Dietary fatty acids and lipoproteins on progression of age-related macular degeneration




Age-related macular degeneration, Dietary fats, Fatty acids, Lipoproteins, Olive oil, Retina


Age-related macular degeneration (AMD) is a medical condition of central loss vision and blindness. Numerous studies have revealed that changes on certain dietary fatty acids (FAs) could have useful for AMD management. This review summarizes the effects of dietary omega-3 long-chain PUFAs, MUFAs, and SFAs, and lipoproteins on AMD. Findings are consistent with the beneficial role of dietary omega-3 long-chain PUFAs, while the effects of dietary MUFAs and SFAs appeared to be ambiguous with respect to the possible protection from MUFAs and to the possible adverse impact from SFAs on AMD. Some of the pathological mechanisms associated with lipoproteins on AMD share those observed previously in cardiovascular diseases. It was also noticed that the effects of FAs in the diet and lipoprotein on AMD could be modulated by genetic variants. From a population health perspective, the findings of this review are in favour of omega-3 long-chain FAs recommendations in a preventive and therapeutic regimen to attain lower AMD occurrence and progression rates. Additional long-term and short-term nutrigenomic studies are required to clearly establish the role and the relevance of interaction of dietary FAs, lipoproteins, and genes in the genesis and progression of AMD.


Download data is not yet available.


Acar N, Berdeaux O, Gregoire S, Cabaret S, Martine L, Gain P, Thuret G, Creuzot-Garcher CP, Bron AM, Bretillon L. 2012. Lipid composition of the human eye: Are red blood cells a good mirror of retinal and optic nerve fatty acids? PLoS One 7, e35102. PMid:22496896 PMCid:PMC3322172

Age-Related Eye Disease Study 2 Research G, Chew EY, Clemons TE, Sangiovanni JP, Danis RP, Ferris FL3rd, et al. 2013. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. JAMA 309, 2005–2015. PMid:23644932

Ananth S, Gnana-Prakasam JP, Bhutia YD, Veeranan- Karmegam R, Martin PM, Smith SB, Ganapathy V. 2014. Regulation of the cholesterol efflux transporters ABCA1 and ABAG1 in retina in hemochromatosis and by the endogenous siderophore 2,5-dihydroxybenzoic acid. Biochem. Biophys. Acta 1842, 603–612.

Baltmr A, Lightman S, Tomkins-Netzer O. 2014. Examining the choroid in ocular inflammation: a focus on enhanced depth imaging. J. Ophthalmol. 2014, 459136. PMid:25024846 PMCid:PMC4082870

Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. 2012. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst. Rev. 3, CD007176.

Bretillon L, Simon E, Acar N, Bron A, Creuzot-Garcher C. 2012. The LDL receptor in the retina: the missing link in aging, the new target in dietary prevention. Acta Ophthalmologica 90, s249.

Celkova L, Doyle SL, Campbell M. 2015. NLRP3 inflammasome and pathobiology in AMD. J. Clin. Med., 4, 172–192. PMid:26237026 PMCid:PMC4470247

Chiras D, Kitsos G, Petersen MB, Skalidakis I, Kroupis C. 2015. Oxidative stress in dry age-related macular degeneration and exfoliation syndrome. Crit. Rev. Clin. Lab. Sci. 52, 12–27. PMid:25319011

Chiu CJ, Chang ML, Zhang FF, Li T, Gensler G, Schleicher M, Taylor A. 2014. The relationship of major American dietary patterns to age-related macular degeneration. Am. J. Ophthalmol. 158, 118–127. PMid:24792100 PMCid:PMC4101985

Cho E, Hung S, Willet WC, Spiegelman D, Rimm EB, Seddon JM, 2001. Prospective study of dietary fat and the risk of age-related macular degeneration. Am. J. Clin. Nutr. 73, 209–218. PMid:11157315

Chong EW, Kreis AJ, Wong TY. 2008. Dietary omega-3 fatty acid and fish intake in the primary prevention of age-related macular degeneration: a systematic review and meta-analysis. Arch. Ophthalmol. 126, 826–833. PMid:18541848

