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Elvira Agron, Emily Chew, Tiarnan D L Keenan, Julie A Mares, Traci E Clemons; Dietary Nutrient Intake and Progression to Late Age-Related Macular Degeneration in the Age-Related Eye Disease Study. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2994.
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Late age-related macular degeneration (AMD), a leading cause of blindness, occurs in two forms: geographic atrophy (GA) and neovascular AMD (NV). NV requires repeated intravitreal injections while no treatment is available for GA. Prospective observational analysis was used to evaluate the association between dietary nutrient intake and progression to late AMD and its two forms using the Age-Related Eye Disease Study (AREDS)
A validated food frequency questionnaire was administered at baseline. The results were processed with the DietSys software to obtain estimates of daily nutrient intake for each participant. Association between 38 nutrients and progression to late AMD, GA, and NV was analyzed using proportional hazards regression, adjusting for age, sex, smoking, body mass index, total calories and correlation between eyes. For each nutrient, hazard ratios (HR) were calculated to compare the risk of progression in participants with the highest and the lowest quintiles of intake. The unit of analysis was the eye.
A total of 8235 eyes of 4503 participants were analyzed. The figure shows the HR for those nutrients whose intake quintiles 4 or 5 were significantly associated with altered risk of late AMD, GA or NV at the Bonferroni-adjusted level (.0004). In nine nutrients, higher intake was significantly associated with decreased risk of late AMD: vitamin A, lutein and zeaxanthin, vitamin B1, folate, vitamin C, magnesium, EPA, DHA and galactose. By contrast, higher intake of monounsaturated fatty acid and oleic acid were each associated with increased risk. Regarding GA, for six nutrients, higher intake was associated with significantly decreased risk: beta-carotene, lutein and zeaxanthin, niacin, folate, iron and galactose. For NV, higher intake of DHA was associated with decreased risk.
These findings suggest that dietary intake is closely linked to decreased risk of late AMD for multiple nutrients. This includes distinct nutrient classes: vitamins, omega-3 fatty acids, carotenoids, and mineral ions. Particularly, these associations related almost exclusively to GA rather than NV. This is important, since no therapeutic strategies are available to prevent or treat GA. These findings have significant public health implications and provide vital insights into the biological mechanisms underlying AMD.
This is a 2020 ARVO Annual Meeting abstract.
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