Abstract
BackgroundOffspring of parent(s) with age-related macular degeneration (AMD) have a 45% lifetime risk of developing the disease. High foveal macular pigment optical density (MPOD) is protective, whereas individuals with a “foveal macular pigment dip” (FMPD) are at increased risk. Shortage of the dietary carotenoids lutein, zeaxanthin as well as fish consumption are reported AMD risk factors. This Early Biomarkers of AMD (EBAMD) study evaluates serum factors that protect foveal MPOD architecture in Caucasian offspring of parent(s) with AMD.MethodsN = 130 subjects [mean (SD) age 62.8 (8.6) years; 36/94 male/female] were recruited from Scripps Health/ Scripps Memorial Hospital/ Scripps Mericos Eye Institute between 2012 and 2017. Macula pigment 3D topography was evaluated using specular reflectance. Buccal genetic cheek swab, circulating serum dietary carotenoids and long-term RBC omega-3 fatty acid status, as well as common secondary clinical structural and vision function parameters were obtained.Results41 % of offspring of AMD parent(s) presented with FMPD. These offspring were about 4 years younger than those without FMPD (controls; P = 0.012) and had thinner foveas (P = 0.010). There were no differences in gender, BMI, % body fat, visual acuity or contrast sensitivity between those with and without FMPD. % RBC membrane docosahexaenoic acid (DHA) was reduced in FMPD offspring vs. control offspring (P = 0.04). The Omega-3 Index was significantly decreased in the FMPD group (P = 0.03).ConclusionsThe percentage of FMPD in AMD offspring is nearly twice that reported for the general population in the scientific literature. Offspring presenting FMPD had similar AMD genetic risk, but significantly reduced % RBC membrane omega-3 fatty acids and thinner foveas compared with those without FMPD. Our data supports the importance of ‘essential fatty’ acids as an independent AMD risk factor.
Highlights
Offspring of parent(s) with age-related macular degeneration (AMD) have a 45% lifetime risk of developing the disease
macular pigment optical density (MPOD) was not measured in the Age-related Eye Disease Study II (AREDS II), repletion of lutein and zeaxanthin in high risk AMD patients was associated with a 26% AMD risk reduction in the low dietary carotenoid intake group, suggesting a causal role within a recent review of macular pigment [15]
Inclusion criteria 1) Age > 40 years; 2) no history of cigarette smoking; 3) No visible AMD pathology defined by AREDS [34] or confounding ocular/ systemic disease; 4) Mother and/or father with AMD diagnosed by an ophthalmologist
Summary
Offspring of parent(s) with age-related macular degeneration (AMD) have a 45% lifetime risk of developing the disease. Shortage of the dietary carotenoids lutein, zeaxanthin as well as fish consumption are reported AMD risk factors. This Early Biomarkers of AMD (EBAMD) study evaluates serum factors that protect foveal MPOD architecture in Caucasian offspring of parent(s) with AMD. MPOD was not measured in the Age-related Eye Disease Study II (AREDS II), repletion of lutein and zeaxanthin in high risk AMD patients was associated with a 26% AMD risk reduction in the low dietary carotenoid intake group, suggesting a causal role within a recent review of macular pigment [15]. Increased prevalence of atypical central dip profiles is a further risk factor for AMD, and has been associated with age [24], smoking [24], certain ethnicities [25], and intake of dietary carotenoids [26]
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