 13.8%. Noninfectious uveitis was present in 112 patients (75.7%); 105 (71%) patients had bilateral disease. Anterior uveitis accounted for 30.4%, intermediate uveitis for 27.7%, posterior uveitis for 23.7%, and panuveitis for 18.2% of patients. Patients were followed for a mean of 71.7 months (range, 0 months-44 years) after diagnosis. Approximately 34% of all patients had 1 or more complications at the time of first diagnosis of uveitis by an ophthalmologist, increasing to 61.6% by 3 months, 69.4% by 6 months, 75.2% by 1 year, and 86.3% by 3 years after diagnosis. There were a total of 617 complications of all types. Anterior and intermediate uveitis had a higher risk of band keratopathy (P = 0.005). Posterior and intermediate uveitis had a lower risk of cataract (P = 0.009) or posterior synechiae (P<0.001). Intermediate uveitis had a higher risk of cystoid macular edema compared with anterior or posterior uveitis (P = 0.002). The cumulative percentages (standard error) of patients with first loss to 20/200 or worse after diagnosis in the affected eyes of unilateral cases or in either eye of the bilateral cases were: 31.3% (3.9) at 1 month; 40.5% (4.1) at 6 months; 56.0% (4.3) at 24 months; and 69.6% (4.5) at 60 months. Fifty-four patients (48.2%) received systemic antiinflammatory or immunomodulatory therapy. Sixty-eight patients (45.9%) had ocular surgery, and 38 of these had ocular surgery in both eyes. Childhood uveitis is significant for numerous complications, many of which are vision threatening. Complications increase with duration of disease.

Solubilization patterns of lutein and lutein esters in food grade nonionic microemulsions.

Lutein, a naturally occurring carotenoid, is widely distributed in fruits and vegetables and is particularly concentrated in the Tagetes erecta flower. Epidemiological studies suggest that a high lutein intake (6 mg/day) increases serum levels that are associated with a lower risk of cataract and age-related macular degeneration. Lutein can either be free or esterified (myristate, palmitate, or stearate). Both are practically insoluble in aqueous systems, and their solubility in food grade solvents (oils) is very limited, resulting is low bioavailability. To improve its solubility and bioavailability, lutein was solubilized in U-type food grade microemulsions based on ethoxylated sorbitan fatty acid esters, glycerol, R-(+)-limonene, and ethanol. Some of the main findings are as follows: (1) reverse micellar and W/O compositions solubilized both luteins better than an O/W microemulsion, and maximum solubilization is obtained within the bicontinuous phase; (2) free lutein is solubilized better than the esterified one, in the W/O microemulsions, whereas the esterified lutein is better accommodated within the O/W microemulsion; (3) vegetable oils decrease the solubilization of free lutein; (4) glycerol and alcohol enhance the solubilization of both luteins; (5) solubilization is surfactant-dependent in all mesophase structures, but its strongest effect is in the bicontinuous phase.

Lutein in patients with cataracts and age‐related macular degeneration: a long‐term supplementation study

AbstractLutein, a non‐provitamin A xanthophyll, is widely distributed in fruits and vegetables frequently consumed. In human serum, lutein is transported by lipoproteins and selectively accumulated in certain tissues (eg the retina). Epidemiological studies suggest that high intake and serum levels of lutein are associated with a lower risk of cataracts and age‐related maculopathy. Subjects diagnosed with cataracts (CA; n = 5) or age‐related macular degeneration (ARMD; n = 5) agreed to take three lutein capsules per week. Each capsule potentially provided about 12 mg of all‐trans‐lutein, 3 mg of 13/15‐cis‐lutein and 3.3 mg of α‐tocopherol, as revealed by HPLC. Zeaxanthin was not detected. Average supplementation time was 13 months (range 4–20 months) for ARMD subjects and 26 months (range 16–36 months) for CA subjects. Blood samples for carotenoid analysis were collected every 3 months, coinciding with ophthalmological revision. In serum, concentrations of lutein, 13‐cis‐lutein and two ketocarotenoids increased significantly. Maximum increments were observed at 3–6 months, reaching levels above the 95th percentile of the reference population (&gt;0.44 µmol l−1). Ophthalmological evaluation showed an average increment in visual acuity of 0.4, and glare sensitivity also improved. No significant side effects such as hypercarotenemia, carotenodermia or changes in biochemical or haematological profile were observed. Thus, lutein supplementation at achievable dietary levels increased and maintained serum lutein levels, which were associated with an improvement in the visual function of the patients.© 2001 Society of Chemical Industry

Serum carotenoids and tocopherols and incidence of age-related nuclear cataract

It is not known whether the protective effects of antioxidants on cataract observed in experimental animals are relevant to age-related opacities in humans. The relations of serum carotenoids and tocopherols to the incidence of age-related nuclear cataract were investigated in a random sample of 400 adults, 50-86 y of age, in the Beaver Dam Eye Study. Nuclear opacity was assessed by using lens photographs taken at baseline (in 1988-1990) and follow-up (in 1993-1995). Nonfasting concentrations of individual carotenoids and alpha- and gamma-tocopherol, were determined from serum obtained at baseline. A total of 252 persons were eligible for incident cataract, of whom 57 developed nuclear cataract in at least one eye. Results were adjusted for age, smoking, serum cholesterol, heavy drinking, adiposity, and, in the tocopherol models, dietary linoleic acid intake. Only serum tocopherol (the sum of alpha- and gamma-tocopherol, in micromol/mmol cholesterol) was associated with cataract. For total serum tocopherol, persons in tertile 3 had a lower risk of cataract than persons in tertile 1 [odds ratio (OR): 0.4; 95% CI: 0.2, 0.9; P = 0.03 for linear trend]. Although serum carotenoids were not significantly associated with nuclear cataract, marginal inverse associations with lutein (OR: 0.3; 95% CI: 0.1, 1.2; P = 0.13 for linear trend) and cryptoxanthin (OR: 0.3; 95% CI: 0.1, 1.3; P = 0.11 for linear trend) were suggested in people < or = 65 y of age. Findings were compatible with the possibility that nuclear cataract may be linked inversely to vitamin E status, but neither strongly supported nor negated the hypothesized inverse association of nuclear cataract with serum carotenoids.