Effectiveness and tolerability of dietary supplementation with a combination of omega-3 polyunsaturated fatty acids and antioxidants in the treatment of dry eye symptoms: results of a prospective study

Abstract

BackgroundWe assessed the effectiveness and tolerability of a dietary supplement based on the combination of omega-3 essential fatty acids and antioxidants on dry eye-related symptoms.MethodsA total of 905 patients (72% women, median age 60 years) with dry eye syndrome and using artificial tears to relieve symptoms participated in an open-label prospective intervention study. They were recruited during a routine ophthalmological appointment. Patients were instructed to take three capsules/day of the nutraceutical formulation (Brudysec® 1.5 g) for 12 weeks. Dry eye symptoms (categorized as 0, none; 1, mild; 2, moderate; and 3, severe) included scratchy and stinging sensation in the eyes, eye redness, grittiness, painful eyes, tired eyes, grating sensation, and blurry vision.ResultsThe mean intensity of dry eye symptoms varied from 1.1 (± standard deviation [SD] 0.9) for painful eyes to 2.0 (0.9) for grittiness, with a mean value of 11.9 (4.8) for all symptoms together. At week 12, all individual symptoms improved significantly (P<0.001). The mean value for all symptoms together decreased from a mean value of 11.9 (± SD 4.8) at baseline to 6.8 (± SD 4.5) after 12 weeks of treatment (P<0.001). There was a decrease in the percentage of patients in which dry eye symptoms predominated nearly all the time (53.5% versus 34.1%). A total of 68.1% of patients reported better tolerance to contact lenses after treatment. The mean number of daily instillations of artificial tears also decreased significantly (3.8 [± SD 1.6] versus 3.3 [± SD 1.6], P<0.001). A total of 634 patients (70.1%) did not report any adverse events. In the remaining patients with adverse events, the most frequent was fish-tasting regurgitation in 13.5% of cases, followed by nausea in 4.9%, diarrhea in 1.3%, and vomiting in 0.3%.ConclusionDietary supplementation with a combination of omega-3 essential fatty acids and antioxidants was an effective treatment for dry eye.

Omega-3 fatty acid supplementation improves dry eye symptoms in patients with glaucoma: results of a prospective multicenter study

“…Despite the well-known disadvantages of an open-label design (eg, introduction of bias through unblinding), open-label trials are less complex and can be conducted at lower costs, and thus can be used to recruit more patients and to improve the value of results of clinical studies. In the present study, the open-label design was very useful to recruit a large number of patients diagnosed of glaucoma with dry eye symptoms in order to replicate the favorable results obtained in previous studies 21 , 22 using an oral omega-3 supplement in the patients with dry eye syndrome attended during routine daily practice. Some variables measured in the study may vary with the time of the day.…”

“… 18 On the other hand, inflammation and oxidative stress may play a key role in the development of dry eye syndrome. 13 , 19 , 20 Omega-3 polyunsaturated fatty acid supplementation has been shown to potentiate the antioxidant defenses, to relieve the bothering symptoms and signs of eye dryness by improving the lubrication and tear stability, and to reduce the ocular surface inflammation in patients with glaucoma, 21 in patients with pure dry eye, 22 – 24 in patients suffering from meibomian gland dysfunction, 25 , 26 and in patients after photoreactive keratectomy. 27 …”

Effect of Oral Re-esterified Omega-3 Nutritional Supplementation on Dry Eyes

“… 15 Three studies have previously shown symptomatic improvement in meibomian gland disease with oral omega-3 supplementation. 16 – 18 …”

Experimental and Clinical Applications of Chamaecyparis obtusa Extracts in Dry Eye Disease

“…For instance, a mixture of four natural plant ethyl alcohol extracts decreased the levels of inflammatory cytokines and oxidative stress markers on the ocular surface in the murine dry eye model and antioxidant glasses containing extracts of medical plants which improved the OSDI score and TBUT in patients with dry eye disease [ 6 , 16 ]. In addition, omega-3 polyunsaturated fatty acids, such as antioxidants, have been found to be effective in improving dry eye symptoms [ 45 ]. Furthermore, Kim et al [ 46 ] reported that topical vitamin A eye drops contribute to improvements in blurred vision, TBUT, Schirmer's test, and findings from impression cytology in patients with dry eye disease.…”