Associations Between Systemic Omega-3 Fatty Acid Levels With Moderate-to-Severe Dry Eye Disease Signs and Symptoms at Baseline in the Dry Eye Assessment and Management Study

Abstract

fatty acid supplementation is used to treat systemic inflammatory diseases, but the role of n-3 in the pathophysiology and therapy of dry eye disease (DED) is not definitive. We evaluated the relationship of systemic n-3 levels with signs and symptoms at baseline in the Dry Eye Assessment and Management (DREAM) Study. Methods: Blood samples from participants at baseline were analyzed for n-3 and n-6, measured as relative percentage by weight among all fatty acids in erythrocytes. Symptoms were evaluated using the Ocular Surface Disease Index. Signs including conjunctival staining, corneal staining, tear breakup time (TBUT), and Schirmer's test with anesthesia were also evaluated.Results: There was no correlation between the systemic n-3 levels and DED symptoms. When the associations with signs of DED were assessed, lower DHA levels were associated with higher conjunctival staining, with mean scores of 3.31, 2.96, and 2.82 for low, medium, and high levels of DHA, respectively (linear trend P¼0.007). None of the other signs were associated with DHA or the other measures of n-3. Conclusion: Previous studies have found varying results on the role of n-3 supplementation with the signs and symptoms of DED. Among patients with DED enrolled in the DREAM Study, lower systemic n-3 levels were not associated with worse symptoms and most signs of DED.

A literature-derived dataset on risk factors for dry eye disease

“…DED etiology and pathology findings have indicated that patients with different DED etiologies may present with different signs and symptoms 8 . It has been reported that patients who smoke or have comorbidities experience more severe symptoms of DED, when compared to patients in a control group 9 . The potential factors that might increase the incidence of DED include primary lacrimal gland diseases, rheumatoid arthritis, ultraviolet ray exposure, improper wearing of contact lenses, older age, female, smoking, and some medicines, such as tricyclic antidepressants and antihypertensive drugs 3,6,[10][11][12] .…”

NLRP3 Inflammasome as a Potential Therapeutic Target in Dry Eye Disease

“…Reduced expression of HLA-DR was observed following three month supplementation of omega-3 and -6 [ 140 ]. However, more recent studies have reported no difference between omega-3 and placebo supplement groups on symptoms and signs of DED [ 141 , 142 , 143 ]. Finally, a recent Cochrane review concluded that there is a possible role for long-chain omega-3 supplementation in DED management, although with uncertainty and inconsistency in the evidence [ 144 ].…”

Dry Eye Disease in the Middle East and Northern Africa: A Position Paper on the Current State and Unmet Needs

“… 65 For instance, the DREAM study concluded that patients with DED who received omega-3 fatty acid supplementation did not show a significant improvement in symptoms compared to a similar cohort that received olive oil as placebo. 66 It is possible, however, that omega-9 fatty acids, which are present in olive oil, could improve DED signs and symptoms similar to omega-3 fatty acids. 67 A meta-analysis of randomized clinical trials of omega-3 fatty acids concluded that they can be effective for treating DED.…”