Abstract
Purpose :
To evaluate associations between dietary nutrient intake and rate of geographic atrophy (GA) progression towards the foveal center-point (FCP).
Methods :
Color fundus photographs from annual study visits of Age-Related Eye Diseases Study (AREDS) participants with non-central GA underwent reading center grading for GA proximity to the FCP. Dietary nutrient intakes and the alternative Mediterranean diet index (aMedi) were calculated from food frequency questionnaires. Nine nutrients were analyzed (Table 1). The aMedi was calculated from the intake of nine components (Table 1). Mixed-model regressions were performed with GA proximity as outcome and nutrient intake/aMedi as exposure. Models included: age, sex, smoking, GA proximity at first GA, calories, nutrient tertile (T; T3=highest intake), year, and interaction of year and nutrient tertile. The unit of analysis was the eye.
Results :
The study population comprised 413 eyes with non-central GA (prevalent: 88, incident: 325), from 347 participants. Eyes of participants with the highest intake of these nutrients had significantly slower GA progression towards the FCP per year (µm/y), compared to those with the lowest intake (T3 vs T1; Table 1): zinc (34.8 (95% CI 29.6,40.1) vs 45.5 (95% CI 39.9,51.1), P=.006), β-carotene (29.8 (95% CI 24.2,35.3) vs 46.6 (95% CI 41.3,51.9), P<.0001), lutein/zeaxanthin (32.9 (95% CI 26.2,39.6) vs 47.5 (95% CI 42.4,52.7), P=.001), and EPA (35.5 (95% CI 29.2,41.8) vs 43.7 (95% CI 38.8, 48.6), P=.05). No significance was observed for the aMedi (Table 1). When analyzed separately, the same nutrients were associated with a slower rate in the prevalent GA cohort but not in the incident GA cohort.
Conclusions :
For non-central GA, higher dietary intake of several nutrients is strongly associated with slower GA progression towards the central macula. These include lutein/zeaxanthin, β-carotene, zinc, and omega-3 fatty acids. This suggests that these nutrients may contribute to the natural phenomenon of relative foveal sparing in GA and that this phenomenon can be augmented by higher dietary intake. By contrast, higher adherence to a Mediterranean diet is not strongly associated. Patients with non-central GA may benefit from dietary advice targeted towards these specific nutrients, above and beyond general advice on the adoption of a healthy diet.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.