Skip to main content Accessibility help

Vitamin E and risk of age-related cataract: a meta-analysis

  • Yufei Zhang (a1), Wenjie Jiang (a1), Zhutian Xie (a1), Wenlong Wu (a1) and Dongfeng Zhang (a1)...



We conducted a meta-analysis to evaluate the relationship between vitamin E and age-related cataract (ARC).


The fixed- or random-effect model was selected based on heterogeneity. Meta-regression was used to explore potential sources of between-study heterogeneity. Publication bias was evaluated using Begg’s test. The dose–response relationship was assessed by a restricted cubic spline model.


Relevant studies were identified by a search of PubMed and the Cochrane Library to May 2014, without language restrictions.


Studies involved samples of people of all ages.


Dietary vitamin E intake, dietary and supplemental vitamin E intake, and high serum tocopherol levels were significantly associated with decreased risk of ARC, the pooled relative risk was 0·73 (95 % CI 0·58, 0·92), 0·86 (95 % CI 0·75, 0·99) and 0·77 (95 % CI 0·66, 0·91), respectively. Supplemental vitamin E intake was non-significantly associated with ARC risk (relative risk=0·92; 95 % CI 0·78, 1·07). The findings from dose–response analysis showed evidence of a non-linear association between dietary vitamin E intake and ARC. The risk of ARC decreased with dietary vitamin E intake from 7 mg/d (relative risk=0·94; 95 % CI 0·90, 0·97).


The findings of the meta-analysis indicated that dietary vitamin E intake, dietary and supplemental vitamin E intake, and high level of serum tocopherol might be significantly associated with reduced ARC risk.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Vitamin E and risk of age-related cataract: a meta-analysis
      Available formats

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Vitamin E and risk of age-related cataract: a meta-analysis
      Available formats

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Vitamin E and risk of age-related cataract: a meta-analysis
      Available formats


