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

Abstract

Age-related macular degeneration (AMD) is a leading cause of irreversible vision loss in elderly persons.^1-3Docosahexaenoic acid (DHA) (C22:6 ω-3), the major dietary and structural ω-3 long-chain polyunsaturated fatty acid (LCPUFA) of the retina, has the capacity to modulate processes implicated in AMD pathogenesis.⁴Eicosapentaenoic acid (EPA) (C20:5 ω-3), the precursor to DHA and the other major dietary ω-3 LCPUFA, can exert similar actions to DHA.⁴Report 20 from the Age-Related Eye Disease Study (AREDS) describes a 40% to 50% reduced likelihood of having neovascular (NV) AMD among participants who reported the highest levels of ω-3 LCPUFA consumption (odds ratio [OR], 0.61; 95% confidence interval [CI], 0.41-0.90)⁵; these findings are concordant with those from other studies examining relationships of ω-3 LCPUFAs^6-9and ω-3 LCPUFA–rich food intake^6-8,10-13with various stages of incident^8,9,14,15and prevalent^6,7,10-13AMD. Although statistical relationships did not always exist in these studies, measures of association were consistently in the direction of benefit.In addition to its value for cross-sectional analyses, AREDS provides a large and carefully phenotyped prospective sample of participants examined for progression to advanced AMD. Higher levels of ω-3 LCPUFA and fish intake were associated with a decreased likelihood of progression to advanced AMD in subgroups from the 2 published studies examining this issue.^8,14In this report, we document an inverse relationship of EPA and ω-3 LCPUFAs with progression to central geographic atrophy (CGA) among AREDS participants at moderate risk of this event.