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Cochrane Database of Systematic Reviews

Ácidos grasos omega 3 para prevenir o enlentecer la progresión de la degeneración macular senil

Información

DOI:
https://doi.org/10.1002/14651858.CD010015.pub3Copiar DOI
Base de datos:
  1. Cochrane Database of Systematic Reviews
Versión publicada:
  1. 09 abril 2015see what's new
Tipo:
  1. Intervention
Etapa:
  1. Review
Grupo Editorial Cochrane:

  1. Grupo Cochrane de Salud ocular y de la visión

Copyright:
  1. Copyright © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Autores

  • John G Lawrenson

    Correspondencia a: Division of Optometry & Visual Science, City University London, London, UK

    [email protected]

  • Jennifer R Evans

    Cochrane Eyes and Vision Group, ICEH, London School of Hygiene & Tropical Medicine, London, UK

Contributions of authors

JL assessed studies for inclusion and exclusion, assessed risk of bias, extracted data, entered data and authored the first draft of the review
JE assessed studies for inclusion and exclusion, assessed risk of bias, extracted data, entered data reviewed and commented on the text of the review

Sources of support

Internal sources

  • No sources of support supplied

External sources

  • National Institute for Health Research, UK.

    • Richard Wormald, Co‐ordinating Editor for the Cochrane Eyes and Vision Group (CEVG) acknowledges financial support for his CEVG research sessions from the Department of Health through the award made by the National Institute for Health Research to Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology for a Specialist Biomedical Research Centre for Ophthalmology.

    • The NIHR also funds the CEVG Editorial Base in London.

    The views expressed in this publication are those of the authors and not necessarily those of the NIHR, NHS, or the Department of Health.

Declarations of interest

JL: none known
JE: none known

Acknowledgements

We thank Catey Bunce, Andrew Law and William G Christen for their comments on this review. We are grateful to Iris Gordon from the Cochrane Eyes and Vision Group (CEVG) for preparing the electronic searches for this review and to Anupa Shah, Managing Editor for CEVG for her assistance throughout the review process.

Version history

Published

Title

Stage

Authors

Version

2015 Apr 09

Omega 3 fatty acids for preventing or slowing the progression of age‐related macular degeneration

Review

John G Lawrenson, Jennifer R Evans

https://doi.org/10.1002/14651858.CD010015.pub3

2012 Nov 14

Omega 3 fatty acids for preventing or slowing the progression of age‐related macular degeneration

Review

John G Lawrenson, Jennifer R Evans

https://doi.org/10.1002/14651858.CD010015.pub2

2012 Aug 15

Omega 3 fatty acid supplementation for preventing and slowing the progression of age‐related macular degeneration

Protocol

John G Lawrenson, Jennifer R Evans

https://doi.org/10.1002/14651858.CD010015

Open in table viewer
Table 1. Adverse effects

Adverse effects

Omega 3

N (%)

Placebo

N (%)

AREDS 2

Total number of participants

N = 1068

N = 1012

Participants with ≥ 1 adverse event

· Cardiac disorders

· Gastrointestinal disorders

· Infections

· Neoplasms

· Nervous system disorders

· Respiratory and chest disorders

505 (47.3)

119 (11.1)

58 (5.4)

103 (9.6)

83 (7.8)

72 (6.7)

37 (3.5)

479 (47.3)

96 (9.5)

76 (7.5)

90 (8.9)

80 (7.9)

66 (6.5)

44 (4.3)

NAT‐2

Total number of participants

N = 134

N = 129

Total adverse events

· Treatment emergent adverse events*

· Ocular

· Serious non‐ocular

125 (83.3)

5 (4.7)

88 (58.4)

31 (23.1)

115 (77.7)

2 (1.6)

74 (50.0)

30 (23.6)

* As defined by the study authors (including gastrointestinal disorders, allergic dermatitis and breath odour)

Differences between protocol and review

None

Notes

None

Keywords

MeSH

Medical Subject Headings (MeSH) Keywords

Medical Subject Headings Check Words

Humans;

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Results from searching for studies for inclusion in the review.
Figuras y tablas -
Figure 1

Results from searching for studies for inclusion in the review.

