Omega-3 could supplement anti-VEGF treatment in AMD

By Eleanor McDermid, Senior medwireNews Reporter

Pilot study findings suggest that taking omega-3 fatty acid supplements could increase the efficacy or reduce the needed frequency of anti-vascular endothelial growth factor (VEGF) treatment in patients with exudative age-related macular degeneration (AMD).

Researcher Flavio Rezende (University of Montreal, Quebec, Canada) and co-workers say that 5–10% of patients with wet AMD lose three lines or more of visual acuity, despite treatment, and that more frequent anti-VEGF injections are associated with side effects.

They investigated omega-3 supplementation as an adjunctive treatment in 30 patients with wet AMD and 10 with epiretinal membrane or macular hole, as an additional control group.

Twenty of the patients with wet AMD were receiving intravitreal anti-VEGF treatment; 10 of these patients were also given daily omega-3 fatty acids (docosahexaenoic acid and eicosapentaenoic acid), along with antioxidants, zinc and carotenoids, while the other 10 just received the antioxidants, zinc and carotenoids.

At follow-up, patients receiving anti-VEGF treatment without omega-3 had a wide range of vitreous VEGF-A levels, with an average of 626.09 pg/mL, similar to what was seen in the 10 treatment-naïve patients (average 735.48 pg/mL).

By contrast, patients taking omega-3 supplements had a much narrower range of VEGF-A levels, with an average of 141.11 pg/mL. This was similar to the average level of 235.81 pg/mL found in the control group of patients with epiretinal membrane or macular hole.

Among the patients receiving anti-VEGF treatment, seven of nine patients finally analysed from the omega-3 group had lower VEGF-A levels than all but one of the six patients analysed who were not taking these fatty acids.

Central foveal thickness was similar between the groups, and there were also no differences in plasma levels of VEGF-A.

“Therefore, our data suggest that omega-3 supplementation selectively lowers pathologic ocular VEGF-A in the retina, but not physiologic systemic VEGF-A”, write the researchers in the American Journal of Ophthalmology.

“Long-term studies will be required to determine if the observed reduction in VEGF-A by omega-3- supplementation combined with anti-VEGF translates into lesser [choroidal neovascularisation] progression or activity.”

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