A Review of Topical and Systemic Vitamin Supplementation in Ocular Surface Diseases

Abstract

In the homeostasis of the ocular surface, vitamins play a critical role in regulating inflammatory responses and promoting cell differentiation, development and correct function. Systemic vitamin supplementation has been available for many decades; in recent years, thanks to pharmacological advancements, topical vitamin delivery has also become available in an attempt to better treat ocular surface disease (OSD) and dry eye disease (DED). In this paper, we reviewed the current evidence on the role of vitamin supplementation in OSD and DED. We originally searched the PubMed archive, inspected the references and restricted the search to pertinent papers. The body of evidence was evaluated using the amelioration of both signs and symptoms as the outcome, when available. We found that in patients with vitamin deficiency, systemic supplementation of Vitamin A is effective in treating OSD, reducing both DED signs and symptoms. Additionally, systemic supplementation of vitamin D is useful in reducing DED symptoms and increasing tear volume. Vitamin A is also effective in reducing DED signs and symptoms when administered locally. The efficacy of supplementation with other vitamins is still not fully proven. In conclusion, the inclusion of vitamins into the treatment strategies for OSD and DED allows for better treatment customization and better outcomes in these patients.

Effect of multivitamin drug on intractable dry eye symptoms

“…β-Carotene is a precursor of vitamin A, deficiency of which leads to xerophthalmia and ocular surface inflammation (45,46). Topical and oral vitamin A supplementation reduces dry eye signs and symptoms, also promoting goblet cell proliferation (47)(48)(49). Zinc is a part of many essential enzymes, including superoxide dismutase (50).…”

Naturally Occurring Antioxidants in Seven Well-Known Fruits from the Republic of Suriname (South America): Part 2

“…Many of the health-promoting effects of vitamin C have been attributed-directly or indirectly-to its notable antioxidant activity. This held true for, for instance, its strong anti-inflammatory and antihistaminic activity and its ability to inhibit several types of inflammatory mediators such as tumor necrosis factor-α [93]; its inhibitory effects on signaling for lipopolysaccharide formation and ROS production during infection [94]; its anti-aging effect due to the stimulation of collagen formation and the protection of particularly elastin from ROS-mediated damage [95]; and its cytotoxicity (in mega-doses) against cancer [96,97], and perhaps also against diabetes mellitus, cardiovascular ailments, metabolic syndrome, and ocular diseases [98][99][100][101]. All these beneficial effects have been associated with vitamin C's capacity to generate cytotoxic ascorbyl radicals which do not harm normal cells [102], its antibacterial effects due to its ability to neutralize bacterial endotoxins [102] and impede bacterial replication [103]; and its immune-stimulatory properties by promoting the phagocytic properties of neutrophils and macrophages, the production and titer of antibodies, and the activity of lymphocytes [104].…”

Artificial Tears: Biological Role of Their Ingredients in the Management of Dry Eye Disease

“…The use of lipoic acid as an antioxidant has also been evaluated for DED patients and may improve tear film stability [ 69 , 70 ]. Moreover, epsilon amino caproic acid, vitamins E, B6 and B12, and panthenol have been largely used in Japanese formulations of tears substitutes [ 71 ] ( Table 5 ).…”