Mortality data emerge from AREDS

New Orleans-Valuable new data continue to be gleaned from the Age-Related Eye Disease Study (AREDS). In this large randomized, controlled clinical study of 4,753 patients, investigators at 11 sites evaluated the effect of antioxidants vitamins C and E and zinc compared with placebo in age-related macular degeneration (AMD). The patients were divided by disease severity into categories 1-4 , with category 1 indicating the presence of few if any small drusen and category 4 indicating the most severe form of AMD, unilateral advanced disease, or unilateral visual loss worse than 20/32.

The investigators evaluated all-cause mortality in 534 of the patients who died between November 1992 and October 2001. Justin Gottlieb, MD, from the University of Wisconsin, Madison, reported, All-cause mortality rates increased with increasing severity of macular disease. AMD category 4 compared with AMD category 1 had a significantly increased risk of mortality after adjustment for age, sex, race, education, smoking, body mass index, diabetes, angina, cancer, and hypertension. All-cause mortality decreased for participants.

In addition, most of the deaths resulted from circulatory system pathologies and neoplasms (68%). Zinc did not show a protective effect against those disorders, but a protective effect was seen for other causes. The investigators, who presented their data at the retina subspecialty day at the American Academy of Ophthalmology annual meeting, speculated that zinc might improve immunity and resistance to infection.