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Results from searching for studies for inclusion in the review.
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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.
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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.
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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.
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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

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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
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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)

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Table 1. Adverse effects
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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
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