Three-Year Outcomes in a Randomized Single-Blind Controlled Trial of Intravitreal Ranibizumab and Oral Supplementation With Docosahexaenoic Acid and Antioxidants for Diabetic Macular Edema

Lafuente, María José; Ortín, Lourdes; Argente, María; Guindo, José L.; López-Bernal, María Dolores; López-Román, Francisco Javier; Domingo, Joan Carles; Lajara, Jerónimo

doi:10.1097/iae.0000000000002114

Cited by 23 publications

(26 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The association of CAT with the latest therapies such as anti-VEFG therapy is very interesting. Lafuente et al [ 124 ] studied 55 T2DM for three years. They measured the effect of adding a combined antioxidant treatment to ranibizumab in the treatment of diabetic macular edema (DME).…”

Section: Clinical Studiesmentioning

confidence: 99%

Update on the Effects of Antioxidants on Diabetic Retinopathy: In Vitro Experiments, Animal Studies and Clinical Trials

et al. 2020

View full text Add to dashboard Cite

Current therapies for diabetic retinopathy (DR) incorporate blood glucose and blood pressure control, vitrectomy, photocoagulation, and intravitreal injections of anti-vascular endothelial growth factors or corticosteroids. Nonetheless, these techniques have not been demonstrated to completely stop the evolution of this disorder. The pathophysiology of DR is not fully known, but there is more and more evidence indicating that oxidative stress is an important mechanism in the progression of DR. In this sense, antioxidants have been suggested as a possible therapy to reduce the complications of DR. In this review we aim to assemble updated information in relation to in vitro experiments, animal studies and clinical trials dealing with the effect of the antioxidants on DR.

show abstract

Section: Clinical Studiesmentioning

confidence: 99%

Update on the Effects of Antioxidants on Diabetic Retinopathy: In Vitro Experiments, Animal Studies and Clinical Trials

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In recent years, there has been growing interest of the health benefits of omega-3 long-chain polyunsaturated fatty acids ( ω -3 PUFAs), particularly docosahexaenoic acid (DHA), the pleiotropic actions of which may affect molecular pathways involved in the pathogenesis of ocular diseases, such as age-related macular edema [ 13 ], diabetic retinopathy and diabetic macular edema [ 14 , 15 ], and dry eye syndrome in glaucoma patients [ 16 ]. The rationale of the use of DHA for improving retinal function is based on the inhibitory effect of DHA on the activation NF- κ B and synthesis of inflammatory cytokines [ 17 , 18 ], generation of eicosanoids and stimulation of inflammation resolving docosanoids (resolvins and protectins) [ 19 ], antiangiogenic effects of ω -3 PUFAs in human endothelial cells, and antioxidant protective effects on retinal pigment epithelium and photoreceptors [ 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Oral Supplementation with Docosahexaenoic Acid (DHA) plus Antioxidants in Pseudoexfoliative Glaucoma: A 6-Month Open-Label Randomized Trial

Villadóniga

García

Epelde

et al. 2018

Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose To assess the effects of antioxidant oral supplementation based on docosahexaenoic acid (DHA) in pseudoexfoliative (PEX) glaucoma. Patients and Methods A prospective 6-month open-label randomized controlled trial was conducted in patients with PEX glaucoma and adequate intraocular pressure (IOP) control. Patients in the DHA group received a high-rich DHA (1 g) nutraceutical formulation. Ophthalmological examination, DHA erythrocyte membrane content (% total fatty acids), plasma total antioxidant capacity (TAC), plasma malondialdehyde (MDA), and plasma IL-6 levels were assessed. Results Forty-seven patients (DHA group 23, controls 24; mean age 70.3 years) were included. In the DHA group, the mean IOP in the right eye decreased from 14.7 [3.3] mmHg at baseline to 12.1 [1.5] mmHg at 6 months (P=0.01). In the left eye, IOP decreased from 15.1 [3.3] mmHg at baseline to 12.2 [2.4] mmHg at 6 months (P=0.007). DHA erythrocyte content increased in the DHA group, with significant differences versus controls at 3 months and 6 months (8.1% [0.9] vs. 4.4% [0.7]; P < 0.0001). At 6 months and in the DHA group only, TAC levels as compared with baseline increased significantly (919.7 [117.9] vs. 856.9 [180.3] µM copper-reducing equivalents; P=0.01), and both MDA (4.4 [0.8] vs. 5.2 [1.1] nmol/mL; P = 0.02) and IL-6 (2.8 [1.3] vs. 4.7 [2.3] pg/mL; P=0.006) levels were lower than in controls. Conclusions Targeting pathophysiology mechanisms of PEX glaucoma by reducing oxidative stress and inflammation with a high-rich DHA supplement might be an attractive therapeutic approach. Despite the short duration of treatment, decrease in IOP supports the clinical significance of DHA supplementation.

