Higher recent dietary intake of total polyunsaturated fatty acids and vitamin E is associated with higher odds of neovascular age-related macular degeneration: a case-control study
Dewi Fathin Romdhoniyyah, Supanji Supanji, Ayudha Bahana Ilham Perdamaian, Mohammad Eko Prayogo, Firman Setya Wardhana, Muhammad Bayu Sasongko, Dian Caturini SulistyoningrumBackground
The role of dietary nutrients in age-related macular degeneration (AMD) remains debated, particularly high-dose antioxidant supplementation.
Objectives
To compare recent and habitual dietary nutrient intake in relation to the odds of neovascular AMD (nAMD).
Design
Hospital-based, individually-recruited case-control study, reported following STROBE.
Methods
We enrolled 52 treatment-naive patients with nAMD and 50 controls attending tertiary ophthalmology clinics, with diagnosis confirmed by retinal specialists using colour fundus photography and optical coherence tomography. Dietary intake was assessed by semi-quantitative food-frequency questionnaire (SQFFQ) and 24-hour recall, and analysed by multivariable logistic regression with Firth’s penalised likelihood. Primary models were not energy-adjusted; pre-specified sensitivity analyses addressed energy adjustment, alternative specifications and multiple comparisons.
Results
On 24-hour recall, patients with nAMD reported higher protein, fat, polyunsaturated fatty acid (PUFA) and vitamin E intakes than controls (all p ≤ 0.015). In fully adjusted models, the highest versus lowest tertile of recent PUFA and vitamin E intake carried 10.8-fold (95% CI 2.5–46.2; p = 0.001) and 4.2-fold (95% CI 1.1–15.8; p = 0.04) higher odds of nAMD. Habitual (SQFFQ) odds ratios were non-significant in the fully adjusted model. The PUFA association remained significant with total energy as a covariate (OR 10.5) and after multiple-testing correction, but attenuated after energy-adjusted nutrient residual applied (OR 2.16, 95% CI 0.69-6.81; p = 0.19); vitamin E was specification-sensitive.
Conclusion
Higher recent intakes of total PUFA and vitamin E, assessed by 24-hour recall, were associated with higher odds of nAMD, whereas habitual SQFFQ intake showed only weak, non-significant trends. Since our data captured total PUFA only and could not distinguish omega-3 from omega-6, these findings are exploratory and hypothesis-generating. They raise a testable question in an under-studied Southeast Asian population: whether the composition of dietary fat, rather than its quantity, matters. Prospective studies with repeated dietary assessment and fatty-acid profiling are needed before causal inference.
Registration
Not applicable; this observational study was not registered.