title: Dynamic Drusen Remodelling in Participants of the Nutritional AMD Treatment-2 (NAT-2) Randomized Trial.
abstract: OBJECTIVE
  To evaluate the dynamic remodeling of drusen in subjects with unilateral neovascular age-related macular degeneration (AMD) receiving a three-year course of oral docosahexaenoic acid (DHA) or placebo.
  
  
  METHODS
  Institutional setting.
  
  
  METHODS
  Three hundred subjects with age-related maculopathy and neovascular AMD in the fellow eye were randomly assigned to receive either 840 mg/day DHA or placebo for 3 years. Main outcome measures of this post-hoc sub-group analysis were progression of drusen number, total diameter, and total area on fundus photography, and their association with DHA supplementation, socio-demographic and genetic characteristics.
  
  
  RESULTS
  Drusen progression was analyzed in 167 subjects that did not develop CNV (87 that received DHA and 80 that received placebo). None of the drusen remodeling outcomes were significantly associated with DHA supplementation. Total drusen diameter reduction in the inner subfield was significantly associated with age (older patients: r = -0.17; p = 0.003). Women showed a tendency to decreased total drusen diameter in the inner subfield with CFH polymorphism (p = 0.03), where women with TT genotype tended to have a greater reduction in drusen diameter than other genotypes (CC and CT). Drusen area in the inner subfield was more reduced in older patients (r = -0.17) and in women (p = 0.01). Drusen number showed no significant trends.
  
  
  CONCLUSIONS
  Dynamic drusen remodeling with net reduction in drusen load over three years was found in patients with exudative AMD in one eye and drusen in the other eye (study-eye). This reduction was correlated with increased age and female gender, and showed a tendency to be influenced by CFH genotype, but did not appear to be affected by DHA supplementation.
  
  
  BACKGROUND
  Controlled-Trials.com ISRCTN98246501.
authors.affiliation: Department of Ophthalmology - Hôpital intercommunal de Créteil - Université Paris Est Créteil, Créteil, France.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Querques
authors.affiliation: Department of Ophthalmology - Hôpital intercommunal de Créteil - Université Paris Est Créteil, Créteil, France.
authors.forename: Bénédicte M J
authors.initials: BM
authors.lastname: Merle
authors.affiliation: Department of Ophthalmology, New York University, New York, New York, United States of America.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Pumariega
authors.affiliation: APHP - Hôpital Saint Antoine - biochemistry and molecular biology department - F-75012 Paris; Université Lille 2, INSERM UMRS 1011, Lille, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Benlian
authors.affiliation: INSERM, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France.|Univ. Bordeaux, ISPED, Bordeaux, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Delcourt
authors.affiliation: Department of Ophthalmology - Hôpital intercommunal de Créteil - Université Paris Est Créteil, Créteil, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Zourdani
authors.affiliation: Department of Ophthalmology, New York University, New York, New York, United States of America.
authors.forename: Heather B
authors.initials: HB
authors.lastname: Leisy
authors.affiliation: Department of Ophthalmology, New York University, New York, New York, United States of America.
authors.forename: Michele D
authors.initials: MD
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, New York University, New York, New York, United States of America.
authors.forename: R Theodore
authors.initials: RT
authors.lastname: Smith
authors.affiliation: Department of Ophthalmology - Hôpital intercommunal de Créteil - Université Paris Est Créteil, Créteil, France.
authors.forename: Eric H
authors.initials: EH
authors.lastname: Souied
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D004281:Docosahexaenoic Acids / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015594:Optic Disk Drusen / Q000473:pathology / Q000503:physiopathology*; D011446:Prospective Studies
chemical_list: D004281:Docosahexaenoic Acids