1. Associations Between Vitamin D Intake and Progression to Incident Advanced Age-Related Macular Degeneration
- Author
-
Bénédicte M. J. Merle, Rachel E Silver, Johanna M. Seddon, and Bernard Rosner
- Subjects
advanced age-related macular degeneration ,Male ,medicine.medical_specialty ,Calorie ,genetic structures ,vitamin D ,Lower risk ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Geographic Atrophy ,medicine ,Vitamin D and neurology ,Humans ,Nutritional Physiological Phenomena ,030212 general & internal medicine ,Prospective Studies ,Prospective cohort study ,Survival analysis ,Aged ,Aged, 80 and over ,business.industry ,Clinical and Epidemiologic Research ,Incidence ,Hazard ratio ,Vitamins ,Macular degeneration ,Middle Aged ,medicine.disease ,Confidence interval ,eye diseases ,Diet Records ,Diet ,nutrition ,Dietary Supplements ,030221 ophthalmology & optometry ,Disease Progression ,Wet Macular Degeneration ,epidemiology ,Female ,progression ,business ,Energy Intake ,Follow-Up Studies - Abstract
Purpose There is growing evidence of the importance of nutrition in age-related macular degeneration (AMD), but no prospective studies have explored the impact of vitamin D. We evaluated the association between vitamin D intake and progression to advanced AMD. Methods Among 2146 participants (3965 eyes), 541 (777 eyes) progressed from early or intermediate AMD to advanced disease (mean follow-up: 9.4 years) based on ocular imaging. Nutrients were log transformed and calorie adjusted. Survival analysis was used to assess associations between incident advanced disease and vitamin D intake. Neovascular disease (NV) and geographic atrophy (GA) were evaluated separately. Combined effects of dietary vitamin D and calcium were assessed based on high or low consumption of each nutrient. Results There was a lower risk of progression to advanced AMD in the highest versus lowest quintile of dietary vitamin D intake after adjustment for demographic, behavioral, ocular, and nutritional factors (hazard ratio [HR]: 0.60; 95% confidence interval [CI]: 0.43-0.83; P trend = 0.0007). Similar results were observed for NV (HR: 0.59; 95% CI: 0.39-0.89; P trend = 0.005) but not GA (HR: 0.83; 95% CI: 0.53-1.30; P trend = 0.35). A protective effect was observed for advanced AMD among participants with high vitamin D and low calcium compared to the group with low levels for each nutrient (HR: 0.67; 95% CI: 0.50-0.88; P = 0.005). When supplement use was considered, the effect was in the protective direction but was not significant. Conclusions A diet rich in vitamin D may prevent or delay progression to advanced AMD, especially NV. Additional exploration is needed to elucidate the potential protective role of vitamin D and its contribution to reducing visual loss.
- Published
- 2017