Association of Plasma Omega-3 Fatty Acids With POAG

Purpose: To investigate the association between plasma levels of omega-3 fatty acids and the risk of POAG. Methods: We conducted prospective cohort analyses among 254,157 participants of European descent in the UK Biobank cohort. Mendelian randomization analyses were further performed to assess the causal relationship between omega-3 fatty acids and POAG using publicly available genome-wide association study summary statistics. Results: Over 13.84 years of follow-up, 1,166 patients (0.46%) developed POAG. After adjustment for covariates including POAG polygenetic risk scores, a 1-unit (mmol/L) increment in plasma levels of omega-3 polyunsaturated fatty acids was significantly associated with a decreased risk of incident POAG (hazard ratio, 0.61; 95% confidence interval, 0.43–0.88; P = 0.008). The association of plasma docosahexaenoic acid (DHA) levels with the risk of POAG was borderline significant (hazard ratio, 0.42; 95% confidence interval, 0.17–1.01; P = 0.05). Moreover, the associations were more prominent among individuals with high glaucoma genetic risks, although no significant interaction was detected between omega-3/DHA levels and glaucoma polygenic risk scores (all P > 0.05). For Mendelian randomization analyses, the results of random-effect inverse-variance weighted models and two other sensitivity analyses indicated that genetically predicted plasma levels of omega-3 and DHA were significantly inversely associated with the risk of POAG (all P < 0.05). Conclusions: Our findings suggested a protective effect of omega-3 fatty acids on POAG, underscoring their potential value in POAG prevention strategies.