Chong EW, Robman LD, Simpson JA, Hodge AM, Aung KZ, Dolphin TK, English DR, Giles GG, Guymer RH. 2009. Fat consumption and its association with age-related macular degeneration. Arch. Ophthalmol. 127, 674–680. PMid:19433719

Christen WG, Schaumberg DA, Glynn RJ, Buring JE. 2011. Dietary omega-3 fatty acid and fish intake and incident age-related macular degeneration in women. Arch. Ophthalmol. 129, 921– 929. PMid:21402976 PMCid:PMC3134638

Clemons TE, Milton RC, Klein R, Seddon JM, Ferris FL. 2005. III Risk factors for the incidence of advanced age-related macular degeneration in the age-related eye disease study (AREDS) AREDS report no. 19. Ophthalmol. 112, 533– 539. PMid:15808240 PMCid:PMC1513667

Curcio CA, Johnson M, Huang JD, Rudolf M. 2009. Apolipoprotein B-conteining lipoproteins in retinal aging and age-related macular degeneration. J. Lipid Res. 28, 393–422.

Dasari B, Prasanthi JR, Marwarha G, Singh BB, Ghribi O. 2011. Cholesterol-enriched diet causes age-related macular degeneration-like pathology in rabbit retina. BMC Ophthalmol. 11, 22. PMid:21851605 PMCid:PMC3170645

Delcourt C, Carriere I, Cristol JP, Lacroux A, Gerber M. 2007. Dietary fat and the risk of age-related maculopathy: The polanut study. Eur. J. Clin. Nutr. 61, 1341–1344. PMid:17299457

Demeestere D, Libert C, Vandenbroucke RE. 2015. Clinical implications of leukocyte at the choroid plexus in (neuro) inflammatory disorders. Drug Discov. Today 20, 928–941. PMid:25979470

DiBattista AM, Dumanis SB, Song JM, Bu G, Weeber E, Rebeck GW, Hoe HS. 2015. Very low density lipoprotein receptor regulates dendritic spine formation in a RasGRF1/ CaMKII dependent manner. Biochem. Biophys. Acta 1853, 904–917. PMid:25644714 PMCid:PMC4580245

Ersoy L, Ristau T, Hahn M, Karlstetter M, Langmann T, Droge K, Caramoy A, den Hollander AI, Fauser, S. 2014. Genetic and environmental risk factors for age-related macular degeneration in persons 90 years and older. Invest. Ophthalmol. Vis. Sci. 55, 1842–1847. PMid:24576882

Espinosa-Heidmann DG, Sall J, Hernandez EP, Cousins SW. 2004. Basal laminar deposit formation in APO B100 transgenic mice: complex interactions between dietary fat, blue light, and vitamin E. Invest. Ophthalmol. Vis. Sci. 45, 260–266. PMid:14691182

Evans JR, Lawrenson JG. 2014. A review of the evidence for dietary interventions in preventing or slowing the progression of age-related macular degeneration. Ophthalmic Physiol. Opt. 34, 390–396. PMid:24903538

Fritsche LG, Chen W, Schu M, Yaspan BL, Yu Y, Thorleifsson G, Zack DJ, Arakawa S, Cipriani V, Ripke S, et al. 2013. Seven new loci associated with age-related macular degeneration. Nat. Genet. 45, 433–439. PMid:23455636 PMCid:PMC3739472

Fujihara M, Bartels E, Nielsen LB, Handa JT. 2009. A human apoB100 transgenic mouse express human apoB100 in the RPE and develops features of early AMD. Exp. Eye Res. 88, 1115–1123. PMid:19450445 PMCid:PMC2729121

Gorusupudi A, Liu A, Hageman GS, Bernstein PS. 2016. Associations of human retinal very long-chain polyunsaturated fatty acids with dietary lipid biomarkers. J. Lipid Res. 57, 499–508. PMid:26764040 PMCid:PMC4766999

Haab O. 1888. Ueber die Erkrankung der Macula Lutea. In Bergmann JF (ed). Siebienter Periodischer internationaler Ophthalmologen-Congress. Heidelberg, Denmark, 1888, pp 429–437.