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Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figuras y tablas -
Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Forest plot of comparison (Analysis 1.1): 1 Omega 3 fatty acids versus control, outcome: 1.10 Progression of AMD.
Figuras y tablas -
Figure 4

Forest plot of comparison (Analysis 1.1): 1 Omega 3 fatty acids versus control, outcome: 1.10 Progression of AMD.

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Comparison 1 Omega 3 fatty acids versus control, Outcome 1 Progression of AMD.
Figuras y tablas -
Analysis 1.1

Comparison 1 Omega 3 fatty acids versus control, Outcome 1 Progression of AMD.

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Summary of findings for the main comparison. Omega 3 fatty acids compared to placebo for slowing the progression of age‐related macular degeneration

Omega 3 fatty acids compared to placebo for slowing the progression of age‐related macular degeneration

Patient or population: people with AMD
Settings: community
Intervention: omega 3 fatty acids
Comparison: no omega 3 fatty acids (placebo)

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

No omega 3 fatty acids (placebo)

Omega 3 fatty acids

Loss of 3 or more lines of VA at 24 months

100 per 1000

114 per 1000
(53 to 245)

RR 1.14, 95% CI 0.53 to 2.45

236
(1 study)

⊕⊕⊕⊝
moderate1

Loss of 3 or more lines of VA at 36 months

150 per 1000

187 per 1000
(104 to 339)

RR 1.25, 95% CI 0.69 to 2.26)

230
(1 study)

⊕⊕⊕⊝
moderate1

Incidence of CNV at 24 months

100 per 1000

106 per 1000
(47 to 240)

RR 1.06, 95% CI 0.47 to 2.40

224
(1 study)

⊕⊕⊕⊝
moderate1

Incidence of CNV at 36 months

150 per 1000

168 per 1000
(80 to 357)

RR 1.12, 95% CI 0.53 to 2.38

195
(1 study)

⊕⊕⊕⊝
moderate1

Progression of AMD over 5 years

300 per 1000

290 per 1000
(259 to 325)

HR 0.96
(0.84 to 1.1)

2343
(2 studies)

⊕⊕⊕⊕
high

Adverse effects

500 per 1000

505 per 1000
(470 to 545)

RR 1.01, 95% CI 0.94 to 1.09

2343
(2 studies)

⊕⊕⊕⊕
high

AREDS2 reported participants with one or more serious adverse events (AE). NAT‐2 reported total AE including treatment emergent and serious non‐ocular events

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk ratio; OR: Odds ratio; HR: Hazard ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Downgraded for imprecision

Figuras y tablas -
Summary of findings for the main comparison. Omega 3 fatty acids compared to placebo for slowing the progression of age‐related macular degeneration
Ir a la tabla de la revisión
Table 1. Adverse effects

Adverse effects

Omega 3

N (%)

Placebo

N (%)

AREDS 2

Total number of participants

N = 1068

N = 1012

Participants with ≥ 1 adverse event

· Cardiac disorders

· Gastrointestinal disorders

· Infections

· Neoplasms

· Nervous system disorders

· Respiratory and chest disorders

505 (47.3)

119 (11.1)

58 (5.4)

103 (9.6)

83 (7.8)

72 (6.7)

37 (3.5)

479 (47.3)

96 (9.5)

76 (7.5)

90 (8.9)

80 (7.9)

66 (6.5)

44 (4.3)

NAT‐2

Total number of participants

N = 134

N = 129

Total adverse events

· Treatment emergent adverse events*

· Ocular

· Serious non‐ocular

125 (83.3)

5 (4.7)

88 (58.4)

31 (23.1)

115 (77.7)

2 (1.6)

74 (50.0)

30 (23.6)

* As defined by the study authors (including gastrointestinal disorders, allergic dermatitis and breath odour)

Figuras y tablas -
Table 1. Adverse effects
Ir a la tabla de la revisión
Comparison 1. Omega 3 fatty acids versus control

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Progression of AMD Show forest plot

2

Hazard Ratio (Fixed, 95% CI)

0.96 [0.84, 1.10]
Figuras y tablas -
Comparison 1. Omega 3 fatty acids versus control
Ir a la tabla de la revisión