Role of nutrition and genetics in age-related macular degeneration (AMD)
- Name : Jean-François Korobelnik
AMD is the major cause of blindness in industrialized countries. Since a few years, important progress has been made in the understanding and treatment of this disease. It is increasingly evident that this disease results of a genetic susceptibility, combined with environmental factors. Among those, smoking and nutrition represent major modifiable factors. In particular, an American randomized trial has shown that supplementation with antioxidants and zinc is useful in the secondary prevention of AMD.
We carry out, since 2006, the Alienor (Antioxydants, Lipides Essentiels, Nutrition et maladies OculaiRes) study, an epidemiological study bearing on almost 1000 elderly subjects living in Bordeaux. Our objective is to study the role of nutritional factors (antioxidants, lutein and zeaxanthin, omega 3 fatty acids) in AMD, taking into account the genetic susceptibility of subjects (using several polymorphisms) (1). The baseline examination took place in 2006-2008. A first follow-up examination has been performed in 2010-2011, thanks to the financial support from the Fondation Voir et Entendre, and a second follow-up is currently ongoing, 4 years after baseline.
Maculopathy linked to age
Our study has, until now, allowed the confirmation of a strong association of AMD with smoking and the gene of Complement Factor H (2). We have also evidenced a decreased risk for AMD in people having high dietary intake of long-chain omega 3 fatty acids (EPA, DHA) (3). These data consolidate results from about fifteen studies, worldwide, which all suggest that long-chain omega 3 fatty acids, which are mainly provided by fish, may have a protective role for AMD.
Other works are ongoing, with regard to several genetic polymorphisms (ARMS2, factors C3 and C2/B of the complement, LIPC…), together with the role of other modifiable factors (blood pressure, plasma lipids, antioxidants, lutein and zeaxanthin, sunlight exposure…). The Alienor Study is currently the only ongoing epidemiological cohort on AMD in France. It will allow major progress in the identification of high-risk individuals, who may benefit from increased ophthalmological follow-up and preventative measures (smoking cessation, nutritional advice, food supplements…).
1. Delcourt C, Korobelnik JF, Barberger-Gateau P, et al. Nutrition and Age-Related Eye Diseases: The ALIENOR (Antioxydants, Lipides Essentiels, Nutrition et Maladies Oculaires) Study. J Nutr Health Aging. 2010; 14: 854-861.
2. Delcourt C, Delyfer MN, Rougier MB, et al. Associations of Complement Factor H and Smoking with Early Age-Related Macular Degeneration: The ALIENOR Study. Invest Ophthalmol Vis Sci. 2011; 52: 5955-5962.
3. Merle B, Delyfer MN, Korobelnik JF, et al. Dietary omega-3 Fatty acids and the risk for age-related maculopathy: the alienor study. Invest Ophthalmol Vis Sci. 2011; 52: 6004-6011.
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