Jager RD, Mieler WF, Miller JW. 2008. Age-related macular degeneration. N. Engl. J. Med. 358, 2606–2617. PMid:18550876

Johnson LV, Leitner WP, Rivest AJ, Staples MK, Radeke MJ, Anderson DH. 2002. The alzheimer's a beta-peptide is deposited at sites of complement activation in pathologic deposits associated with aging and age-related macular degeneration. Proc. Natl. Acad. Sci. USA 99, 11830–11835. PMid:12189211 PMCid:PMC129354

Kishan AU, Modjtahedi BS, Martins EN, Modjtahedi SP, Morse LS. 2011. Lipids and age-related macular degeneration. Surv. Ophthalmol. 56, 195–213. PMid:21439604

Klein R, Cruickshanks KJ, Myers CE, Sivakumaran TA, Iyengar SK, Meuer SM, Schubert CR, Gangnon RE, Klein BE. 2013. The relationship of atherosclerosis to the 10-year cumulative incidence of age-related macular degeneration: the Beaver Dam studies. Ophthalmology 120, 1012–1019. PMid:23399375 PMCid:PMC3646961

Klein R, Klein BE, Knudtson MD, Cotch MF, Wong TY, Liu K, Burke GL, Saad MF, Jacobs, DR Jr, Sharrett AR. 2007. Subclinical atherosclerotic cardiovascular disease and early age-related macular degeneration in a multiracial cohort: the Multiethnic Study of Atherosclerosis. Arch. Ophthalmol. 125, 534–543. PMid:17420374

Kliffen M, Lutgens E, Daemen MJ, Muinck ED, Jong PTVM. 2000. The APO(*)E3-Leiden mouse as an animal model for basal laminar deposit. Br. J. Ophthalmol. 84, 1415– 1419. PMid:11090485 PMCid:PMC1723360

Lee Y, Hussain AA, Seok JH, Kim SH, Marshall, J. 2015. Modulating the transport characteristics of bruch's membrane with steroidal glycosides and its relevance to age-related macular degeneration (AMD). Invest. Ophthalmol. Vis. Sci. 56, 8403–8418. PMid:26747771

Lim LS, Mitchell P, Seddon JM, Holz FG, Wong TY. 2012. Age-related macular degeneration. Lancet 379, 1728–1738.

López S, Bermúdez B, Montserrat-de la Paz S, Jaramillo S, Varela LM, Ortega-Gomez A, Abia R, Muriana FJG. 2014. Membrane composition and dynamics: A target of bioactive virgin olive oil constituents. BBA – Biomembranes 1838, 1638–1656.

Mares-Perlman JA, Brady WE, Klein R, VandenLangenberg GM, Klein BE, Palta M. 1995. Dietary fat and age-related maculopathy. Arch. Ophthalmol. 113, 743–748. PMid:7786215

Merle BM, Benlian P, Puche N, Bassols A, Delcourt C, Souied EH, Nutritional AMD Treatment 2 Study Group. 2014. Circulating omega-3 fatty acids and neovascular age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 55, 2010–2019. PMid:24557349

Merle BM, Richard F, Benlian P, Puche N, Delcourt C, Souied EH. 2015. CFH Y402H and ARMS2 A69S polymorphisms and oral supplementation with docosahexaenoic acid in neovascular age-related macular degeneration patients: The NAT2 Study. PloS One 10, e0130816. PMid:26132079 PMCid:PMC4489493

Millen AE, Meyers KJ, Liu Z, Engelman CD, Wallace RB, LeBlanc ES, Tinker LF, Iyengar SK, Robinson JG, Sarto GE, et al. 2015. Association between vitamin D status and age-related macular degeneration by genetic risk. JAMA Ophthalmol. 133, 1171–1179. PMid:26312598 PMCid:PMC4841267

Montserrat-de la Paz S, Naranjo MC, Bermudez B, Lopez S, Moreda W, Abia R, Muriana FJG. 2016. Postprandial dietary fatty acids exert divergent inflammatory responses in retinal-pigmented epithelium cells. Food Funct. 7, 1345– 1353. PMid:26914244

