This issue includes reviews of drugs for glaucoma, age-related macular degeneration (AMD), bacterial conjunctivitis, and dry eye disease. Allergic conjunctivitis is reviewed in a separate issue.

The results of the Age-Related Eye Disease Study 2 (AREDS2) have now been published. The primary purpose of the study was to evaluate the efficacy and safety of the carotenoids lutein and zeaxanthin and the omega-3 polyunsaturated fatty acids (PUFAs) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) in reducing the risk of developing advanced age-related macular degeneration (AMD). A secondary goal was to test the effects of reducing the amount of zinc and eliminating beta carotene from the original AREDS formulation. Beta carotene has been shown to increase the risk of lung cancer in smokers and former smokers.

The US Preventive Services Task Force (USPSTF) has issued a Draft Recommendation Statement saying, in effect, that community-dwelling women and men should not take calcium and vitamin D supplements for primary prevention of osteoporotic fractures because the evidence that they are helpful is insufficient and they increase the risk of kidney stones. The Medical Letter has said previously that there is no evidence that patients with an adequate intake of calcium (1000-1200 mg/day) and vitamin D (600-800 IU/day) will benefit from taking supplements.1

1. Drugs for postmenopausal osteoporosis. Treat Guidel Med Lett 2011; 9:67.

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The recent Medical Letter article on vitamin supplements1 included 2 sentences on vitamin E that could be misleading. "Vitamin E in food, which is mostly gamma-tocopherol, acts as an antioxidant. Vitamin E in supplements is mostly alpha-tocopherol, which may block the anti-oxidant effect of gamma-tocopherol and may have a pro-oxidant effect in vivo."

Gamma-tocopherol is the most common form of vitamin E in the North American diet, and supplements are mostly alpha-tocopherol, which can, under some conditions, have a pro-oxidant effect. However, there is no evidence that taking supplements can block the antioxidant effect of vitamin E in food. Whether the pro-oxidant effect of alpha-tocopherol, which is also plentiful in food, has any biological importance is unclear.2

1. Who should take vitamin supplements? Med Lett Drugs Ther 2011; 53:101.

2. VW Bowry et al. Vitamin E in human low-density lipoprotein. When and how this antioxidant becomes a pro-oxidant. Biochem J 1992; 288 (Pt 2):341.

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Many patients ask their healthcare providers whether they should take vitamins. Since the last Medical Letter article on this subject, more data have become available on the benefits and risks of taking vitamins.

Many patients ask their physicians whether they should take vitamins. Since the last Medical Letter article on this subject, more data have become available on the benefits and risks of taking vitamin supplements.

Many patients ask their physicians whether they should take vitamins. In recent years, more data have become available on the risks and benefits of taking vitamin supplements.