September 18, 2013
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Nutritional supplements drive significant improvement in dry eye symptoms, study finds

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Postmenopausal patients with moderate-to-severe keratoconjunctivitis sicca may benefit from supplements with gamma-linolenic acid and omega-3 polyunsaturated fatty acids for treatment of tear dysfunction, according to a study.

“Nutritional supplementation with black currant seed oil [gamma-linolenic acid] and fish oil [omega-3 polyunsaturated fatty acids] should be considered in the treatment of tear dysfunction to decrease irritation symptoms and prevent exacerbations in ocular surface inflammation and corneal epithelial disease,” the study authors said.

The multicenter, double-masked placebo-controlled clinical trial included both eyes of 38 patients with tear dysfunction. Patients were randomized to supplemental gamma-linolenic and omega-3 polyunsaturated fatty acids or placebo for 6 months.

Ocular Surface Disease Index, surface asymmetry, tear breakup time, tear production and corneal and conjunctival staining were measured at baseline and at 4, 12 and 24 weeks. The study also gauged dendritic cell CH11c integrin and HLA-DR expression over the period.

The Ocular Surface Disease Index improved with supplementation after 24 weeks and was lower than in the placebo group (P = .05). Surface asymmetry also was significantly lower in the supplement group (P = .005).

Those receiving placebo also demonstrated significantly higher HLA-DR intensity and CD11c (increased by 36% ± 9% and 34% ± 7%, respectively) at 24 weeks (P = .001).

No effect was seen on tear production, tear breakup time or corneal or conjunctival staining.

The study was limited by the potential impact of subjects’ unknown consumption of individual nutrients and by patient compliance being judged based o self-reporting.

Disclosure: Sheppard is an advisor with Alcon, Allergan, B + L, Lux Biosciences, Merck, ScienceBased Health and Vistakon. Pflugfelder is a consultant for Allergan, Alcon, B + L, GlaxoSmithKline, Mimetogen, and ScienceBased Health and receive research funding from Allergan and Glaxo Smith Kline. Singh, McClellan, Weikert, Scoper, Joly, Whitley and Kakkar have no related financial interests.