Exploring the Efficacy of Omega-3 Fatty Acid Supplementation in Dry Eye Disease: A Comprehensive Review
DOI:
https://doi.org/10.12775/JEHS.2024.53.012Keywords
dry eye disease, omega-3, fatty acidAbstract
Introduction
Dry eye syndrome, as defined by TFOS, is a multifactorial ocular surface disease with tear film instability, hyperosmolarity, inflammation, and neuro-sensory abnormalities. With a prevalence between 6.5% and 52.4%, it poses a substantial public health challenge, significantly affecting patients' quality of life. Omega-3 fatty acid supplementation is often suggested by clinicians as an adjunctive treatment, offering potential benefits across various levels.
Aim of the study
The purpose of the study was to investigate the effect of oral supplementation of omega-3 fatty acids on the treatment of dry eye syndrome.
Materials and methods
Literature selections of PubMed and Google Scholar databases from the last seven years (2016-2023) were performed. Articles were searched in English using the following keywords: dry eye disease; omega-3; fatty acid.
Results
Omega-3 fatty acids may have benefits in the treatment of dry eye syndrome, as argued by a number of potential mechanisms of action. However, the literature does not agree on the efficacy of their use in the treatment of dry eye syndrome, and thus there is insufficient evidence to bring omega-3 acids into the standard of treatment for dry eye syndrome.
Conclusion
Studies on the effect of oral supplementation of omega-3 fatty acids on the treatment of dry eye syndrome are at an early stage and need to be continued to improve knowledge. There is a need for further long-term studies to standardize conclusions about the efficacy of these acids in reducing dry eye symptoms.
References
Craig JP, Nichols KK, Akpek EK, et al. TFOS DEWS II Definition and Classification Report. Ocul Surf. 2017 Jul;15(3):276-283. https://doi.org/10.1016/j.jtos.2017.05.008. Epub 2017 Jul 20. PMID:28736335.
Asbell PA, Maguire MG, Pistilli M, et al. n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease. N Engl J Med. 2018 May 3;378(18):1681-1690. https://doi.org/10.1056/NEJMoa1709691. Epub 2018 Apr 13. PMID:29652551.
Qian L, Wei W. Identified risk factors for dry eye syndrome: A systematic review and meta-analysis. PLoS One. 2022 Aug 19;17(8):e0271267. https://doi.org/10.1371/journal.pone.0271267. PMID: 35984830.
Park J, Yoo Y-S, Shin E, et al. Effects of the re-esterified triglyceride (rTG) form of omega-3 supplements on dry eye following cataract surgery. 2021 Nov;105(11):1504-1509. https://doi.org/10.1136/bjophthalmol-2020-317164. Epub 2020 Sep 11. PMID:32917627.
Goyal P, Jain AK, Malhotra Ch. Oral Omega-3 Fatty Acid Supplementation for Laser In Situ Keratomileusis-Associated Dry Eye. Cornea. 2017 Feb;36(2):169-175. https://doi.org/10.1097/ICO.0000000000001108. PMID:28060063.
Bhargava R, Pandey K, Ranjan S, et al. Omega-3 fatty acids supplements for dry eye- Are they effective or ineffective? Indian J Ophthalmol. 2023 Apr;71(4):1619-1625. https://doi.org/10.4103/IJO.IJO_2789_22. PMID:37026312.
Bhargava R, Kumar P, Arora Y. Short-Term Omega 3 Fatty Acids Treatment for Dry Eye in Young and Middle-Aged Visual Display Terminal Users. Eye Contact Lens. 2016 Jul;42(4):231-6. https://doi.org/10.1097/ICL.0000000000000179. PMID:26322917.
Yu K, Bunya V, Maguire M, et al. Systemic Conditions Associated with Severity of Dry Eye Signs and Symptoms in the Dry Eye Assessment and Management Study. Ophthalmology. 2021 Oct;128(10):1384-1392. https://doi.org/10.1016/j.ophtha.2021.03.030. Epub 2021 Mar 27. PMID: 33785415.
Bhargava R, Chandra M, Bansal U, et al. A Randomized Controlled Trial of Omega 3 Fatty Acids in Rosacea Patients with Dry Eye Symptoms. Curr Eye Res. 2016 Oct;41(10):1274-1280. https://doi.org/10.3109/02713683.2015.1122810. Epub 2016 Apr 6. PMID:27050028.
Zhou Y, Murrough J, Yu Y, et al. Association Between Depression and Severity of Dry Eye Symptoms, Signs, and Inflammatory Markers in the DREAM Study. JAMA Ophthalmol. 2022 Apr 1;140(4):392-399. https://doi.org/10.1001/jamaophthalmol.2022.0140. PMID:35266971.
Kwestionariusz diagnostyczny: wskaźnik choroby powierzchni oka. Medycyna Praktyczna: Kwestionariusze. https://www.mp.pl/okulistyka/praktyka/kwestionariusze/100671,kwestionariusz-diagnostyczny-wskaznik-choroby-powierzchni-oka-osdi (dostęp: 2023.12.24).
