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The Relationship of Dietary -3 Long-Chain Polyunsaturated Fatty Acid Intake With Incident Age-Related Macular Degeneration

AREDS Report No. 23

John Paul SanGiovanni, ScD; Emily Y. Chew, MD; Elvira Agrón, MA; Traci E. Clemons, PhD; Frederick L. Ferris III, MD; Gary Gensler, MS; Anne S. Lindblad, PhD; Roy C. Milton, PhD; Johanna M. Seddon, MD; Ronald Klein, MD; Robert D. Sperduto, MD; for the Age-Related Eye Disease Study Research Group

Arch Ophthalmol. 2008;126(9):1274-1279.

Objective  To examine the association of dietary -3 long-chain polyunsaturated fatty acid and fish intake with incident neovascular age-related macular degeneration (AMD) and central geographic atrophy (CGA).

Methods  Multicenter clinic-based prospective cohort study from a clinical trial including Age-Related Eye Disease Study (AREDS) participants with bilateral drusen at enrollment. Main outcome measures were incident neovascular AMD and CGA, ascertained from annual stereoscopic color fundus photographs (median follow-up, 6.3 years). We estimated nutrient and food intake from a validated food frequency questionnaire (FFQ) at baseline, with intake of docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), c ombined EPA and DHA, and fish as primary exposures.

Results  After controlling for known covariates, we observed a reduced likelihood of progression from bilateral drusen to CGA among people who reported the highest levels of EPA (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.23-0.87) and EPA+DHA (OR, 0.45; 95% CI, 0.23-0.90) consumption. Levels of DHA were associated with CGA in age-, sex-, and calorie-adjusted models (OR, 0.51; 95% CI, 0.26-1.00); however, this statistical relationship did not persist in multivariable models.

Conclusions  Dietary lipid intake is a modifiable factor that may influence the likelihood of developing sight-threatening forms of AMD. Our findings suggest that dietary -3 long-chain polyunsaturated fatty acid intake is associated with a decreased risk of progression from bilateral drusen to CGA.

Author Affiliations: National Eye Institute, Bethesda, Maryland (Drs SanGiovanni, Chew, Ferris, and Sperduto and Ms Agrón); The EMMES Corporation, Rockville, Maryland (Drs Clemons, Lindblad, and Milton and Mr Gensler); New England Eye Center, Tufts-New England Medical Center, Boston, Massachusetts (Dr Seddon); and Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison (Dr Klein).
Group Information: A list of the Age-Related Eye Disease Study Research Group members was published in Arch Ophthalmol. 2004;122(5):716-726.