Nutritional AMD Treatment Phase I (NAT-1): Feasibility of Oral DHA Supplementation in Age-Related Macular Degeneration

Purpose To create a pilot study in order to evaluate the feasibility of a prospective case-control study of oral supplementation with fish oil (docosahexaenoic acid [DHA]; eicosapentaenoic acid [EPA]) in a population with age-related macular degeneration (AMD). Methods A homogeneous group of 38 patients with drusenoid pigment epithelial detachment in one eye (PED) without choroidal new vessels (CNV) was selected. A complete ophthalmologic examination, and a complete profile of fatty acids in serum (S) and in red blood cell membranes (RBCM), were recorded at day 0 and month 6. In group 1, 22 patients were orally supplemented with EPA (720 mg/day) and DHA (480 mg/day) during 6 months. In group 2, 16 patients were followed as controls. Nutritional recommendations on fish consumption were given to both groups. Results In group 1, after 6 months supplementation we observed a significant blood enrichment in EPA (EPA-S: 2.20 vs 0.79, p<0.0001 and EPA-RBCM: 2.24 vs 0.85, p<0.0001) and in DHA (DHA-S: 2.47 vs 1.56, p<0.0001 and DHA-RBCM: 6.47 vs 4.67, p<0.0001). No change was observed in group 2 despite nutritional recommendations. In this short follow-up, no evolution to CNV was noted in either of the two groups. Neither side effects nor dropouts were observed in either of the groups. Conclusions This study supports the feasibility of a long-term double-masked prospective case-control study in an AMD population in order to evaluate a potential benefit from oral supplementation with DHA.

[1]  K. Tsubota,et al.  Eicosapentaenoic acid is anti-inflammatory in preventing choroidal neovascularization in mice. , 2007, Investigative ophthalmology & visual science.

[2]  Lois E. H. Smith,et al.  Increased dietary intake of ω-3-polyunsaturated fatty acids reduces pathological retinal angiogenesis , 2007, Nature Medicine.

[3]  F. Ferris,et al.  The relationship of dietary lipid intake and age-related macular degeneration in a case-control study: AREDS Report No. 20. , 2007, Archives of ophthalmology.

[4]  Johanna M Seddon,et al.  The genetics of age-related macular degeneration: a review of progress to date. , 2006, Survey of ophthalmology.

[5]  M. Sampson,et al.  Efficacy of ω-3 Fatty Acids in Preventing Age-Related Macular Degeneration : A Systematic Review , 2006 .

[6]  P. Barberger‐Gateau,et al.  Plasma lutein and zeaxanthin and other carotenoids as modifiable risk factors for age-related maculopathy and cataract: the POLA Study. , 2006, Investigative ophthalmology & visual science.

[7]  M. Sampson,et al.  Efficacy of omega-3 fatty acids in preventing age-related macular degeneration: a systematic review. , 2006, Ophthalmology.

[8]  A. Hofman,et al.  Dietary intake of antioxidants and risk of age-related macular degeneration. , 2005, JAMA.

[9]  J. Sangiovanni,et al.  The role of omega-3 long-chain polyunsaturated fatty acids in health and disease of the retina , 2005, Progress in Retinal and Eye Research.

[10]  W. Willett,et al.  Prospective study of intake of fruits, vegetables, vitamins, and carotenoids and risk of age-related maculopathy. , 2004, Archives of ophthalmology.

[11]  J. Ott,et al.  Extremely discordant sib-pair study design to determine risk factors for neovascular age-related macular degeneration. , 2004, Archives of ophthalmology.

[12]  Stuart Richer,et al.  Double-masked, placebo-controlled, randomized trial of lutein and antioxidant supplementation in the intervention of atrophic age-related macular degeneration: the Veterans LAST study (Lutein Antioxidant Supplementation Trial). , 2004, Optometry.

[13]  Sonia H Yoo,et al.  Age-related macular degeneration: etiology, pathogenesis, and therapeutic strategies. , 2003, Survey of ophthalmology.

[14]  N. Rotstein,et al.  Protective effect of docosahexaenoic acid on oxidative stress-induced apoptosis of retina photoreceptors. , 2003, Investigative ophthalmology & visual science.

