In this week's BMJ , Chong and colleagues present a systematic
review and meta-analysis of the effectiveness of dietary
antioxidants, including supplements, in the primary prevention
of age related macular degeneration.1 Age related macular
degeneration is one of the most important causes of visual loss
in older people. The number of people affected will increase as
populations age.2 Two types of age related macular degeneration
exist. Geographic atrophy is a sharply demarcated area of
depigmentation caused by atrophy of the retinal pigment
epithelium; neovascular degeneration occurs when new blood
vessels grow under the retinal pigment epithelium leading to
haemorrhage and scarring. Age related macular degeneration is
diagnosed in people aged 50 or more when no other obvious cause
for degeneration exists. New treatments are being developed
rapidly. In the past two years, intraocular injections of agents
that interfere with angiogenesis have been licensed for use in
this condition.3 These bind to vascular end