Abstract
Abstract: :
Purpose: Docosahexaenoic acid (22: n-3; DHA), the major polyunsaturated fatty acid within rod outer segments, plays a crucial role in the lipid balance of the retina. Our purpose was to evaluate the feasibility of a prospective case-control study of oral supplementation with fish oil in an AMD population. Patients and Methods: 38 patients (age = 72.74 ± 6.25 yrs, 28F/10M) affected with drusenoid pigment epithelial detachment in one eye (PED) without choroidal new vessels (CNV) were selected in order to evaluate an homogenous subgroup of AMD. A complete profile of fatty acids in serum (S) and in red blood cell membranes (RBCM) performed by gas chromatography, best corrected visual acuity, fundus examination, digital fluorescein angiography, OCT and ICG were recorded at day 0 and month 6. In group 1, 22 patients were orally supplemented with fish oil (EPA: 720 mg/day and DHA, 480 mg/day) during 6 months. In group 2, 16 patients were followed as controls. Compliance to oral treatment was evaluated by the analysis of EPA and DHA concentrations (S and RBCM). Results: At day 0, EPA and DHA concentrations in % were similar and normal for age in group 1 and group 2 (EPA-S: 0.79 vs 0.83, EPA-RBCM: 0.85 vs 0.75; DHA-S: 1.56 vs 1.52 and DHA-RBCM: 4.67 vs 4.61 respectively). In group 1, after 6 months omega-3 fatty acid 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. During this short period of time, no progression was observed neither in the size of the drusenoid PED nor in the areas of atrophy. No evolution to CNV was noted in any of the two groups. Neither side effects nor dropouts were observed in either of both groups. Discussion: This first study, called NAT1, gives strong support for 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.
Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: tre • lipids