Plasma Omega-3 Fatty Acid Linked With Reduced AMD Risk

392902 03: A magnified image of an eye with age-related macular degeneration August 6, 2001 in Wheaton, IL. Through the Optobionics Corp., doctors recently implanted three microscopic artificial silicon retina chips in the eyeballs of men suffering from retinal damage. The operation is the second phase of a study to determine whether the chips can restore human vision for patients with retinitis pigmentosa. (Photo Courtesy of Optobionics/Getty Images)
Patients with higher levels of polyunsaturated fatty acids may have greater protection against macular degeneration, a report shows.

Increasing levels of the omega-3 polyunsaturated fatty acids (PUFA) appear to be associated with reduced risk of early age-related macular degeneration (AMD), according to research published in Retina.

To examine the association between omega-3 PUFAs (docosahexaenoic acid [DHA] and eicosapentaenoic acid [EPA]) and AMD, the researchers used data from the multi-center, prospective Multi-ethnic Study of Atherosclerosis (MESA).

The MESA cohort included 6814 participants of 4 ancestry groups, White, Black, Hispanic/Latino, and Chinese descent. The researchers excluded those with cardiovascular disease and included all participants with baseline omega-3 PUFA measurements and retinal photography at exam 5. They assessed fundus photographs for AMD using a standard grading protocol and evaluated associations between omega-3 PUFA levels and AMD using relative risk regression (log-link) models.

A total of 3772 participants were included in the study (40% White, 25% Black, 22% Hispanic/Latino, and 12% Chinese descent). Among them, 3558 (94%) patients had no AMD, while 215 (5.7%) patients had early AMD. Patients with no AMD were younger than those with AMD (mean, 58.7±9.0 vs 65.8±9.8; P <.001).

Using 2 regression models, the researchers found significant associations between increasing DHA levels and reduced risk for early AMD and between increasing DHA+EPA levels and reduced risk for early AMD (model 1: DHA, P =.03; DHA + EPA, P =.034) model 2: DHA, P =.014; DHA+EPA, P =.014). They found that EPA levels alone were not significantly associated with AMD.

In both models, patients among the 2 highest quartiles for DHA levels had a statistically significant 40 to 50% risk reduction for early AMD compared with the patients comprising the lowest quartile. The team found similar risk reduction for patients among the 2 highest quartiles for DHA+EPA levels compared with those in the lowest quartile.

“Our results suggest a significant association between DHA and DHA+EPA levels and reduced risk for early AMD in a multi-ethnic cohort,” researchers explain. “This represents the first racially diverse study demonstrating an association between omega-3 PUFAs and AMD risk.”

The team suggested that additional studies are warranted to determine whether high doses of omega-3 PUFA supplementation can decrease risk for AMD and to evaluate the relationship between omega-3 PUFAs and late AMD risk.

Limitations of the study included both prevalent and incident cases in the AMD diagnosis data, measurement of plasma fatty acid levels at a single time point in 2000 to 2002 and assessment of AMD via fundus photography 10 years later (2010–2012), and an insufficient number of late AMD cases for analysis.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.  


Karger AB, Guan W, Nomura SO, et al. Association of plasma ω-3 fatty acids with early age-related macular degeneration in the Multi-Ethnic Study of Atherosclerosis (MESA) Retina. Published online March 9, 2022.  doi:10.1097/IAE.0000000000003465