A randomized, double-blind, placebo-controlled study of oral antioxidant supplement therapy in patients with dry eye syndrome

Abstract

PurposeTo evaluate the efficacy of oral antioxidant supplementation in the treatment of patients with dry eye syndrome (DES).MethodsA prospective, randomized, double-blinded study compared the effects of an antioxidant supplement (containing anthocyanosides, astaxanthin, vitamins A, C, and E, and several herbal extracts, including Cassiae semen and Ophiopogonis japonicus) with placebo on patients with DES. We assessed dry eye symptoms, visual acuity, Schirmer’s test, tear film breakup time, cornea and conjunctiva fluorescein staining, serum anti-SSA/anti-SSB antibodies, and the level of reactive oxygen species (ROS) in tears. The supplementation period was 8 weeks and patients were followed up every 4 weeks for 16 weeks. A linear mixed model was used to compare the groups, while within-group differences were tested by repeated-measures analysis of variance.ResultsForty-three patients, 20 and 23 in treatment and placebo groups, respectively, completed the study. Liver and renal functions were normal. Diastolic blood pressure decreased in the treatment group. There were no significant differences in systolic blood pressure, dry eye symptoms, serum anti-SSA and anti-SSB, visual acuity, intraocular pressure, or fluorescein corneal staining between the groups. Tear film breakup time scores and Schirmer’s test without topical anesthesia significantly improved in the treatment group. Tear ROS level differed between the groups and decreased after treatment. Overall subjective impression revealed a significant improvement with treatment compared with placebo.ConclusionOral antioxidant supplementations may increase tear production and improve tear film stability by reducing tear ROS. The vegetable-based antioxidant supplement used in this study is safe and can be utilized as an adjuvant therapy to conventional artificial tear therapy for patients with DES.

The Role of Nutrition and Nutritional Supplements in Ocular Surface Diseases

“…A randomized controlled trial investigated the efficacy of an antioxidant supplementation consisting of anthocyanosides, astaxanthin, vitamins A, C, E and several herbal extracts, such Cassiae semen and Ophiopogonis japonicas in the treatment of patients with DED. After therapy, objective parameters including reactive oxygen species tear levels, Schirmer test, tear break-up time and corneal fluorescein staining significantly improved, confirming the efficacy of such preparation in enhancing lacrimal gland function, tear film stability and decreasing epithelial damage [87].…”

“…By promoting the production of surfactants, it incorporates the lipid component of tear film and tear substitutes, thus stabilizing the ocular surface system. Finally, it modulates systemic calcium absorption, which has a crucial role in maintaining a fluid secretion in both salivary and lacrimal glands [87]. Serum levels of vitamin D have shown significant correlations with tear production, stability and DE symptoms [89,90].…”

The impact of micronutrients on athletes’ vision: a retrospective analysis of revalent articles

“…[5]. Наконец, он модулирует системную абсорбцию кальция, которая играет решающую роль в поддержа нии секреции жидкости как в слюнных, так и в слезных железах [6]. Сывороточные уровни витамина D показа ли значимые корреляции с продукцией слезы, стабиль ностью слезной пленки и выраженностью симптомов синдрома сухого глаза (ССГ) [7].…”

Clinical Applications of Astaxanthin in the Treatment of Ocular Diseases: Emerging Insights

“…The supplementation period lasted 8 weeks and patients were followed up every 4 weeks for 16 weeks. Results showed that oral micronutrients supplementation significantly improved tear production and stability while decreased corneal fluorescein staining and tear ROS levels, thus leading to a significant amelioration in both signs and symptoms [65]. The rationale of the use of astaxanthin derives from its capacity to directly address the vicious cycle of the disease, and in particular the underlying inflammation and oxidative stress.…”