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  • Vitamin D3, Omega-3 Fatty Acids, and AMD Risk

    By Lynda Seminara
    Selected and Reviewed By: Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, December 2020

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    Christen et al. explored the effect of daily supplementation with vitamin D3 and marine omega-3 fatty acids on the risk and progression of age-related macular degeneration (AMD). They found that neither individual supple­ment nor the combination of the two influenced AMD incidence or progres­sion.

    This study, known as VITAL-AMD, was an ancillary analysis of the place­bo-controlled VITAL study. Patients (mean age, 67 years) with and without AMD at baseline were randomized to receive one of four daily treatments: 2,000 IU of vitamin D3 (cholecalcif­erol) plus placebo, 1 g of omega-3 fatty acids (fish oil) plus placebo, the combi­nation of both nutrients, or a placebo capsule of each. The primary outcome measure was composite AMD events, defined as cases of AMD that occurred during the study plus cases of progres­sion to advanced disease in those with AMD at baseline. Between-group dif­ferences were determined from hazard ratios (HRs).

    Of the 25,871 patients included in the analysis, approximately half were women, and 71% self-identified as non-Hispanic White. The median time of treatment and follow-up was 5.3 years. During this period, AMD events occurred in 324 patients: 285 were incident cases and 39 involved disease progression. Among patients who took vitamin D3 (alone or with fish oil), 163 experienced an AMD event, compared with 161 patients who received placebo D3 (HR, 1.02). Of the patients who supplemented with fish oil (alone or with vitamin D3), 157 AMD events occurred, compared with 167 events in the corresponding placebo group (HR, 0.94). The HRs and 95% confidence intervals determined for treatment versus placebo indicated no significant differences in risk. Moreover, no be­tween-group differences were observed from assessments of secondary end­points by type of AMD event (incident AMD vs. progression) or by incident cases of visually significant or advanced AMD in those without AMD at base­line. (Also see related commentary by Robert N. Frank, MD, in the same issue.)

    The original article can be found here.