High–Dose Supplementation with EPA/DHA Significantly Improves Age-Related Macular Degeneration
Georgiou,T. et al., PharmaNutrition, 2:8-11, 2014
Ophthalmos Research and Educational Institute, Nicosia, Cyprus and Inflammation Research Foundation, Marblehead, MA ,USA
Age-related macular regeneration (AMD) is a clinical condition that usually affects older adults with a loss of vision in the central portion of the visual field due to damage to the retina of the eye. The so-called ‘dry’ form of AMD involves the accumulation of debris (referred to as ‘drusen’) which can cause the retina to become detached. In view of the known anti-inflammatory potential of long-chain omega-3 fatty acids (EPA and DHA) and indications that local inflammatory processes play a role in the development of AMD, it was of interest to test the potential benefits of EPA/DHA supplementation in patients with AMD.
For this purpose, 25 elderly patients (average age of 67 years) with dry AMD were given a liquid formulation daily providing 5000 mgs of long-chain omega-3 (3400 mgs EPA plus 1600 mgs DHA) for 6 months with follow-up every 6 weeks throughout. All patients showed a significant improvement in average vision based on visual acuity as determined by the improvement of lines of vision that could be read by a patient using an electronic Early Treatment Diabetic Retinopathy Study (ETDRS) chart. By 6 months, the average increase in vision was 2 lines of vision or 10 letters. One-third of the subjects each showed an improvement of either 1, 2, or 3 lines of vision with all patients gaining a minimum of at least 1 line of vision by 4.5 months. This pilot study suggested that high-dose EPA/DHA omega-3 supplementation may be effective in treating age-related macular degeneration (a leading cause of blindness over the age of 50).
The present clinical trial is of considerable interest for various reasons. Firstly, results from the well-known and recently-reported AREDS-2 study (J. Am. Medical Assoc., 309: 2005-2015, 2013) found no significant benefit of daily supplementation with 1000 mg EPA/DHA daily over a median duration of 5 years in reducing the risk of aging subjects from developing advanced AMD. The present trial with a daily dose of EPA/DHA being 5-fold that used in AREDS-2 raises the important possibility that high-dose omega-3 supplementation may prove to be effective in the complementary treatment of dry AMD. It is noteworthy that very few human trials have been conducted to date using daily intakes of EPA/DHA of 5000 mgs or higher. The present publication and a few others recently indicates that much more research is needed wherein higher doses of EPA/DHA are clinically tested in controlled clinical trials in subjects with various clinical disorders.
Secondly, it is noted that the European Food Safety Authority (EFSA) considers a daily dose of up to 5000 mgs (5 grams) of EPA plus DHA to be generally safe as does Health Canada. This was the daily dose used in the present study by Georgiou et al. herein. The present authors acknowledged that one of the limitations in the present study design was the omission of a control group of matched AMD patients given a ‘placebo’ supplement lacking EPA/DHA. Thus, future placebo-controlled randomized clinical trials using high-dose EPA/DHA supplementation in patients with dry AMD will be of considerable interest.