• Lutein/zeaxanthin and Omega-3 poly-unsaturated fatty acids and AMD
• Dietary Fat and AMD
  
• The US Department of Agriculture (USDA) - Nutrient Database for Standard Reference
  

A recent article in JAMA evaluated all the articles that dealt with the benefit of eating fish along with the articles that dealt with its contamination. The article’s conclusion was that the benefit, (reducing the risk of coronary artery disease), outweighs the risks. They recommended that women of child-bearing age should also eat fish but avoid the species that have the highest concentrations of mercury.

In general, the highest mercury concentrations are found in long-living predator fish such as swordfish and shark and lower levels are found in shorter-living species such as shellfish and salmon. Oily fish with low levels of mercury may the best such as: sardines, herring, salmon, mussels, and oysters. The paper recommended though, that one should eat a variety of seafood.

We should remember that it hasn’t yet been proven that the intake of omega-3 polyunsaturated fatty acids reduces the risk of AMD. We also don’t know how much omega-3 is necessary although we believe that it’s a modest amount. Therefore, if you’re not too keen on seafood, eating it twice a week is probably plenty.

Reference:

Mozaffarian D, Rimm EB. Fish intake, contaminants, and human health: evaluating the risks and the benefits. JAMA. 2006 Oct 18;296(15):1885-99.

The results of the MARINA and ANCHOR trials were published in the October 5^th issue of the New England Journal of Medicine. The MARINA trial proved that injections of either 0.3mg or 0.5mg of Lucentis (ranibizumab) was much better at both preserving and improving vision than was sham treatment. The ANCHOR trial showed that either dose was better than Visudyne treatment. The blog has reported this data previously given during oral presentations at various meetings.

I’ve also mentioned that many retinal doctors are still using Avastin, (bevacizumab), to treat patients with wet AMD. Remember that Lucentis is made from Avastin. The advantage of Avastin is that it needs to be injected only every six weeks rather than every four weeks for Lucentis. This disadvantage is that it hasn’t been tested in rigorous randomized controlled trials like Lucentis.

The National Institutes of Health, (NIH), announced that they would sponsor a trial comparing Avastin to Lucentis. The trial will consist of 1,200 patients who will be randomized to one or the other drug. There will probably be two arms of the trial. In one arm, either Lucentis or Avastin will be given at regular intervals. In the other arm, the first three injections of each drug will be given at regular intervals and then on an “as needed” basis if the fluid or new blood vessels return. Hopefully the trial will start in late spring. Iowa will be one of the clinical centers in the trial but we won’t be allowed to tell you anything until the results are announced. Probably the earliest the results will be known will be late summer 2008 unless one drug is clearly better than the other.

References

1. Rosenfeld PJ, Brown DM, Heier JS, Boyer DS, Kaiser PK, Chung CY, Kim RY; MARINA Study Group. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006 Oct 5;355(14):1419-31.

2. Brown DM, Kaiser PK, Michels M, Soubrane G, Heier JS, Kim RY, Sy JP, Schneider S; ANCHOR Study Group. Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med. 2006 Oct 5;355(14):1432-44.