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The purpose of this study was to describe vitreomacular adhesion (VMA), diagnosed with spectral-domain optical coherence tomography (SD-OCT), its risk factors, and its association with AMD in a population-based study of French elderly subjects.Six hundred twenty-two of 624 (99.7%) participants of the Alienor study (Bordeaux, France), ≥75 years of age, had gradable SD-OCT scans of the macula in at least one eye. VMA was defined as visible perifoveal vitreous separation with remaining vitreomacular attachment and unperturbed foveal morphologic features. Late AMD was classified from retinal color photographs, SD-OCT, and ophthalmologic history. Early AMD was classified from retinal photographs and defined by the presence of large drusen and/or reticular drusen and/or pigmentary abnormalities.The prevalence of VMA was 15.8%, decreased with age (18.1% in subjects 75 to 84 years of age versus 8.9% after 85 years of age), and was higher in men than women (20.6% vs. 12.8%). VMA also tended to be less frequent in eyes with a history of cataract surgery (odds ratio [OR] = 0.66, P = 0.05), after adjustment for age and sex. No associations of VMA with other risk factors (cardiovascular risk factors, dietary intake of omega-3 fatty acids, lifetime ultraviolet radiation exposure, major AMD genetic polymorphisms) were found. After multivariate adjustment, VMA was not significantly associated with early or late AMD (OR = 1.14, P = 0.70 and OR = 0.78, P = 0.51 for early and late AMD, respectively).VMA was visible on SD-OCT in 16% in this sample of elderly French subjects but was not associated with AMD. Prospective studies of the associations of VMA with AMD are needed.

Purpose To assess diagnostic accuracy of spectral-domain optical coherence tomography (SD-OCT) to discriminate glaucoma and control subjects in an elderly population. Methods The antioxidants, essential lipids, nutrition and ocular maladies study (ALIENOR: "Antioxydants, Lipides Essentiels, Nutrition et Maladies Oculaires") is a population-based study. From 2009 to 2010, a total of 624 subjects, aged 74 years or older underwent a complete eye examination, including optic disc color photography and SD-OCT examination of the macula and the optic nerve head. Glaucoma diagnosis was made using retinophotography of the optic nerve head and International Society for Epidemiologic and Geographical Ophthalmology criteria. Average and sectorial peripapillary retinal nerve fiber layer thicknesses (RNFLT) were compared between glaucoma and control subjects using area under the receiver operating characteristic curves (AUC), positive and negative likelihood ratios (LR+/LR-), and diagnostic odds ratios (DOR). Results A total of 532 subjects had complete data, 492 were classified as controls and 40 were classified as glaucoma. Mean age was 82.1 ± 4.2 years and average RNFLT was significantly different between both groups (controls: 88.7 ± 12.2 μm, glaucoma: 65.4 ± 14.4 μm, P < 0.001). Highest AUC values were observed for average (0.895), temporal-inferior (0.874), and temporal-superior (0.868) RNFLT. Temporal-superior RNFLT had the highest DOR (25.31; LR+, 4.65; LR-, 0.18), followed by average RNFLT (DOR: 24.80; LR+, 6.36; LR-, 0.26). When using the normative database provided by the machine, DOR increased to 31.03 (LR+, 1.75; LR-, 0.06) if at least one parameter was considered abnormal (at P < 0.05). Conclusions Parameters of SD-OCT RNFL may provide valuable information in a screening strategy to improve glaucoma detection in a general population of elderly people.

To assess the correlation between macular pigment optical density and plasma levels of lutein, zeaxanthin, and fatty acids, especially omega-3 polyunsaturated fatty acids (PUFAs).The PIMAVOSA study is an observational study of 107 healthy volunteers, aged 20 to 60 years and born in southwest France, without histories of ocular disease. Macular pigment optical density (MPOD) was measured using the two-wavelength autofluorescence method with a modified scanning laser ophthalmoscope. Plasma measurements (lutein, zeaxanthin, and fatty acids) were performed from fasting blood samples collected on the day of the eye examination.MPOD within 6° correlated with plasma levels of lutein and zeaxanthin (r = 0.35, P0.001, and r = 0.30, P0.005, respectively). MPOD also significantly correlated with total plasma omega-3 PUFAs (r = 0.22, P0.05). Among the different omega-3 PUFAs, docosapentaenoic acid (DPA) had the highest correlation with MPOD (r = 0.31, P0.001), whereas correlation with eicosapentaenoic acid (EPA) was moderate (r = 0.21, P0.05) and did not reach statistical significance for docosahexaenoic acid (r = 0.14, P = 0.14).In the present study, macular pigment density was associated not only with plasma lutein and zeaxanthin but also with omega-3 long-chain PUFAs, particularly with EPA and DPA. Further studies will be needed to confirm these findings and to identify the underlying mechanisms.

PURPOSE. Previous studies have suggested a lower risk for agerelated maculopathy (ARM) in subjects with high dietary intake of long-chain omega-3 polyunsaturated fatty acids (PUFA). The authors report the associations of ARM with past dietary intakes in French elderly subjects. METHODS. The Alienor Study is a population-based epidemiologic study on nutrition and age-related eye diseases performed in residents of Bordeaux 73 years of age and older. Six hundred sixty-six subjects (1289 eyes) with complete data were included in the analyses. ARM was classified from retinal photographs taken in 2006 to 2008 in five exclusive stages: late neovascular ARM (n 21 subjects, 29 eyes); late atrophic ARM (n 19 subjects, 33 eyes); large soft indistinct drusen and/or reticular drusen and/or large distinct drusen with pigment abnormalities (early ARM2, n 67 subjects, 100 eyes); large soft distinct drusen alone or pigment abnormalities alone (early ARM1, n 119 subjects, 163 eyes); and no ARM (n 440 subjects, 964 eyes). Dietary intakes were estimated from a 24-hour dietary recall performed by dieticians (2001‐2002). Associations were estimated using logistic Generalized Estimating Equation. RESULTS. After multivariate adjustment, subjects with high intake of long-chain omega-3 PUFA showed a decreased risk for early ARM1 (odds ratio [OR], 0.83; 95% confidence interval [95% CI], 0.71‐0.98; P 0.03) and late neovascular ARM (OR, 0.26; 95% CI, 0.08‐0.83; P 0.02). Associations with late atrophic ARM were in the same direction but did not reach statistical significance (OR, 0.74; 95% CI, 0.52‐1.06; P 0.10). Overall, high intakes of long-chain omega-3 PUFA were associated with reduced risk for late ARM (OR, 0.59; 95% CI, 0.39‐ 0.88; P 0.01). CONCLUSIONS. These results confirm a decreased risk for ARM in subjects with high intake of long-chain omega-3 PUFA. (Invest Ophthalmol Vis Sci. 2011;52:6004‐6011) DOI:10.1167/iovs.117254