title: Risk factors for exudative age-related macular degeneration in a large French case-control study.
abstract: OBJECTIVE
  The purpose of the CAP (Creteil AMD PHRC-funded) Study was to analyze risk factors of exudative age-related macular degeneration (AMD) in a large French case-control population.
  
  
  METHODS
  One thousand and twenty-four patients with exudative AMD and 275 controls were recruited. Information about lifestyle, medical history, and dietary intake were collected. Associations of risk factors were estimated using logistic regression.
  
  
  RESULTS
  After multivariate adjustment, CFH Y402H and ARMS2 A69S polymorphisms were associated with very high risk for exudative AMD (OR = 6.21 and OR = 11.7, respectively, p < 0.0001). Risk for exudative AMD was increased in current smokers (OR = 3.79, p = 0.0003) and former smokers having quitted since less than 20 years ago (OR = 2.30, p = 0.002), but not in former smokers having quitted since 20 years or more ago (OR = 0.81, p = 0.43). Heavy smokers (at least 25 pack-years) were particularly at risk (OR = 3.61, p < 0.0001). Use of cooking oils rich in omega 3 fatty acids was significantly associated with a reduced risk of exudative AMD (OR = 0.55, 95 % CI: 0.36-0.84, p = 0.006), as well as a high consumption of fruits (OR = 0.60, 95 % CI: 0.37-0.98, p = 0.04), but not the consumption of fish, vegetables or oils rich in omega 6. High waist circumference was associated with increased risk for exudative AMD (OR = 2.53, p < 0.0001), but not hypercholesterolemia, hypertension, or body mass index.
  
  
  CONCLUSIONS
  The CAP Study confirms major genetic risk factors for exudative AMD. It further documents the high risk in heavy smokers and the long persistence of risk after smoking cessation, and the associations with waist circumference and fruit consumption. Furthermore, we observed an inverse correlation between AMD and cooking oils harboring a beneficial omega-3 fatty acid profile.
authors.affiliation: Department of Ophthalmology, Hopital Intercommunal de Creteil, University Paris Est Creteil, Creteil, France.
authors.forename: Jennyfer
authors.initials: J
authors.lastname: Zerbib
authors.forename: Cécile
authors.initials: C
authors.lastname: Delcourt
authors.forename: Nathalie
authors.initials: N
authors.lastname: Puche
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Querques
authors.forename: Salomon Yves
authors.initials: SY
authors.lastname: Cohen
authors.forename: José
authors.initials: J
authors.lastname: Sahel
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Korobelnik
authors.forename: Mélanie
authors.initials: M
authors.lastname: Le Goff
authors.forename: Eric H
authors.initials: EH
authors.lastname: Souied
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D004396:Coloring Agents; D017242:Complement Factor H / Q000235:genetics; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D005260:Female; D005451:Fluorescein Angiography; D005602:France / Q000453:epidemiology; D005638:Fruit; D060005:Genotyping Techniques; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D016133:Polymerase Chain Reaction; D020641:Polymorphism, Single Nucleotide; D011506:Proteins / Q000235:genetics; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D041623:Tomography, Optical Coherence; D057135:Wet Macular Degeneration / Q000453:epidemiology* / Q000235:genetics / Q000517:prevention & control
chemical_list: C514392:ARMS2 protein, human; C493495:CFH protein, human; D004396:Coloring Agents; D015525:Fatty Acids, Omega-3; D011506:Proteins; D017242:Complement Factor H; D007208:Indocyanine Green