Circulating omega-3 Fatty acids and neovascular age-related macular degeneration

Invest Ophthalmol Vis Sci. 2014 Mar 28;55(3):2010-9. doi: 10.1167/iovs.14-13916.


Purpose: We assessed the associations of serum, red blood cell membranes (RBCM) and dietary long-chain n-3 polyunsaturated fatty acids (LC-PUFAs) with neovascular age-related macular degeneration (AMD).

Methods: We included 290 patients of the Nutritional AMD Treatment 2 Study (NAT2) with neovascular AMD in one eye and early AMD lesions in the other eye, and 144 normal vision controls without AMD. Dietary intake of seafood was estimated by food frequency questionnaire. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) composition in serum and RBCM were determined by gas chromatography from 12-hour fasting blood samples and was expressed as percentages of total fatty acids profile. Logistic regressions estimated associations of neovascular AMD with dietary intake of seafood and circulating n-3 LC-PUFAs.

Results: Dietary oily fish and seafood intake were significantly lower in AMD patients than in controls. After adjustment for all potential confounders (age, sex, CFH Y402H, ARMS2 A69S, and ApoE4 polymorphisms, plasma triglycerides, hypertension, hypercholesterolemia, and family history of AMD), serum EPA was associated significantly with a lower risk for neovascular AMD (odds ratio [OR] = 0.41; 95% confidence interval [CI], 0.22-0.77; P = 0.005). Analysis of RBCM revealed that EPA and EPA+DHA were associated significantly with a lower risk for neovascular AMD (OR = 0.25; 95% CI, 0.13-0.47; P < 0.0001 and OR = 0.52; 95% CI, 0.29-0.94; P = 0.03, respectively).

Conclusions: The RBCM EPA and EPA+DHA, as long-term biomarkers of n-3 dietary PUFA status, were associated strongly with neovascular AMD and may represent an objective marker identifying subjects at high risk for neovascular AMD, who may most benefit from nutritional interventions. ( number, ISRCTN98246501).

Keywords: age-related macular degeneration; case-control study; epidemiology; omega-3 fatty acids.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chromatography, Gas
  • Double-Blind Method
  • Fatty Acids, Omega-3 / pharmacokinetics*
  • Female
  • Fish Oils / administration & dosage*
  • Fish Oils / pharmacokinetics
  • Follow-Up Studies
  • Humans
  • Macular Degeneration / blood
  • Macular Degeneration / complications
  • Macular Degeneration / diet therapy*
  • Male
  • Retinal Neovascularization / blood
  • Retinal Neovascularization / complications
  • Retinal Neovascularization / diet therapy*
  • Retrospective Studies
  • Surveys and Questionnaires
  • Treatment Outcome


  • Fatty Acids, Omega-3
  • Fish Oils

Associated data

  • ISRCTN/ISRCTN98246501