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.

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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