Mediterranean diet as a modifiable risk factor for age-related macular degeneration: A systematic review and meta-analysis

A BSTRACT Objectives: Age-related macular degeneration (AMD) is a chronic and degenerative disease of the retina that leads to irreversible blindness. There is no proven effective treatment for early AMD and advanced AMD. Mediterranean diet (MD) has been linked to reducing the risk or delaying the progression of AMD. Therefore, in this study, we aim to investigate the potential of MD as a modifiable risk factor for AMD. Materials and Methods: A systematic search was performed in three databases: PubMed, EBSCO host, and Proquest. We search for studies that determine the association of MD in AMD. Then, we pooled the data for meta-analysis. Results: Eight studies were included in our systematic review. Seven studies were included for meta-analysis. Subjects with medium–high (hazard ratio [HR] 0.82; 95% confidence interval [CI]: 0.75–0.90) adherence to the MD showed a reduced risk of developing AMD. Moreover, medium adherence AMD shows a significant and inverse relationship with the progression to advanced AMD (HR: 0.87; 95% CI: 0.81–0.93). Although it is still inconsistent, the reduction appears stronger for geographic atrophy than for neovascular AMD. Conclusion: Adhering to the MD, particularly at a medium to high level, appears to confer a protective effect against AMD. The sub-analysis demonstrates even that there is a protective effect associated with moderate adherence against advanced AMD. The presence of considerable heterogeneity within the results warrants cautious interpretation. Further research is needed to enhance our understanding.