Omega-3 Supplementation Influences Vitreal Levels of Vascular Endothelial Growth Factor in Exudative Age-Related Macular Degeneration

Abstract

Purpose: : To examine the influence of omega-3 long-chain poly-unsaturated fatty acids (LCPUFAs) supplementation on vitreal levels of vascular endothelial growth factor (VEGF) in exudative age-related macular degeneration (AMD).

Methods: : Patients with active exudative AMD undergoing intravitreal anti-VEGF treatment were recruited from February to August 2011 after ethics committee approval and informed consent was obtained. In this pilot study, we compared vitreous levels of VEGF in 14 patients receiving daily omega-3 supplementation (200 mg of docosahexaenoic acid and 400 mg of eicosapentaenoic acid) for at least 2 months prior to biops with thosein 5 patients not receiving supplements and matched on age, gender, number of previous anti-VEGF injections and time elapsed since last treatment. Undiluted vitreous samples were collected at the time of anti-VEGF (bevacizumab 1.25 mg/0.05 ml) treatment with a portable office-based vitrectomy system (Intrector, Insight Instruments, Inc, Stuart, FL). VEGF levels were measured by enzyme-linked immunosorbent assay. We measured central foveal thickness (CFT) using spectral-domain optical coherence tomography (Cirrus, Carl Zeiss Meditec, Toronto, Canada), and collected data on number of previous anti-VEGF injections and time elapsed since last injection.

Results: : Vitreous levels of VEGF in people receiving omega-3 supplements were 6-fold lower than those in people not receiving omega-3 supplements (P=0.0308). CFT was significantly decreased by 25% in the supplemented group (P=0.0138). No complications related to the biopsy procedure were noted.

Conclusions: : To the best of our knowledge, this is the first study to demonstrate that omega-3 supplementation protocols can decrease VEGF levels in the vitreous of patients with exudative AMD undergoing anti-VEGF treatment. Larger studies are underway to evaluate their clinical benefits of anti-VEGF + omega-3 LCPUFA combined therapy.

Keywords: age-related macular degeneration • lipids • vascular endothelial growth factor