Efficacy of Marine ω-3 Fatty Acid Supplementation vs Placebo in Reducing Incidence of Dry Eye Disease in Healthy US Adults

Abstract

IMPORTANCEResults of several small randomized clinical trials have suggested that supplements of marine ω-3 fatty acids may be beneficial in treating signs and symptoms of dry eye disease (DED). However, randomized clinical trial data to examine whether ω-3 fatty acid supplements can prevent DED are lacking.OBJECTIVE To evaluate whether long-term daily supplementation with marine ω-3 fatty acids prevents the development of DED. DESIGN, SETTING, AND PARTICIPANTSThis was a prespecified ancillary study of the Vitamin D and Omega-3 Trial (VITAL), a nationwide randomized double-blind placebo-controlled 2 × 2 factorial trial of vitamin D and marine ω-3 fatty acids in the primary prevention of cancer and cardiovascular disease. Participants in this ancillary study were 23 523 US adults (men 50 years and older and women 55 years and older) who at study entry were free of a previous diagnosis of DED and were not experiencing severe dry eye symptoms.

Update on Dry Eye Disease Treatment: Evidence From Randomized Controlled Trials

“…Two key essential fatty acids (EFAs) are the omega-3 (O-3) and omega-6 (O-6) fatty acids, which compete for the enzymes that regulate their metabolism, to produce eicosanoids that can modulate systemic inflammation (Table 4). 58–67…”

“…Two key essential fatty acids (EFAs) are the omega-3 (O-3) and omega-6 (O-6) fatty acids, which compete for the enzymes that regulate their metabolism, to produce eicosanoids that can modulate systemic inflammation (Table 4). [58][59][60][61][62][63][64][65][66][67] Omega-3 essential polyunsaturated fatty acids have a broad range of systemic anti-inflammatory effects and can inhibit the production of proinflammatory cytokines and prevent T-lymphocyte proliferation. 60 A handful of RCTs have sought to determine the efficacy of O-3 EFA supplementation in DED.…”

“…60 A handful of RCTs have sought to determine the efficacy of O-3 EFA supplementation in DED. [58][59][60][61][62][63][64][65] Most RCTs performed were single-site studies, varied in DED causative factors/severity/use of short-chain versus long-chain subtype EFAs, had variable comparators (olive oil, coconut oil, etc), had short follow-up, used variable outcome measures, and did not measure compliance with blood serum fatty acid analysis. [58][59][60][61][62][63][64] The DREAM study is the largest multicenter RCT performed on O-3 supplementation in DED to date.…”

Moxibustion with Walnut Shell Spectacles Could Improve the Objective Symptoms and Tear Film Stability of Patients with Dry Eye Disease: A Randomized Controlled Trial

“…Currently, the most important method for treating DED is using artifcial tears locally to improve ocular surface humidity and lubrication capacity [38,39]. Some topical drugs are approved for treating DED with anti-infammatory and immunomodulatory efects, such as Cyclosporin A [40], corticosteroids [41], as well as emerging therapeutics such as lacrimal and diquafosol sodium [42][43][44][45][46]. Also, there are still challenges in the treatment of DED [47].…”

Integrated microbiome, metabolome and transcriptome profiling reveals the beneficial effects of fish oil and Bacillus subtilis jzxj-7 on mouse gut ecosystem

“…7 However, several clinical meta-analyses have shown no positive influence on these endpoints, and this discrepancy may be because n-3 PUFAs were used as the only dietary supplement. [8][9][10] We believe nutritional strategies to enhance the bioavailability of n-3 PUFAs will improve their health benefits.…”