EPA & DHA Linked to Lower AMD Risk in AREDS 2 Baseline Data

AREDS 2 Basics

AREDS 2 is a nationwide study to determine whether high dose carotenoids (lutein and zeaxanthin) and omega-3 fatty acids (DHA and EPA) can slow vision loss in people at moderate to high risk for the progression of AMD. The study began in the fall of 2006, and is expected to be completed in 2013.

The 3 interventions arms for the carotenoids and omega-3s are: 1) 10 mg of lutein and 2 mg of zeaxanthin plus placebo; 2) 350 mg of DHA and 650 mg of EPA plus placebo; and 3) a combination of the DHA/EPA and lutein/ zeazanthin. In addition, all participants are offered the original AREDS formula (now considered standard of care) or 3 variations of this formula: (1) no beta-carotene; (2) lower amounts of zinc; and (3) no beta-carotene and lower zinc.

At the Association for Research in Vision and Ophthalmology's meeting in May, researchers presented the baseline demographic and dietary characteristics of AREDS 2 participants, and their associations with AMD (1). They report that people consuming the most DHA or EPA had the lowest rating of AMD severity.

Study Design

Baseline fundus photographs were centrally graded with a standardized protocol using drusen size and pigment characteristics to assign the AREDS 5 level simple scale score of severity. Participants completed a dietary assessment at baseline, and nutrient density values were classified into quintiles. Data were adjusted for age, gender and

Results

Demographic characteristics are shown in Table 1. Dietary DHA and EPA were inversely related to AMD severity score in energy-adjusted comparisons of highest versus lowest quintile intake (p<0.05 for both nutrients, see Table 2). Trend tests on quintile median nutrient values yielded a p-value of <0.01 for both EPA and DHA. The association of lutein and zeaxanthin intake with severity score was in the direction of benefit, but did not achieve statistical significance.

Comments

At baseline, AREDS 2 participants had good visual function in their study eye(s). The majority had large drusen and/or pigmentary changes in the retinal pigment epithelium, risk factors for progression to advanced AMD. The authors conclude that those with the highest intake of DHA or EPA were significantly less likely than their peers to have higher AMD severity scores.

References

1. Chang JR, et al. Demographic and dietary characteristics of the Age-Related Eye Disease Study 2 (AREDS2) participants and their associations with age-related macular degeneration (AMD). ARVO May 2-6, 2010, Ft. Lauderdale, FL, e-Abs 97.