[15]  T. Peto,et al.  The prevalence of age-related maculopathy in iceland: Reykjavik eye study. , 2002, Archives of ophthalmology.

[16]  P. Mitchell,et al.  Smoking and the 5-year incidence of age-related maculopathy: the Blue Mountains Eye Study. , 2002, Archives of ophthalmology.

[17]  S. Kinoshita,et al.  A Novel Relation of Fatty Acid with Age-Related Macular Degeneration , 2002, Ophthalmologica.

[18]  W. Willett,et al.  Dietary fat and risk for advanced age-related macular degeneration. , 2001, Archives of ophthalmology.

[19]  E. Rimm,et al.  Prospective study of dietary fat and the risk of age-related macular degeneration. , 2001, The American journal of clinical nutrition.

[20]  U. Das.  Beneficial effect(s) of n-3 fatty acids in cardiovascular diseases: but, why and how? , 2000, Prostaglandins, leukotrienes, and essential fatty acids.

[21]  J. Chua,et al.  The association between cigarette smoking and ocular diseases. , 2000, Hong Kong medical journal = Xianggang yi xue za zhi.

[22]  P. Mitchell,et al.  Dietary fat and fish intake and age-related maculopathy. , 2000, Archives of ophthalmology.

[23]  C. Delcourt,et al.  Smoking and age-related macular degeneration. The POLA Study. Pathologies Oculaires Liées à l'Age. , 1998, Archives of ophthalmology.

[24]  R. Klein,et al.  Associations between antioxidant and zinc intake and the 5-year incidence of early age-related maculopathy in the Beaver Dam Eye Study. , 1998, American journal of epidemiology.

[25]  A. Munnich,et al.  The γ e4 allele of the apolipoprotein E gene as a potential protective factor for exudative age-related macular degeneration , 1998 .

[26]  W. Willett,et al.  A prospective study of cigarette smoking and age-related macular degeneration in women. , 1996, JAMA.

[27]  R. Klein,et al.  Dietary fat and age-related maculopathy. , 1995, Archives of ophthalmology.

[28]  R Hiller,et al.  Dietary carotenoids, vitamins A, C, and E, and advanced age-related macular degeneration. Eye Disease Case-Control Study Group. , 1994, JAMA.

[29]  Lawrence A. Yannuzzi,et al.  Dietary Carotenoids, Vitamins A, C, and E, and Advanced Age-Related Macular Degeneration , 1994 .

[30]  A. Simopoulos.  Omega-3 fatty acids in health and disease and in growth and development. , 1991, The American journal of clinical nutrition.

[31]  V. Hubbard,et al.  Changing dietary patterns. , 1990, The American journal of clinical nutrition.

[32]  J. G. Bieri,et al.  THE ROLES OF VITAMIN E AND UNSATURATED FATTY ACIDS IN THE VISUAL PROCESS , 1982, Retina.

[33]  A. Tamakoshi,et al.  Report on the nationwide epidemiological survey of exudative age-related macular degeneration in Japan , 2004, International Ophthalmology.

[34]  S. Grundy.  N-3 fatty acids: priority for post-myocardial infarction clinical trials. , 2003, Circulation.

[35]  A. Simopoulos.  n−3 fatty acids and human health: Defining strategies for public policy , 2001, Lipids.

[36]  Jennifer I. Lim,et al.  A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8. , 2001, Archives of ophthalmology.

[37]  Risk factors for neovascular age-related macular degeneration. The Eye Disease Case-Control Study Group. , 1992, Archives of ophthalmology.

[38]  T. Maruo,et al.  Changes in causes of visual handicaps in Tokyo. , 1991, Japanese journal of ophthalmology.

[39]  N. Bazan.  The metabolism of omega-3 polyunsaturated fatty acids in the eye: the possible role of docosahexaenoic acid and docosanoids in retinal physiology and ocular pathology. , 1989, Progress in clinical and biological research.

[40]  G. Anderson,et al.  The essentiality of n-3 fatty acids for the development and function of the retina and brain. , 1988, Annual review of nutrition.