Dry Eye Disease and Essential Fatty Acids

Dry eye disease (DED) is a common disease, and have an adverse effect the physical, functional, and psychological quality of life. It is a multifactorial disorder characterized by the loss of tear film homeostasis, in which self-perpetuating vicious cycle leads to deterioration of function and inflammation of the lacrimal functional unit. Hence, treatment strategies should be aimed at the interruption of the vicious inflammatory cycle and alleviation of ocular surface inflammation. Anti-inflammatory therapies have been shown to improve the signs and symptoms of the disease. Evidence indicates that polyunsaturated fatty acids (PUFAs) may contribute to reinforcement of innate anti-inflammatory mechanisms, and systemic and topical administration of PUFAs may help modulate ocular surface inflammation. In the present review, the authors will introduce the results of clinical and experimental studies to elucidate the mechanism, efficacy, and safety of systemic and topical supplementation with PUFAs as an alternative therapeutic strategy for DED. This review will also include discussion regarding current perspectives, including evidence-based recommendations and possible side effects of PUFAs supplementation. The review of the literature suggests that PUFAs supplementation can be a viable option for the treatment of DED, although further studies are needed for establishment of treatment guidelines.

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High doses of fatty acids for treating severe dry eye disease

Acta Ophthalmologica ◽

10.1111/j.1755-3768.2013.s003.x ◽

2013 ◽

Vol 91 ◽

pp. 0-0

Author(s):

T GEORGIOU ◽

D NICOLAOU ◽

A NEOKLEOUS ◽

S MICHAEL ◽

C IKONOMU

Keyword(s):

Fatty Acids ◽

Dry Eye ◽

Dry Eye Disease ◽

Eye Disease ◽

High Doses

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Effects of Polyunsaturated Fatty Acids on Nonspecific Typical Dry Eye Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Nutrients ◽

10.3390/nu11050942 ◽

2019 ◽

Vol 11 (5) ◽

pp. 942 ◽

Cited By ~ 7

Author(s):

Sheng-Chu Chi ◽

Hsin-I Tuan ◽

Yi-No Kang

Keyword(s):

Fatty Acids ◽

Clinical Trials ◽

Polyunsaturated Fatty Acids ◽

Dry Eye ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Dry Eye Disease ◽

Cochrane Library ◽

Eye Disease ◽

Short Term Treatment

To investigate the effects of polyunsaturated fatty acids (PUFAs) in patients with dry eye disease (DED), a multifactorial inflammatory disorder, we searched Cochrane Library, EMBASE, PubMed, and Web of Science for randomized clinical trials (RCTs) investigating the effect of PUFAs in patients with DED before March 2019. Two reviewers independently abstracted data of tear breakup time (TBUT), Schirmer’s test, osmolarity, and ocular surface disease index (OSDI). We conducted pairwise meta-analysis using means and standard deviations (SDs) in a random-effects model for continuous outcomes. Thirteen eligible RCTs with 1782 patients with nonspecific typical DED were included. Patients who received PUFA treatment without other eye medications exhibited greater improvements in TBUT (MD = 1.80; p = 0.001), Schirmer test scores (MD = 0.50; p < 0.001), osmolarity (MD = −15.95; p < 0.001), and OSDI scores (MD = −10.19; p < 0.001) than those who received placebo treatment. However, the effects of PUFAs on TBUT (p < 0.001) and OSDI scores (p = 0.03) weakened with treatment duration. PUFAs are effective in treating nonspecific typical DED, particularly as a short-term treatment, with relatively few adverse events. Therefore, in real-world clinical practice, PUFA supplements are worth being suggested to patients with nonspecific typical DED who are not concurrently using other topical or systematic eye medications.

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