Corresponding author

* Corresponding author: Email


Hide All
1. Congdon, NG, Friedman, DS & Lietman, T (2003) Important causes of visual impairment in the world today. JAMA 290, 20572060.
2. Klein, BE & Klein, R (2007) Lifestyle exposures and eye diseases in adults. Am J Ophthalmol 144, 961969.
3. Pascolini, D & Mariotti, SP (2012) Global estimates of visual impairment: 2010. Br J Ophthalmol 96, 614618.
4. Varma, SD, Devamanoharan, PS & Ali, AH (1999) Oxygen radicals in the pathogenesis of cataracts – possibilities for therapeutic intervention. In Nutritional and Environmental Influences on the Eye, pp. 524 [A Taylor, editor]. Boca Raton, FL: CRC Press.
5. Azzi, A, Breyer, I, Feher, M et al. (2000) Specific cellular responses to α-tocopherol. J Nutr 130, 16491652.
6. Taylor, A & Hobbs, M (2001) 2001 assessment of nutritional influences on risk for cataract. Nutrition 17, 845857.
7. Bunce, GE, Kinoshita, J & Horwitz, J (1990) Nutritional factors in cataract. Annu Rev Nutr 10, 233254.
8. Sies, H, Stahl, W & Sundquist, AR (1992) Antioxidant functions of vitamins. Vitamins E and C, β-carotene, and other carotenoids. Ann N Y Acad Sci 669, 720.
9. Jacques, PF & Taylor, A (1992) Micronutrients and age-related cataracts. In Micronutrients in Health and Disease Prevention, pp. 358379 [A Bendich and CE Butterworth Jr, editors]. New York: Marcel Dekker.
10. Robertson, JM, Donner, AP & Trevithick, JR (1991) A possible role for vitamins C and E in cataract prevention. Am J Clin Nutr 53, 1 Suppl., 346S351S.
11. Leske, MC, Wu, SY, Hyman, L et al. (1995) Biochemical factors in the lens opacities. Case–control study. The Lens Opacities Case–Control Study Group. Arch Ophthalmol 113, 11131119.
12. Rouhiainen, P, Rouhiainen, H & Salonen, JT (1996) Association between low plasma vitamin E concentration and progression of early cortical lens opacities. Am J Epidemiol 144, 496500.
13. Leske, MC, Chylack, LT Jr, He, Q et al. (1998) Antioxidant vitamins and nuclear opacities: the longitudinal study of cataract. Ophthalmology 105, 831836.
14. Jacques, PF (1999) The potential preventive effects of vitamins for cataract and age-related macular degeneration. Int J Vitam Nutr Res 69, 198205.
15. Theodoropoulou, S, Samoli, E, Theodossiadis, PG et al. (2014) Diet and cataract: a case–control study. Int Ophthalmol 34, 5968.
16. Hankinson, SE, Stampfer, MJ, Seddon, JM et al. (1992) Nutrient intake and cataract extraction in women: a prospective study. BMJ 305, 335339.
17. McCarty, CA, Mukesh, BN, Fu, CL et al. (1999) The epidemiology of cataract in Australia. Am J Ophthalmol 128, 446465.
18. Taylor, A, Jacques, PF, Chylack, LT Jr et al. (2002) Long-term intake of vitamins and carotenoids and odds of early age-related cortical and posterior subcapsular lens opacities. Am J Clin Nutr 75, 540549.
19. McNeil, JJ, Robman, L, Tikellis, G et al. (2004) Vitamin E supplementation and cataract: randomized controlled trial. Ophthalmology 111, 7584.
20. Christen, WG, Glynn, RJ, Sesso, HD et al. (2010) Age-related cataract in a randomized trial of vitamins E and C in men. Arch Ophthalmol 128, 13971405.
21. Zheng Selin, J, Rautiainen, S, Lindblad, BE et al. (2013) High-dose supplements of vitamins C and E, low-dose multivitamins, and the risk of age-related cataract: a population-based prospective cohort study of men. Am J Epidemiol 177, 548555.
22. Higgins, JP & Thompson, SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21, 15391558.
23. Higgins, JP, Thompson, SG, Deeks, JJ et al. (2003) Measuring inconsistency in meta-analyses. BMJ 327, 557560.
24. DerSimonian, R & Laird, N (1986) Meta-analysis in clinical trials. Control Clin Trials 7, 177188.
25. Begg, CB & Mazumdar, M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50, 10881101.
26. Egger, M, Davey Smith, G, Schneider, M et al. (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315, 629634.
27. Orsini, N, Li, R, Wolk, A et al. (2012) Meta-analysis for linear and nonlinear dose–response relations: examples, an evaluation of approximations, and software. Am J Epidemiol 175, 6673.
28. Harrell, FE Jr, Lee, KL & Pollock, BG (1988) Regression models in clinical studies: determining relationships between predictors and response. J Natl Cancer Inst 80, 11981202.
29. Jackson, D, White, IR & Thompson, SG (2010) Extending DerSimonian and Laird’s methodology to perform multivariate random effects meta-analyses. Stat Med 29, 12821297.
30. The Italian–American Cataract Study Group (1991) Risk factors for age-related cortical, nuclear, and posterior subcapsular cataracts. Am J Epidemiol 133, 541553.
31. Creighton, MO & Trevithick, JR (1979) Cortical cataract formation prevented by vitamin E and glutathione. Exp Eye Res 29, 689693.
32. Mares-Perlman, JA, Klein, BE, Klein, R et al. (1993) Nutrient supplements contribute to the dietary intake of middle- and older-aged adult residents of Beaver Dam, Wisconsin. J Nutr 123, 176188.
33. Taylor, A, Jacques, PF & Epstein, EM (1995) Relations among aging, antioxidant status, and cataract. Am J Clin Nutr, 62, 6 Suppl., 1439S1447S.
34. Trevithick, JR & Mitton, KP (2000) Vitamins C and E in cataract risk reduction. Int Ophthalmol Clin 40, 5969.
35. Age-Related Eye Disease Study Research Group (2001) A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E and β carotene for age-related cataract and vision loss: AREDS report no. 9. Arch Ophthalmol 119, 14391452.