show abstract

“…European patent granted, date April 2, 2014 ). 15 , 16 , 17 , 18 , 19 , 20 The product was manufactured by the pharmaceutical company (Brudylab, Barcelona, Spain) and gently provided in unlabeled individual plastic containers (similar in size and shape to the eyedrop receptacles) to the investigators, and the doctors gave them to all participants without any charge. Neither the investigators nor the participants knew the specific composition of the product.…”

Section: Methodsmentioning

confidence: 99%

“… 5 , 15 , 16 , 17 , 18 Indeed, LC- ω-3 fatty acids are incorporated into the cell membrane phospholipids. Tridocosahexaenoine-AOX® (TDAH-AOX) is a highly concentrated DHA triglyceride, patented as a biological molecule that offers both cellular antioxidant protection and anti-inflammatory activity 19 , 20 , 21 by (1) stimulating the intracytoplasmic synthesis of glutathione; (2) inhibiting E2 proinflammatory prostaglandins synthesis, but stimulating the anti-inflammatory E3 prostaglandins synthesis; and (3) favoring the resolution process of inflammation by inducing production of docosanoids as metabolic by-products called resolvins and protectins.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety study of an eyelid gel after repeated nocturnal application in healthy contact lens users and non-users

Pinazo-Durán

Raga-Cervera

Sanz-González

et al. 2021

Journal of Optometry

View full text Add to dashboard Cite

Purpose To evaluate skin biocompatibility of a nighttime hydrating eyelid gel and possible ocular surface effects in contact lens users (CLU) and non-contact lens users (NCLU). The formulation is registered as a medical device as Tridocosahexaenoine-AOX® (TDHA-AOX) (a concentrated DHA triglyceride), containing also hyaluronic acid (HA). Methods A prospective, randomized, masked clinical trial was performed with 62 participants of both sexes, aged 20–70 years, split into: (1) CLU (n = 30) and (2) NCLU (n = 32). All participants were instructed to apply a single dose of the moisturizing gel (containing TDHA-AOX and HA) nightly to the upper and inner eyelids of their right eye (RE) only, and during 2 consecutive weeks. Personal interviews, questionnaires, ophthalmic examinations and reflex tear collection were performed. Ophthalmological parameters included ocular surface response and contact lens status. Levels of satisfaction/adverse events were also recorded. Biochemical parameters included basal and final determination of pro-inflammatory mediator molecules in tear samples by multiplex analyses. Statistics were done by the SPSS 24.0 program. Results The CLU group had higher OS dysfunction than NCLU, but overall clinical parameters (corneal staining, and Schirmer/FBUT tests) and OSDI scores showed significant improvement in CLU individuals as compared to the NCLU participants, at the end of study. CLDEQ-8 scores pinpointed significant amelioration in initial risk of developing DEs by applying eyelid gel. Multiplex analyses demonstrated significantly lower VEGF expression levels (p < 0,05) in tears among the CLU compared to NCLU after nightly application of eyelid gel. Conclusions Eyelid gel appeared to safely and efficiently provide hydration and decongestion of the skin and amelioration of the ocular surface during sleep.

show abstract

Three-Year Outcomes in a Randomized Single-Blind Controlled Trial of Intravitreal Ranibizumab and Oral Supplementation With Docosahexaenoic Acid and Antioxidants for Diabetic Macular Edema

Cited by 23 publications

References 24 publications

Update on the Effects of Antioxidants on Diabetic Retinopathy: In Vitro Experiments, Animal Studies and Clinical Trials

Update on the Effects of Antioxidants on Diabetic Retinopathy: In Vitro Experiments, Animal Studies and Clinical Trials

Effects of Oral Supplementation with Docosahexaenoic Acid (DHA) plus Antioxidants in Pseudoexfoliative Glaucoma: A 6-Month Open-Label Randomized Trial

Efficacy and safety study of an eyelid gel after repeated nocturnal application in healthy contact lens users and non-users

Contact Info

Product

Resources

About