Effect of Oral Omega-3 Fatty Acid Supplementation on Contrast Sensitivity in Patients With Moderate Meibomian Gland Dysfunction

Malhotra, Chintan; Singh, Swati; Chakma, Partha; Jain, Arun Kumar

doi:10.1097/ico.0000000000000446

Cited by 29 publications

(32 citation statements)

References 30 publications

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“…Two articles were excluded from the meta-analysis study due to missing data of the primary outcome (TBUT in seconds) or the endpoint was 12 months instead of 90 days. Six studies were retained for qualitative eligibility, 13 – 18 and four studies were retained for quantitative eligibility primary outcome (TBUT) 13 , 14 , 17 , 18 and two studies were retained for secondary outcome (OSDI 13 , 17 & tear osmolarity 13 , 14 ). The flowchart presenting the selection of eligible studies is summarized in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

A systematic review of the effect of omega-3 supplements on meibomian gland dysfunction

Al-Namaeh

2020

Ophthalmol Eye Dis

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Introduction: Meibomian gland dysfunction (MGD) is the leading cause of dry eye syndrome (DES). Many ocular disorders including DES and blepharitis can be linked to MGD. If we treat MGD, we can treat related diseases easily. Purpose: This systematic review is intended to determine the efficacy of omega-3 supplementation in MGD patients. Methods: This systematic review included an electronic search on PubMed and Clinicaltrials.gov to include all randomized clinical trials (RCTs) using omega-3 as a treatment for MGD. Results: Database search yielded to one RCT and six clinical trials through the MEDLINE of a total of 350 participants for the systematic review and meta-analysis study. The investigated treatment group (omega-3 group) had a positive effect on MGD protection in the invasive sodium fluorescein-tear break up time (NaFl-TBUT) score compared with the placebo group (odd ratio = 8.72, 95% confidence interval: 4.73, 16.09; p < 0.001). These data suggest that the odd ratios of the omega-3 group to control group increased the likelihood of the improved stated outcome tear break up time (TBUT) being achieved in the treatment group. No evidence of publication bias was detected in the funnel plot inspection or the Egger’s statistical test ( p = 0.2944). Conclusions: A moderate daily dose of omega-3 may be a beneficial therapeutic for MGD. Omega-3 has been beneficial in many diseases, such as heart attack prevention and agerelated macular degeneration, and this systematic review emphasizes its protection against MGD. In addition, this review emphasizes the precision of noninvasive TBUT (NITBUT) compared with invasive NaFl-TBUT which may suggest the importance of NITBUT in the clinic.

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Section: Resultsmentioning

confidence: 99%

A systematic review of the effect of omega-3 supplements on meibomian gland dysfunction

Al-Namaeh

2020

Ophthalmol Eye Dis

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“…Most of these trials showed significantly greater improvement in symptoms or in at least one of several signs of dry eye disease in the n–3 fatty acid group than in the placebo group. 15,18–22,24,26 Some studies had highly restrictive eligibility criteria. For example, of the 375 patients in the DREAM trial who had tear osmolarity measurements, only 24 (6.4%) would have met the following eligibility criteria in a recent study: an osmolarity of at least 312 mOsm per milliliter in at least one eye and mild meibomian-gland dysfunction in both eyes.…”

