September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Dietary folate, B vitamins, genetic susceptibility, and progression to advanced non-exudative age-related macular degeneration with geographic atrophy
Author Affiliations & Notes
  • Rachel E Silver
    Ophthalmic Epidemiology and Genetics Service, Tufts Medical Center, Boston, Massachusetts, United States
  • Benedicte MJ Merle
    Ophthalmic Epidemiology and Genetics Service, Tufts Medical Center, Boston, Massachusetts, United States
  • Bernard Rosner
    Channing Division of Network Medicine, Harvard Medical School, Boston, Massachusetts, United States
  • Johanna M Seddon
    Ophthalmic Epidemiology and Genetics Service, Tufts Medical Center, Boston, Massachusetts, United States
    Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Rachel Silver, None; Benedicte Merle, None; Bernard Rosner, None; Johanna Seddon, None
  • Footnotes
    Support  JMS: RO1-EY11309 from the National Institutes of Health; the Massachusetts Lions Eye Research Fund Inc., New Bedford, MA; unrestricted grants from Research to Prevent Blindness Inc., New York, NY; and the Age-Related Macular Degeneration Research Fund, Ophthalmic Epidemiology and Genetics Service, Tufts Medical Center, Tufts University School of Medicine, Boston, MA. BR: RO1-EY022445 from the National Institutes of Health. BM: Fondation Dalloz - Institut de France, Philippe Foundation and Jean-Walter Zellidja - Académie Française.
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Rachel E Silver, Benedicte MJ Merle, Bernard Rosner, Johanna M Seddon; Dietary folate, B vitamins, genetic susceptibility, and progression to advanced non-exudative age-related macular degeneration with geographic atrophy. Invest. Ophthalmol. Vis. Sci. 201657(12):.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : There is growing evidence of the importance of nutrition in age-related macular degeneration (AMD), but few studies have explored associations with folate and B vitamins. No effective therapeutic strategy for geographic atrophy (GA) is available and prevention could be of great value. We hypothesized that higher dietary intake of folate and B vitamins could reduce progression to GA, and that these associations could be modified by genetic susceptibility.

Methods : Among 2525 subjects (4663 eyes) in the Age-Related Eye Disease Study, 405 subjects (528 eyes) progressed to GA over 13 years (mean follow up: 8.7 years). Folate and B vitamins were log transformed and calorie-adjusted separately for men and women. Ten loci in seven AMD genes (CFH, ARMS2, C2, C3, CFB, COL8A1, and RAD51B) were examined. Survival analysis was used to assess associations between incident GA and dietary intake of folate and B vitamins. Interaction effects between these nutrients and genetic variation on AMD risk were also evaluated.

Results : There was a lower risk of progression to GA with increasing intake of thiamin, riboflavin, and folate after adjusting for age, sex, and total energy intake (P trend=0.01, 0.03, and 0.001, respectively). After adjustment for demographic, behavioral, ocular, and genetic covariates, trends remained significant for folate (hazard ratio [HR]: 0.70; 95% confidence interval [CI]: 0.52-0.95; P trend=0.007) and were borderline for thiamin (P trend=0.05). Riboflavin did not retain statistical significance in these multivariate analyses (P trend=0.20). Dietary folate intake was significantly associated with a lower risk of incident GA among subjects homozygous for the C3 R102G non-risk genotype (CC) (HR: 0.43; 95% CI: 0.27-0.70; P =0.0005), but subjects carrying the risk allele (G) did not appear to benefit (HR: 0.94; 95% CI: 0.62-1.42; P=0.76). Neither folate nor any B vitamin was significantly associated with neovascular AMD.

Conclusions : Our study suggests that high dietary folate intake is associated with a reduced risk of progression to GA. This benefit might be modified by genetic susceptibility, particularly related to C3 R102G. Eating a healthy diet rich in folate could contribute to the reduction and prevention of visual loss due to atrophic macular degeneration.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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