Chinnery HR, Golborne CN, Downie LE. Omega-3 supplementation is 3neuroprotective to corneal nerves in dry eye disease: a pilot study Ophthalmic Physiol Opt. 2017 Jul;37(4):473-481. https://doi.org/10.1111/opo.12365. Epub 2017 Mar 12. PMID:28295445.
Ambroziak AM. Zaburzenia powierzchni oka. ,,Okulistyka kwartalnik medyczny”, zeszyt 2’2013(22), ISSN 1505-2753.
Kaercher T, Messmer EM, Berninger T, et al. Topical Omega-3 Polyunsaturated Fatty Acids for the Treatment of Dry Eye- Results from a Pilot Randomized Controlled Masked-Observer Study. Clin Ophthalmol. 2022 Dec 8:16:4021-4031. https://doi.org/10.2147/OPTH.S388294. PMID:36523849.
Oydanich M, Maguire MG, Pistilli M, et al. Effects of Omega-3 Supplementation on Exploratory Outcomes in the DREAM Study. Ophthalmology. 2020 Jan;127(1):136-138. https://doi.org/10.1016/j.ophtha.2019.07.009. Epub 2019 Jul 25. PMID:31445751.
Greiner JV, Ying G-S, Pistilli M, et al. Association of Tear Osmolarity With Signs and Symptoms of Dry Eye Disease in the Dry Eye Assessment and Management (DREAM) Study. Invest Ophthalmol Vis Sci. 2023 Jan 3;64(1):5. https://doi.org/10.1167/iovs.64.1.5. PMID:36626176.
Asbell PA, Maguire MG, Peskin E, et al. Dry Eye Assessment and Management (DREAM©) Study: Study design and baseline characteristics. Contemp Clin Trials. 2018 Aug:71:70-79. https://doi.org/10.1016/j.cct.2018.06.002. Epub 2018 Jun 6. PMID:29883769.
Hussain M, Shtein RM, Pistilli M, et al. The Dry Eye Assessment and Management (DREAM) Extension Study- A Randomized Clinical Trial of Withdrawal of Supplementation with Omega-3 Fatty Acid in Patients with Dry Eye Disease. Ocul Surf. 2020 Jan;18(1):47-55. https://doi.org/10.1016/j.jtos.2019.08.002. Epub 2019 Aug 16. PMID:31425752.
Roy NS, Yu Y, Ying G-S, et al. Effect of omega-3 on HLA-DR expression by conjunctival cells and tear cytokine concentrations in the Dry Eye Assessment and Management (DREAM) Study. Eye Contact Lens. 2022 Sep 1;48(9):384-390. https://doi.org/10.1097/ICL.0000000000000916. Epub 2022 Jun 30. PMID:35916880
Yu K, Asbell PA, Shtein RM, et al. Dry Eye Subtypes in the Dry Eye Assessment and Management (DREAM) Study: A Latent Profile Analysis. Transl Vis Sci Technol. 2022 Nov 1;11(11):13. https://doi.org/10.1167/tvst.11.11.13. PMID:36383391.
Sayegh RR, Yu Y, Farrar JT. Ocular Discomfort and Quality of Life Among Patients in the Dry Eye Assessment and Management (DREAM) Study. Cornea. 2021 Jul 1;40(7):869-876. https://doi.org/10.1097/ICO.0000000000002580. PMID:33290317.
Chi S-Ch, Tuan H-I, Kang YN. Effects of Polyunsaturated Fatty Acids on Nonspecific Typical Dry Eye Disease: A systematic Review and Meta-Analysis of Randomized Clinical Trials. Nutrients. 2019 Apr 26;11(5):942. https://doi.org/10.3390/nu11050942. PMID:31027357.
Deinema LA, Vingrys AJ, Wong ChY, et al. A Randomized, Double-Masked, Placebo-Controlled Clinical Trial of Two Forms of Omega-3 Supplements for Treating Dry Eye Disease. Ophthalmology. 2017 Jan;124(1):43-52. https://doi.org/10.1016/j.ophtha.2016.09.023. Epub 2016 Nov 3. PMID:27817918.
Epitropoulos AT, ED Donnenfeld, Shah ZA, et al. Effect of Oral Re-esterified Omega-3 Nutritional Supplementation on Dry Eyes. Cornea. 2016 Sep;35(9):1185-91. https://doi.org/10.1097/ICO.0000000000000940. PMID:27442314.
Ng D, Altamirano-Vallejo JC, Gonzalez-De la Rosa A, et al. An Oral Polyphenol Formulation to Modulate the Ocular Surface Inflammatory Process and to Improve the Symptomatology Associated with Dry Eye Disease. Nutrients. 2022 Aug 7;14(15):3236. https://doi.org/10.3390/nu14153236. PMID:35956412.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Anna Martyka, Martyna Kubicka-Figiel, Nina Taborska

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 357
Number of citations: 0