Mullins RF, Russell SR, Anderson DH, Hageman GS. 2000. Drusen associated with aging and age-related macular degeneration contain proteins common to extracellular deposits associated with atherosclerosis, elastosis, amyloidosis, and dense deposit disease. FASEB J. 14, 835–846. PMid:10783137

Neale BM, Fagerness J, Reynolds R, Sobrin L, Parker M, Raychaudhuri S, Tan PL, Oh EC, Merriam JE, Souied E, et al. 2010. Genome-wide association study of advanced age-related macular degeneration identifies a role of the hepatic lipase gene (LIPC). Proc. Natl. Acad. Sci. USA 107, 7395–7400. PMid:20385826 PMCid:PMC2867697

Nita M, Grzybowski A, Ascaso FJ, Huerva V. 2014. Age-related macular degeneration in the aspect of chronic low-grade inflammation (pathophysiological parainflammation). Med. Inflamm. 2014, 930671. PMid:25214719 PMCid:PMC4152952

Omenn GS. 2007. Chemoprevention of lung cancers: lessons from CARET, the beta-carotene and retinol efficancy trial, and prospects for the future. Eur. J. Cancer Prev. 16, 184– 191. PMid:17415088

Parekh N, Voland RP, Moeller SM, Blodi BA, Ritenbaugh C, Chappell RJ, Wallace RB, Mares JA. 2009. Association between dietary fat intake and age-related macular degeneration in the carotenoids in age-related eye disease study (CAREDS): An ancillary study of the women's health initiative. Arch. Ophthalmol. 127, 1483–1493. PMid:19901214 PMCid:PMC3144752

Pascolini D, Mariotti SP. 2012. Global estimates of visual impairment: 2010. Br. J. Ophthalmol. 96, 614–618. PMid:22133988

Promsote W, Veeranan-Karmegam R, Ananth S, Shen D, Chan CC, Lambert NA, Ganapathy V, Martin PM. 2014. L-2- oxothiazolidine-4-carboxylic acid attenuates oxidative stress and inflammation in retinal pigment epithelium. Mol. Vis. 20, 73–88. PMid:24426777 PMCid:PMC3888500

Rassoulinejad SA, Zarghami A, Hosseini SR, Rajaee N, Rasoulinejad SE, Mikaniki E. 2015. Prevalence of age-related macular degeneration among the elderly. Caspian J. Intern. Med. 6, 141–147.

Rezende FA, Lapalme E, Qian CX, Smith LE, SanGiovanni JP, Sapieha P. 2014. Omega-3 supplementation combined with anti-vascular endothelial growth factor lowers vitreal levels of vascular endothelial growth factor in wet age-related macular degeneration. Am. J. Ophthalmol. 158, 1071–1078. PMid:25089351 PMCid:PMC4389631

Robman L, Vu H, Hodge A, Tikellis G, Dimitrov P, McCarty C, Guymer R. 2007. Dietary lutein, zeaxanthin, and fats and the progression of age-related macular degeneration. Can. J. Ophthalmol. 42, 720–726. PMid:17724493

Rudolf M, Winkler B, Aherrahou Z. 2005. Increased expression of vascular endothelial growth factor associated with accumulation of lipids in Bruch's membrane of LDL receptor knockout mice. Br. J. Ophthalmol. 89, 1627–1630. PMid:16299144 PMCid:PMC1772995

Saade C, Smith RT. 2014. Reticular macular lesions: a review of the phenotypic hallmarks and their clinical significance. Clin. Experiment. Ophthalmol. 42, 865–874. PMid:24803342

SanGiovanni JP, Chew EY. 2005. The role of omega-3 long-chain polyunsaturated fatty acids in health and disease of the retina. Prog. Retina Eye Res. 24, 87–138. PMid:15555528

Seddon JM, Cote J, Rosner B. 2003. Progression of age-related macular degeneration: association with dietary fat, transunsaturated fat, nuts, and fish intake. Arch. Ophthalmol. 121, 1728–1737. PMid:14662593

