{omega}-3 Long-chain Polyunsaturated Fatty Acid Intake and 12-y Incidence of Neovascular Age-Related Macular Degeneration and Central Geographic Atrophy: AREDS Report 30, a Prospective Cohort Study From the Age-Related Eye Disease Study

Am J Clin Nutr. 2009 Dec;90(6):1601-7. doi: 10.3945/ajcn.2009.27594. Epub 2009 Oct 7.

Abstract

Background: omega-3 (n-3) Long-chain polyunsaturated fatty acids (LCPUFAs) affect processes implicated in vascular and neural retinal pathogenesis and thus may influence the risk of developing age-related macular degeneration (AMD).

Objective: We investigated whether omega-3 LCPUFA intake was associated with a reduced likelihood of developing central geographic atrophy (CGA) and neovascular (NV) AMD.

Design: We undertook a nested cohort study within a multicenter phase 3 clinical trial, the Age-Related Eye Disease Study (AREDS), to study progression to advanced AMD in 1837 persons at moderate-to-high risk of this condition. The AREDS was designed to assess the clinical course, prognosis, risk factors, and nutrient-based treatments of AMD and ran from November 1992 to December 2005. We obtained baseline data on omega-3 LCPUFA intake with a validated food-frequency questionnaire. Trained fundus graders ascertained AMD status from annual stereoscopic color photographs by using standardized methods at a single reading center across a 12-y period. We applied multivariable repeated-measures logistic regression with the incorporation of generalized estimating equation methods, because this permitted determination of progression to outcome at each visit.

Results: Participants who reported the highest omega-3 LCPUFA intake (median: 0.11% of total energy intake) were 30% less likely than their peers to develop CGA and NV AMD. The respective odds ratios were 0.65 (95% CI: 0.45, 0.92; P <or= 0.02) and 0.68 (95% CI: 0.49, 0.94; P <or= 0.02).

Conclusions: The 12-y incidence of CGA and NV AMD in participants at moderate-to-high risk of these outcomes was lowest for those reporting the highest consumption of omega-3 LCPUFAs. If these results are generalizable, they may guide the development of low-cost and easily implemented preventive interventions for progression to advanced AMD. This trial was registered at clinicaltrials.gov as NCT00594672.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Fatty Acids, Omega-3 / administration & dosage*
  • Female
  • Geographic Atrophy / epidemiology*
  • Humans
  • Incidence
  • Logistic Models
  • Macular Degeneration / epidemiology*
  • Male
  • Middle Aged
  • Prospective Studies

Substances

  • Fatty Acids, Omega-3

Associated data

  • ClinicalTrials.gov/NCT00594672