Papudesu C, et al. - The connection of mortality with visual acuity (VA) impairment, age-related macular degeneration (AMD), and cataract surgery was comprehensively analyzed during this trial. The findings shed light on the link between the presence of late AMD, bilateral cataract surgery, and VA less than 20/40 with decreased survival, in Age-Related Eye Disease Study (AREDS2). Nevertheless, oral supplementation with omega-3 fatty acids, lutein plus zeaxanthin, zinc, or beta-carotene did not exert any statistically prominent effect on mortality.

Methods

• The design of this study was a cohort-based research.
• The eligible candidates included individuals with at least intermediate AMD.
• They were recruited in a randomized controlled clinical trial of lutein/zeaxanthin and/or omega-3 fatty acids, the Age-Related Eye Disease Study 2 (AREDS2), for the treatment of AMD and cataract.
• Baseline and annual eye examinations were carried out.
• These consisted of best-corrected visual acuity (BCVA) assessments, slit-lamp examinations, and stereoscopic fundus photographs that were centrally graded for the development of late AMD (central geographic atrophy or neovascular AMD) or pseudophakia.
• A determination was pursued of the cause-specific mortality, based on the International Classification of Diseases 9th or 10th Revision codes.
• Cox proportional hazards models assisted in contemplating the risk of all-cause and cause-specific mortality adjusted for age, sex, AMD severity, VA, history of cataract surgery, and assigned AREDS2 study treatment.
• The investigations constituted baseline covariates: Race, education, smoking status, diabetes, and cardiovascular disease.

Results

• During follow-up (median 5 years), death was reported in 368 (9%) of the 4,203 AREDS2 enrollees.
• A statistically prominent, increased risk for mortality was noted in candidates with neovascular AMD in 1 eye at baseline compared with enrollees with no or few drusen (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.21-2.01; P < 0.001).
• A link was brought to light between poorer survival with bilateral cataract surgery prior to the enrollment compared with baseline bilateral phakia (HR, 1.63; 95% CI, 1.29-2.07; P < 0.001) and with BCVA of less than 20/40 than subjects with 20/40 or better (HR, 1.56; 95% CI, 1.06-2.30; P=0.024), adjusted for age, sex, and statistically significant covariates.
• Decreased mortality was discovered in those who received antivascular endothelial growth factor therapies for neovascular AMD compared with those who did not (HR, 0.71; 95% CI, 0.57-0.88; P=0.002).
• The connection between all-cause mortality and AREDS2 treatment whether assessing the main or individual treatment effect did not exhibit notable change(omega-3 fatty acids main effect HR, 1.18; 95% CI, 0.96-1.45; P=0.12; lutein/zeaxanthin main effect HR, 1.04; 95% CI, 0.85-1.28; P=0.71).