Seddon JM, Rosner B, Sperduto RD, Yannuzzi L, Haller JA, Blair NP, Willett W. 2001. Dietary fat and risk for advanced age-related macular degeneration. Arch. Ophthalmol. 119, 1191–1199. PMid:11483088

Smith W, Mitchell P, Leeder SR. 2000. Dietary fat and fish intake and age-related maculopathy. Arch. Ophthalmol. 118, 401– 404. PMid:10721964

Sonoda S, Spee C, Barron E, Ryan S, Kannan R, Hinton DR. 2009. A protocol for the culture and differentiation of highly polarized human retinal pigment epithelial cells. Nat. Protoc. 4, 662–673. PMid:19373231 PMCid:PMC2688697

Souied EH, Delcourt C, Querques G, Bassols A, Merle B, Zourdani A, Smith T, Benlian P, Nutritional AMD Treatment 2 Study Group. 2013. Oral docosahexaenoic acid in the prevention of exudative age-related macular degeneration: the Nutritional AMD Treatment 2 study. Ophthalmol. 120, 1619–1631. PMid:23395546

Sui GY, Liu GC, Liu GY, Gao YY, Deng Y, Wang WY, Tong SH, Wang L. 2013. Is sunlight exposure a risk factor for age-related macular degeneration? A systematic review and meta-analysis. Br. J. Ophthalmol. 97, 389–394. PMid:23143904

Tan JS, Wang JJ, Flood V, Mitchell P. 2009. Dietary fatty acids and the 10-year incidence of age-related macular degeneration: the Blue Mountains Eye Study. Arch. Ophthamol. 127, 656–665. PMid:19433717

Verhoeff FH, Grossman HP. 1937. The pathogenesis of disciform degeneration of the macular. Trans. Am. Ophthalmol. Soc. 35, 262–294. PMid:16693123 PMCid:PMC1315611

Wang L, Clark ME, Crossman DK, Kojima K, Messinger JD, Mobley JA, Curcio CA. 2010. Abundant lipid and protein components of drusen. PLoS One 5, e10329. PMid:20428236 PMCid:PMC2859054

Wang YF, Han Y, Zhang R, Qin L, Wang MX, Ma L. 2015. CETP/LPL/LIPC gene polymorphisms and susceptibility to age-related macular degeneration. Sci Rep. 5, 15711. PMid:26503844 PMCid:PMC4621603

Wang K, Xiao J, Peng B, Xing F, So KF, Tipoe GL, Lin B. 2014. Retinal structure and function preservation by polysaccharides of wolfberry in a mouse model of retinal degeneration. Sci. Rep. 4, 7601. PMid:25535040 PMCid:PMC4274520

Weikel KA, Chiu CJ, Taylor A. 2012. Nutritional modulation of age-related macular degeneration. Mol. Aspects Med. 33, 318–375. PMid:22503690 PMCid:PMC3392439

Weikel KA, Fitzgerald P, Shang F, Caceres MA, Bian Q, Handa JT, Stitt AW, Taylor A. 2012. Natural history of age-related retinal lesions that precede AMD in mice fed high or low glycemic index diets. Invest. Ophthalmol. Vis. Sci. 53, 622– 632. PMid:22205601 PMCid:PMC3317410

Whitcup SM, Sodhi A, Atkinson JP, Holers VM, Sinha D, Rohrer B, Dick AD. 2013. The role of the immune response in age-related macular degeneration. Int. J. Inflamm. 2013, 348092. PMid:23762772 PMCid:PMC3676958

Wong WL, Su X, Li X, Cheung CM, Klein R, Cheng CY, Wong TY. 2014. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: A systematic review and meta-analysis. Lancet Glob. Health 2, e106–e116.



How to Cite

Montserrat-de la Paz S, Naranjo MC, Bermúdez B, López S, Abia R, Muriana FJ. Dietary fatty acids and lipoproteins on progression of age-related macular degeneration. grasasaceites [Internet]. 2017Jun.30 [cited 2023Sep.30];68(2):e187. Available from:




Most read articles by the same author(s)