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Dry Eye Disease: Effect of Re-esterified Omega-3 Supplementation

Dry Eye Disease: Effect of Re-esterified Omega-3 Supplementation
    Dr. Alice T. Epitropoulos shares her findings on using Omega-3s for progressive dry eye.
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    • Overview

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

      Alice T. Epitropoulos, MD, Eric D. Donnenfeld, MD, Zubin A. Shah, MPH, Edward J. Holland, MD, Michael Gross, MD, William J. Faulkner, MD, Cynthia Matossian, MD, Stephen S. Lane, MD, Melissa Toyos, MD, Frank A. Bucci, Jr, MD, and Henry D. Perry, MD

      Cornea Volume 35, Number 9, September 2016


      Purpose: To assess the effect of oral re-esterified omega-3 fatty acids on tear osmolarity, matrix metalloproteinase-9 (MMP-9), tear break-up time (TBUT), Ocular Surface Disease Index (OSDI), fluorescein corneal staining, Schirmer score, meibomian gland dysfunction (MGD) stage and omega-3 index in subjects with dry eyes and confirmed MGD.

      Methods: This was a multicenter, prospective, interventional, placebo-controlled, double-masked study. Subjects were randomized to receive 4 softgels containing a total of 1680 mg of eicosapentaenoic acid/560 mg of docosahexaenoic acid or a control of 3136 mg of linoleic acid, daily for 12 weeks. Subjects were measured at baseline, week 6, and week 12 for tear osmolarity, TBUT, OSDI, fluorescein corneal staining, and Schirmer test with anesthesia. MMP-9 testing and omega-3 index were done at baseline and at 12 weeks.

      Results: One hundred five subjects completed the study. They were randomized to omega-3 (n = 54) and control group (n = 51). Statistically significant reduction in tear osmolarity was observed in the omega-3 group versus control group at week 6 (−16.8 ± 2.6 vs. −9.0 ± 2.7 mOsm/L, P = 0.042) and week 12 (−19.4 ± 2.7 vs. −8.3 ± 2.8 mOsm/L, P = 0.004). At 12 weeks, a statistically significant increase in omega-3 index levels (P < 0.001) and TBUT (3.5 ± 0.5 s vs. 1.2 ± 0.5 s, P = 0.002) was also observed. Omega-3 group experienced a significant reduction in MMP-9 positivity versus control group (67.9% vs. 35.0%, P = 0.024) and OSDI scores decreased significantly in omega-3 (−17.0 ± 2.6) versus control group (−5.0 ± 2.7, P = 0.002).

      Conclusions: Oral consumption of re-esterified omega-3 fatty acids is associated with statistically significant improvement in tear osmolarity, omega-3 index levels, TBUT, MMP-9, and OSDI symptom scores.

      Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.

      Reviewed by:

      Alice T. Epitropoulos, MD

      Commercial Support:

      This activity is supported by an independent educational grant from PRN Physician Recommended Nutriceuticals.

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