Nutrition et dégénérescences maculaires liées à l'âge

The pathogenesis of age-related macular degeneration (ARMD) involves nutritional factors related to the oxidative stress. Antioxidant micronutrients, anti-free-radicals and micronutrients that protect from blue light play a role in disease prevention. These nutritional factors are closely related to environmental risk factors such as smoking and chronic blue light exposure. Although experimental and epidemiological data are concordant and coherent, the protective role of these micronutrients is not clearly established and the effective dose devoid of adverse effects remains to be determined. Besides, interventional studies on omega-3 long-chain polyunsaturated fatty acids (LCPFA) supplements constitute a significant advance in terms of primary care prevention. In practice, as primary disease prevention, omega-3 LCPFA supplements may be considered in subjects with a risk for ARMD, while a cocktail of antioxidant and blue-light-protective micronutrients should be considered for patients with grade 3 and grade 4 ARMD, or, as secondary prevention, for subjects with an uncontrolled nutritional status. Of course, such supplements are compatible with simple dietary measures. Their interest might be enhanced by an improved formulation and a dose-optimization of the supplements currently used. Further research and clinical studies remain necessary to definitely validate these formulations and consider them true drugs.