title: {omega}-3 Long-chain polyunsaturated fatty acid intake and 12-y incidence of neovascular age-related macular degeneration and central geographic atrophy: AREDS report 30, a prospective cohort study from the Age-Related Eye Disease Study.
abstract: BACKGROUND
  omega-3 (n-3) Long-chain polyunsaturated fatty acids (LCPUFAs) affect processes implicated in vascular and neural retinal pathogenesis and thus may influence the risk of developing age-related macular degeneration (AMD).
  
  
  OBJECTIVE
  We investigated whether omega-3 LCPUFA intake was associated with a reduced likelihood of developing central geographic atrophy (CGA) and neovascular (NV) AMD.
  
  
  METHODS
  We undertook a nested cohort study within a multicenter phase 3 clinical trial, the Age-Related Eye Disease Study (AREDS), to study progression to advanced AMD in 1837 persons at moderate-to-high risk of this condition. The AREDS was designed to assess the clinical course, prognosis, risk factors, and nutrient-based treatments of AMD and ran from November 1992 to December 2005. We obtained baseline data on omega-3 LCPUFA intake with a validated food-frequency questionnaire. Trained fundus graders ascertained AMD status from annual stereoscopic color photographs by using standardized methods at a single reading center across a 12-y period. We applied multivariable repeated-measures logistic regression with the incorporation of generalized estimating equation methods, because this permitted determination of progression to outcome at each visit.
  
  
  RESULTS
  Participants who reported the highest omega-3 LCPUFA intake (median: 0.11% of total energy intake) were 30% less likely than their peers to develop CGA and NV AMD. The respective odds ratios were 0.65 (95% CI: 0.45, 0.92; P <or= 0.02) and 0.68 (95% CI: 0.49, 0.94; P <or= 0.02).
  
  
  CONCLUSIONS
  The 12-y incidence of CGA and NV AMD in participants at moderate-to-high risk of these outcomes was lowest for those reporting the highest consumption of omega-3 LCPUFAs. If these results are generalizable, they may guide the development of low-cost and easily implemented preventive interventions for progression to advanced AMD. This trial was registered at clinicaltrials.gov as NCT00594672.
authors.affiliation: National Eye Institute, National Institutes of Health, Bethesda, MD 20892-1204, USA. jpsangio@post.harvard.edu
authors.forename: John Paul
authors.initials: JP
authors.lastname: Sangiovanni
authors.forename: Elvira
authors.initials: E
authors.lastname: Agrón
authors.forename: A Dhananjayan
authors.initials: AD
authors.lastname: Meleth
authors.forename: George F
authors.initials: GF
authors.lastname: Reed
authors.forename: Robert D
authors.initials: RD
authors.lastname: Sperduto
authors.forename: Traci E
authors.initials: TE
authors.lastname: Clemons
authors.forename: Emily Y
authors.initials: EY
authors.lastname: Chew
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D057092:Geographic Atrophy / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008268:Macular Degeneration / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D015525:Fatty Acids, Omega-3