LAST 2004Low.

Methods	Lutein Antioxidant Supplementation Trial (LAST). Randomised, double‐blind placebo‐controlled trial with parallel group design (three intervention groups).
Participants	Country: United States of America. Number of participants randomised: 90, 86 men and 4 women, mean age 74.7 years. Inclusion criteria: diagnosis of atrophic age‐related macular degeneration (ARMD) by stereo bio‐ophtalmoscopy and at least one vision‐degrading visual‐psychophysical abnormality associated with ARMD in one or both eyes; clear non‐lenticular ocular media (cornea, aqueous and vitreous), free of advanced glaucoma and diabetes or any other ocular or systemic disease that could affect central or parafoveal macular visual function. Exclusion criteria: recent (within 6 months) cataract or retinal surgery; taking photosenzing drugs (such as phenotiazines and chloroquine).
Interventions	Patients were randomly assigned to receive: group 1: lutein 10 mg (n = 29); group 2: lutein 10 mg, and antioxidants/vitamins and minerals broad spectrum supplementation formula (n = 30); group 3: placebo (maltodextrin) (n = 31); taken as three capsules twice per day with food, over a period of 12 months. The OcuPower supplement consists of: lutein 10 mg; vitamin A 2,500 IU; natural beta‐carotene 15,000 IU (Betatene R); vitamin C 1500 mg (as calcium ascorbate‐Ester C R); vitamin D3 400 IU; natural vitamin E (d‐alpha tocopherol succinate) 500 IU; vitamin B1 50 mg; vitamin B2 10 mg; vitamin B3 70 mg; vitamin B5 50 mg; vitamin B6 50 mg; vitamin B12 500 µg; folic acid 800 µg; biotin 300 mcg; calcium 500 mg; magnesium 300 mg; iodine 75 µg; zinc (as zinc L‐methionine‐L‐Optizinc R) 25 mg; copper 1 mg; manganese 2 mg; selenium 200 µg; chromium 200 µg; molibdenum 75 µg; lycopene 600 µg; bilberry extract (standardized to 25% anthocyanosides); alpha lipoic acid 150 mg; N‐acetyl cysteine 200 mg; quercetin 100 mg; rutin 100 mg; citrus bioflavonoids 250 mg; plant enzymes 50 mg; black pepper extract (Bioperine R) 5 mg; malic acid 325 mg; taurine 900 mg; L‐glycine 100 mg; L‐glutathione 10 mg; boron 2 mg.
Outcomes	The primary outcome measures were: visual function and symptoms in atrophic age‐related macular degeneration (ARMD).
Notes	Compliance was assessed by telephone at one week, two weeks, four weeks, six weeks, three months, and 12 months. Compliance with treatment was good. During one‐year study, 96% of the participants took approximately 92% of their assigned capsules. There was no difference in compliance among the three groups. During the one year clinical trial, one, two, and one participant was lost to follow‐up from each group. Lutein (Floraglo R) was provided by Kemin Foods International, Des Moines, Iowa); lutein in combination with additional antioxidants and nutrients (OcuPower R) and placebo were provided by Nutraceutical Sciences Institute, Boynton Beach, Florida.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Sequence generation was achieved using computer random number generation.
Allocation concealment (selection bias)	Low risk	Allocation was controlled by a central and independent randomisation unit, so that intervention allocations could not have been foreseen in advance of, or during, enrolment.
Blinding (performance bias and detection bias) All outcomes	Low risk	The trial was described as blinded, the parties that were blinded, and the method of blinding was described, so that knowledge of allocation was adequately prevented during the trial.
Incomplete outcome data (attrition bias) All outcomes	Low risk	The numbers and reasons for dropouts and withdrawals in all intervention groups were described.
Selective reporting (reporting bias)	Low risk	Pre‐defined, or clinically relevant and reasonably expected outcomes are reported on.
Other bias	Low risk	The trial appears to be free of other components that could put it at risk of bias.