Section: Discussionmentioning

confidence: 99%

n−3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease

Asbell²,

et al. 2018

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BACKGROUND Dry eye disease is a common chronic condition that is characterized by ocular discomfort and visual disturbances that decrease quality of life. Many clinicians recommend the use of supplements of n–3 fatty acids (often called omega-3 fatty acids) to relieve symptoms. METHODS In a multicenter, double-blind clinical trial, we randomly assigned patients with moderate-to-severe dry eye disease to receive a daily oral dose of 3000 mg of fish-derived n–3 eicosapentaenoic and docosahexaenoic acids (active supplement group) or an olive oil placebo (placebo group). The primary outcome was the mean change from baseline in the score on the Ocular Surface Disease Index (OSDI; scores range from 0 to 100, with higher scores indicating greater symptom severity), which was based on the mean of scores obtained at 6 and 12 months. Secondary outcomes included mean changes per eye in the conjunctival staining score (ranging from 0 to 6) and the corneal staining score (ranging from 0 to 15), with higher scores indicating more severe damage to the ocular surface, as well as mean changes in the tear break-up time (seconds between a blink and gaps in the tear film) and the result on Schirmer’s test (length of wetting of paper strips placed on the lower eyelid), with lower values indicating more severe signs. RESULTS A total of 349 patients were assigned to the active supplement group and 186 to the placebo group; the primary analysis included 329 and 170 patients, respectively. The mean change in the OSDI score was not significantly different between the active supplement group and the placebo group (−13.9 points and −12.5 points, respectively; mean difference in change after imputation of missing data, −1.9 points; 95% confidence interval [CI], −5.0 to 1.1; P=0.21). This result was consistent across prespecified subgroups. There were no significant differences between the active supplement group and the placebo group in mean changes from baseline in the conjunctival staining score (mean difference in change, 0.0 points; 95% CI, −0.2 to 0.1), corneal staining score (0.1 point; 95% CI, −0.2 to 0.4), tear break-up time (0.2 seconds; 95% CI, −0.1 to 0.5), and result on Schirmer’s test (0.0 mm; 95% CI, −0.8 to 0.9). At 12 months, the rate of adherence to treatment in the active supplement group was 85.2%, according to the level of n–3 fatty acids in red cells. Rates of adverse events were similar in the two trial groups. CONCLUSIONS Among patients with dry eye disease, those who were randomly assigned to receive supplements containing 3000 mg of n–3 fatty acids for 12 months did not have significantly better outcomes than those who were assigned to receive placebo. (Funded by the National Eye Institute, National Institutes of Health; DREAM ClinicalTrials.gov number, NCT02128763.)

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“…One of the earliest clinical evidence of the role of omega-3 FAs for the health of the ocular surface came from a large cross-sectional study involving over 30,000 women, which demonstrated the relationship between low dietary intake of omega-3 FAs and increased risk of DED [45]. Since then, various randomized clinical trials have demonstrated the efficacy of omega-3 FAs supplementation in DED (Table 1) [46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61]. However, a recent multicenter double-blind clinical trial (the Dry Eye Assessment and Management [DREAM] study) reported similar clinical outcomes in terms of both signs and symptoms for DED patients who received a daily oral dose of omega-3 EPA and DHA (treatment group) or an olive oil (placebo group) [62].…”

Section: Essential Fatty Acidsmentioning

confidence: 99%

The Role of Nutrition and Nutritional Supplements in Ocular Surface Diseases

et al. 2020

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Dry eye disease (DED) is a multifactorial disease of the ocular surface system whose chore mechanisms are tear film instability, inflammation, tear hyperosmolarity and epithelial damage. In recent years, novel therapies specifically targeting inflammation and oxidative stress are being investigated and used in this field. Therefore, an increasing body of evidence supporting the possible role of different micronutrients and nutraceutical products for the treatment of ocular surface diseases is now available. In the present review, we analyzed in detail the effects on ocular surface of omega-3 fatty acids, vitamins A, B12, C, D, selenium, curcumin and flavonoids. Among these, the efficacy of omega-3 fatty acid supplementation in ameliorating DED signs and symptoms is supported by robust scientific evidence. Further long-term clinical trials are warranted to confirm the safety and efficacy of the supplementation of the other micronutrients and nutraceuticals.

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Effect of Oral Omega-3 Fatty Acid Supplementation on Contrast Sensitivity in Patients With Moderate Meibomian Gland Dysfunction

Abstract: Oral supplementation with ω-3 FAs significantly improved CS under both photopic and mesopic testing conditions in patients with moderate MGD. Tear film stability also improved significantly, whereas no effect was seen on aqueous tear production.

Cited by 29 publications

References 30 publications

A systematic review of the effect of omega-3 supplements on meibomian gland dysfunction

A systematic review of the effect of omega-3 supplements on meibomian gland dysfunction

n−3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease

The Role of Nutrition and Nutritional Supplements in Ocular Surface Diseases

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