36. Chylack, LT Jr, Brown, NP, Bron, A et al. (2002) The Roche European American Cataract Trial (REACT): a randomized clinical trial to investigate the efficacy of an oral antioxidant micronutrient mixture to slow progression of age-related cataract. Ophthalmic Epidemiol 9, 4980.
37. Mohan, M, Sperduto, RD, Angra, SK et al. (1989) India–US case–control study of age-related cataracts. India–US Case–Control Study Group. Arch Ophthalmol 107, 670676.
38. Robertson, JM, Donner, AP & Trevithick, JR (1989) Vitamin E intake and risk of cataracts in humans. Ann N Y Acad Sci 570, 372382.
39. Mares-Perlman, JA, Brady, WE, Klein, BE et al. (1995) Serum carotenoids and tocopherols and severity of nuclear and cortical opacities. Invest Ophthalmol Vis Sci 36, 276288.
40. Christen, WG, Gaziano, JM & Hennekens, CH (2000) Design of Physicians’ Health Study II – a randomized trial of β-carotene, vitamins E and C, and multivitamins, in prevention of cancer, cardiovascular disease, and eye disease, and review of results of completed trials. Ann Epidemiol 10, 125134.
41. Knekt, P, Heliovaara, M, Rissanen, A et al. (1992) Serum antioxidant vitamins and risk of cataract. BMJ 305, 13921394.
42. Vitale, S, West, S, Hallfrisch, J et al. (1993) Plasma antioxidants and risk of cortical and nuclear cataract. Epidemiology 4, 195203.
43. Tavani, A, Negri, E & La Vecchia, C (1996) Food and nutrient intake and risk of cataract. Ann Epidemiol 6, 4146.
44. Teikari, JM, Rautalahti, M, Haukka, J et al. (1998) Incidence of cataract operations in Finnish male smokers unaffected by α tocopherol or β carotene supplements. J Epidemiol Community Health 52, 468472.
45. Lyle, BJ, Mares-Perlman, JA, Klein, BE et al. (1999) Antioxidant intake and risk of incident age-related nuclear cataracts in the Beaver Dam Eye Study. Am J Epidemiol 149, 801809.
46. Lyle, BJ, Mares-Perlman, JA, Klein, BE et al. (1999) Serum carotenoids and tocopherols and incidence of age-related nuclear cataract. Am J Clin Nutr 69, 272277.
47. Nadalin, G, Robman, LD, McCarty, CA et al. (1999) The role of past intake of vitamin E in early cataract changes. Ophthalmic Epidemiol 6, 105112.
48. Gale, CR, Hall, NF, Phillips, DI et al. (2001) Plasma antioxidant vitamins and carotenoids and age-related cataract. Ophthalmology 108, 19921998.
49. Jacques, PF, Chylack, LT Jr, Hankinson, SE et al. (2001) Long-term nutrient intake and early age-related nuclear lens opacities. Arch Ophthalmol 119, 10091019.
50. Valero, MP, Fletcher, AE, De Stavola, BL et al. (2002) Vitamin C is associated with reduced risk of cataract in a Mediterranean population. J Nutr 132, 12991306.
51. Ferrigno, L, Aldigeri, R, Rosmini, F et al. (2005) Associations between plasma levels of vitamins and cataract in the Italian–American Clinical Trial of Nutritional Supplements and Age-Related Cataract (CTNS): CTNS Report #2. Ophthalmic Epidemiol 12, 7180.
52. Christen, WG, Glynn, RJ, Chew, EY et al. (2008) Vitamin E and age-related cataract in a randomized trial of women. Ophthalmology 115, 822829 e1.
53. Christen, WG, Liu, S, Glynn, RJ et al. (2008) Dietary carotenoids, vitamins C and E, and risk of cataract in women: a prospective study. Arch Ophthalmol 126, 102109.
54. Dherani, M, Murthy, GV, Gupta, SK et al. (2008) Blood levels of vitamin C, carotenoids and retinol are inversely associated with cataract in a North Indian population. Invest Ophthalmol Vis Sci 49, 33283335.
55. Ravindran, RD, Vashist, P, Gupta, SK et al. (2011) Inverse association of vitamin C with cataract in older people in India. Ophthalmology 118, 19581965 e2.
56. Pastor-Valero, M (2013) Fruit and vegetable intake and vitamins C and E are associated with a reduced prevalence of cataract in a Spanish Mediterranean population. BMC Ophthalmol 13, 52.
57. Machlin, LJ & Bendich, A (1987) Free radical tissue damage: protective role of antioxidant nutrients. FASEB J 1, 441445.
58. Libondi, T, Menzione, M & Auricchio, G (1985) In vitro effect of α-tocopherol on lysophosphatidylcholine-induced lens damage. Exp Eye Res 40, 661666.
59. Costagliola, C, Iuliano, G, Menzione, M et al. (1986) Effect of vitamin E on glutathione content in red blood cells, aqueous humor and lens of humans and other species. Exp Eye Res 43, 905914.
60. Chang, JR, Koo, E, Agron, E et al. (2011) Risk factors associated with incident cataracts and cataract surgery in the Age-related Eye Disease Study (AREDS): AREDS report number 32. Ophthalmology 118, 21132119.
61. Michael, R & Bron, AJ (2011) The ageing lens and cataract: a model of normal and pathological ageing. Philos Trans R Soc Lond B Biol Sci 366, 12781292.
62. Fan, X, Zhang, J, Theves, M et al. (2009) Mechanism of lysine oxidation in human lens crystallins during aging and in diabetes. J Biol Chem 284, 3461834627.
63. Sireesha, R, Laxmi, SG, Mamata, M et al. (2012) Total activity of glutathione-S-transferase (GST) and polymorphisms of GSTM1 and GSTT1 genes conferring risk for the development of age related cataracts. Exp Eye Res 98, 6774.
64. Beebe, DC, Holekamp, NM, Siegfried, C et al. (2011) Vitreoretinal influences on lens function and cataract. Philos Trans R Soc Lond B Biol Sci 366, 12931300.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed