To the Editor A recent assessment of the Age-Related Eye Disease Study 2 (AREDS2) trial1,2 of micronutrients for treatment of age-related macular degeneration (AMD) was very interesting, detailed, and insightful.3 One recommendation from the trial was to replace beta carotene in the supplement by the carotenoids lutein and zeaxanthin to minimize risk of lung cancer in smokers and ex-smokers. As observed by Musch,3 this was noteworthy for a clinical trial as it prompted recommendation for reformulation of the original AREDS supplement. A subsequent analysis of subgroups found improved confidence in recommending the replacement and revealed moderate improvements in risk reduction of AMD.2 One important issue deserves further comment and elaboration.
Benke KK, Benke KE. Experimental Design Issue for Assessment of Carotenoids Lutein and Zeaxanthin in Age-Related Eye Disease Study 2 Formulation for Age-Related Macular Degeneration. JAMA Ophthalmol. 2014;132(7):904. doi:10.1001/jamaophthalmol.2014.1768