OMEGA FATTY ACIDS

Daily oral supplementation with omega-3 fatty acids appears to provide significant symptomatic benefit in the treatment of moderate dry eye disease, suggest the findings of a randomised, placebo-controlled clinical study presented at the 2015 American Society of Cataract and Refractive Surgery Symposium in San Diego, USA.

The trial enrolled 60 patients with untreated moderate dry eye disease. The Meibomian Gland Disease Workshop standard for moderate disease was used, i.e an oil quality greater than eight but less than 13, expressibility score of two, with moderate lid changes, plugging, and vascularity.

Participants were randomised to 1.2gm per day of omega fatty acid supplement or 400mg of vitamin E per day over a period of three months. The fish oil capsules combined eicosapentaenoic acid and docosahexaenoic acid. All patients were asked to use warm compresses and were given artificial tears.

At the end of the 12-week study, statistically significant improvement in all measures, except Schirmer scores, were seen in both groups. The subjective and objective improvements were statistically significantly greater in patients receiving omega fatty acid capsules, reports Arun K Jain MD, Professor, Cornea, Cataract and Refractive Surgery, Advanced Eye Centre, Post-Graduate Institute of Medical Education and Research, Chandigarh, India.

OBJECTIVE IMPROVEMENT

At the 12-week mark, tear break-up time had increased 105 per cent in the omega-3 group, compared with a 51 per cent improvement in the placebo group. Ocular Surface Disease Index scores improved 67 per cent among omega-3 recipients, compared with 27 per cent among those receiving vitamin E. Meibum quality increased 50 per cent among those receiving the fish oil supplements, versus 12 per cent for those receiving placebo. All of these differences were highly statistically significant.

“The study showed that daily oral intake of omega fatty acid supplements produced subjective improvement in ocular surface disease indices, and objective improvement in tear break-up time, and Meibomian gland expressibility and meibum quality,” he said.

The study results subsequently appeared in the journal Cornea (Malhotra et al, 2015 Jun;34(6):637-43). In addition to the findings reported by Dr Jain, that publication added additional information about the effect of omega-3 supplementation on contrast sensitivity. The researchers conducted contrast sensitivity testing at three, six, 12 and 18 cycles per degree (cpd) at baseline and at 12 weeks.

They report that at the end of 12 weeks, significant improvements in contrast sensitivity were measured in omega-3 recipients in seven of eight testing conditions, both photopic and mesopic. However, among patients receiving placebo, significant improvements were noted in only three of the eight testing conditions.

Arun K Jain: aronkjain@yahoo.com