1: Arch Ophthalmol. 2008 Feb;126(2):219-25.
Topical omega-3 and omega-6 fatty acids for treatment of dry eye.
Rashid S, Jin Y, Ecoiffier T, Barabino S, Schaumberg DA, Dana MR.
Schepens Eye Research Institute, 20 Staniford St, Boston, MA 02114, USA.
OBJECTIVE: To study the efficacy of topical application of alpha-linolenic acid
(ALA) and linoleic acid (LA) for dry eye treatment. METHODS: Formulations
containing ALA, LA, combined ALA and LA, or vehicle alone, were applied to dry
eyes induced in mice. Corneal fluorescein staining and the number and maturation
of corneal CD11b(+) cells were determined by a masked observer in the different
treatment groups. Real-time polymerase chain reaction was used to quantify
expression of inflammatory cytokines in the cornea and conjunctiva. RESULTS: Dry
eye induction significantly increased corneal fluorescein staining; CD11b(+) cell
number and major histocompatibility complex Class II expression; corneal
IL-1alpha and tumor necrosis factor alpha (TNF-alpha) expression; and
conjunctival IL-1alpha, TNF-alpha, interferon gamma, IL-2, IL-6, and IL-10
expression. Treatment with ALA significantly decreased corneal fluorescein
staining compared with both vehicle and untreated controls. Additionally, ALA
treatment was associated with a significant decrease in CD11b(+) cell number,
expression of corneal IL-1alpha and TNF-alpha, and conjunctival TNF-alpha.
CONCLUSIONS: Topical ALA treatment led to a significant decrease in dry eye signs
and inflammatory changes at both cellular and molecular levels. CLINICAL
RELEVANCE: Topical application of ALA omega-3 fatty acid may be a novel therapy
to treat the clinical signs and inflammatory changes accompanying dry eye
syndrome.
Publication Types:
Research Support, Non-U.S. Gov't
PMID: 18268213 [PubMed - indexed for MEDLINE]
2: Aust Fam Physician. 2007 Dec;36(12):1026-8.
Age related macular degeneration--should your patients be taking additional
supplements?
Jones AA.
City Eye Centre, Brisbane, Queensland.
draajones@hotmail.com
BACKGROUND: The use of over-the-counter complementary medicines and supplements
is growing. Patients with age related macular degeneration (AMD) are likely to
have heard of, or are possibly already taking, additional supplements that may
increase their chances of retaining useful eyesight. OBJECTIVE: This article
looks specifically at evidence regarding the effects of over-the-counter oral
supplements such as antioxidants and omega-3 fatty acids on AMD. DISCUSSION: Diet
manipulation and supplementation has a role to play in modifying the risk of
disease progression in AMD patients. A combination of vitamins C and E, beta
carotene, zinc oxide and cupric oxide has been shown to reduce the rate of visual
loss in dry AMD. However, commercially available preparations do not always
recommend the correct intake that would match levels found in clinical trials.
Other carotenoids such as lutein and zeaxanthin may also be beneficial, intake of
these can be increased by altering diet alone. Other useful dietary changes
include reducing both animal and vegetable fats and increasing the consumption of
fish and nuts.
Publication Types:
Review
PMID: 18075628 [PubMed - indexed for MEDLINE]
3: Klin Oczna. 2007;109(1-3):79-84.
[Effect of anti-inflammatory therapy on the treatment of dry eye syndrome]
[Article in Polish]
Mrukwa-Kominek E, Rogowska-Godela A, Gierek-Ciaciura S.
Katedry i Kliniki Okulistyki Slaskiej Akademii Medycznej.
Dry eye syndrome is a common chronic disease; agents and strategies for its
effective management are still lacking. The syndrome tends to be accompanied by
ocular surface inflammation; therefore, the use of anti-inflammatory agents might
prove beneficial. The authors present up-to-date guidelines, strategies, and
efficacy of dry eye syndrome management, including anti-inflammatory treatment.
As no diagnostic tests are now available to assess ocular surface inflammation
severity, the right timing to launch an anti-inflammatory agent is difficult to
determine. Patients with mild intermittent bouts of symptoms which can be
alleviated with ophthalmic lubricants do not typically require anti-inflammatory
therapy. The latter should be considered in those who do not respond to
lubricating drops, obtain poor results on clinical tests, and show symptoms of
ocular surface irritation (eg. conjunctivae redness). Anti-inflammatory treatment
of dry eye syndrome may include short-term corticosteroids, cyclosporine A
emulsion, oral tetracycline therapy, oral omega-3 fatty acid supplements, and
autologous serum eye drops. Anti-inflammatory treatment should be safe and
effective; potential benefits should be evaluated for each individual patient.
The authors have reviewed the advantages of anti-inflammatory treatment in dry
eye syndrome, presented in literature.
Publication Types:
English Abstract
Review
PMID: 17687921 [PubMed - indexed for MEDLINE]
4: BMC Ophthalmol. 2007 Feb 26;7:3.
TOZAL Study: an open case control study of an oral antioxidant and omega-3
supplement for dry AMD.
Cangemi FE.
Vitreo-Retinal Associates of New Jersey, Ridgewood, New Jersey 07450, USA.
franciscangemi@aol.com
BACKGROUND: The primary objective of this prospective study was to measure the
change from baseline in visual function--Best-Corrected Visual Acuity (BCVA) via
the Early Treatment Diabetic Retinopathy Study (ETDRS) chart, contrast
sensitivity, central 10 degree visual fields and retinal imaging (angiograms and
photographs) at 6 months in subjects with atrophic (dry) age-related macular
degeneration treated with a targeted nutritional supplement. METHODS: 37 mixed
gender patients with a mean age of 76.3 +/- 7.8 years were enrolled at 5
independent study sites and received standard of care with a novel formulation of
a nutritional supplement. Results were compared to a placebo cohort constructed
from the literature that was matched for inclusion and exclusion criteria. A
paired t-test was used to test a null hypothesis and a two-sided alpha level of
0.05 was used to determine statistical significance. RESULTS: 76.7% of subjects
receiving the nutritional supplement demonstrated stabilization or improvement of
BCVA at 6 months. Subjects gained an average of 0.0541 logMAR or one-half of a
line of visual acuity (VA) over the 6-month period. There was a statistically
significant improvement in VA from baseline with P = .045. The results provide
strong evidence that the treatment being studied produces an improvement in VA.
CONCLUSION: Treatment with this unique nutritional supplement increased VA above
the expected baseline decrease in the majority of patients in this population
with dry macular degeneration. The results of the TOZAL study agree with the LAST
and CARMIS studies and are predictive for positive visual acuity outcomes in the
AREDS II trial. However, patients will likely require supplementation for longer
than 6 months to effect changes in additional visual parameters.
Publication Types:
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
PMID: 17324285 [PubMed - indexed for MEDLINE]
5: J Fr Ophtalmol. 2006 Oct;29(8):868-73.
[Improvement of dry eye symptoms with polyunsaturated fatty acids]
[Article in French]
Creuzot C, Passemard M, Viau S, Joffre C, Pouliquen P, Elena PP, Bron A, Brignole
F.
Service d'Ophtalmologie, CHU, Dijon.
catherine.creuzot-garcher@CHU-dijon.fr
INTRODUCTION: Polyunsaturated fatty acids (PUFAs) are involved in inflammatory
pathways via prostaglandins. Conjunctival inflammation is a hallmark of all dry
eye syndromes. We investigated the role of dietary n-6 and n-3 fatty acids in
patients suffering from ocular dryness. PATIENTS AND METHODS: Seventy-one
patients presenting with mild to moderate dry eye syndromes were randomly
assigned to Nutrilarm or placebo capsules, twice a day for 6 months. The Schirmer
test, BUT, fluorescein staining, and lissamin green stainings were performed at
inclusion and after 1, 3, and 6 months. Furthermore, a questionnaire related to
the dry eye symptoms and global discomfort was provided at every visit. RESULTS:
The Schirmer test, BUT, fluorescein staining, and lissamin green stainings were
improved with treatment when compared to placebo but the difference was not
statistically significant. The efficacy evaluated by the patients and the
investigator were nearly significant (p=0.052 and p=0.054, respectively). For
some signs, such as reflex tearing and conjunctival hyperemia, the improvement
reached the threshold of significance (p=0.047 and p=0.045, respectively). The
same results were found with skin quality and emotional condition, which were
improved (61% with treatment versus 36% with placebo). CONCLUSION: This
double-masked pilot study shows that PUFAs seem to be an interesting tool to
alleviate the symptoms related to dry eye syndrome. These results should be
confirmed using a larger study population.
Publication Types:
English Abstract
Randomized Controlled Trial
PMID: 17075501 [PubMed - indexed for MEDLINE]
6: Health News. 2006 Apr;12(4):11.
Dry eyes? Eat more fish.
[No authors listed]
Publication Types:
News
PMID: 16583494 [PubMed - indexed for MEDLINE]
7: Am J Clin Nutr. 2005 Oct;82(4):887-93.
Relation between dietary n-3 and n-6 fatty acids and clinically diagnosed dry eye
syndrome in women.
Miljanović B, Trivedi KA, Dana MR, Gilbard JP, Buring JE, Schaumberg DA.
Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA 02215,
USA.
BACKGROUND: Dry eye syndrome (DES) is a prevalent condition, but information on
risk or protective factors is lacking. OBJECTIVE: We aimed to determine the
association between the dietary intake and ratio of n-3 and n-6 fatty acids (FAs)
and DES occurrence. DESIGN: Of the 39876 female health professionals in the
Women's Health Study (WHS), 32470 women aged 45-84 y who provided information on
diet and DES were cross-sectionally studied. We assessed FA intakes by using a
validated food-frequency questionnaire and assessed DES by using self-reports of
clinically diagnosed cases. Of the sample, 1546 (4.7%) subjects reported DES. We
used logistic regression models to estimate the odds ratios (ORs) and 95% CIs to
describe the relation of FA intake with DES. RESULTS: After adjustment for
demographic factors, hormone therapy, and total fat intake, the OR for the
highest versus the lowest quintile of n-3 FAs was 0.83 (95% CI: 0.70, 0.98; P for
trend = 0.05). A higher ratio of n-6 to n-3 FA consumption was associated with a
significantly increased risk of DES (OR: 2.51; 95% CI: 1.13, 5.58) for >15:1
versus <4:1 (P for trend = 0.01). In addition, tuna consumption [1 serving was
113 g (4 oz)] was inversely associated with DES (OR: 0.81; 95% CI: 0.66, 0.99 for
2-4 servings/wk; OR: 0.32; 95% CI: 0.13, 0.79 for 5-6 servings/wk versus < or =1
serving/wk; P for trend = 0.005). CONCLUSIONS: These results suggest that a
higher dietary intake of n-3 FAs is associated with a decreased incidence of DES
in women. These findings are consistent with anecdotal clinical observations and
postulated biological mechanisms.
Publication Types:
Clinical Trial
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
PMID: 16210721 [PubMed - indexed for MEDLINE]
8: Invest Ophthalmol Vis Sci. 2005 Sep;46(9):3121-7.
Topical combination of NGF and DHA increases rabbit corneal nerve regeneration
after photorefractive keratectomy.
Esquenazi S, Bazan HE, Bui V, He J, Kim DB, Bazan NG.
LSU Eye Center, LSU Health Sciences Center, School of Medicine, Louisiana State
University, 2020 Gravier Street, New Orleans, LA 70112, USA.
PURPOSE: To investigate the effect of nerve growth factor (NGF) in combination
with docosahexaenoic acid (DHA) on corneal nerve regeneration in a rabbit model
after PRK and correlate the findings with functional tear test. METHODS:
Unilateral PRK was performed on 21 New Zealand albino rabbits. Three groups, each
consisting of six rabbits, were randomized to receive twice-weekly treatments
with DHA, NGF, or NGF plus DHA delivered by collagen shield. A fourth group, the
control, received treatment with albumin. Rabbits were observed for 8 weeks, and
tear secretion tests were conducted every 15 days. The eyes were prepared for
immunostaining. Monoclonal antibodies for class II beta-tubulin, calcitonin
gene-related peptide (CGRP), substance P (SP), and Ki-67 were used. Cell nuclei
were stained with 4',6'-diamino-2-phenylindole (DAPI). Positive staining areas in
relation to total area were calculated with image-analysis software. RESULTS:
There were no significant differences in the tear-secretion test results among
the four groups. However, none of the eyes treated with NGF plus DHA showed rose
bengal staining 30 days after PRK, compared with 50% in the control group and 33%
in the DHA-treated group. A higher percentage of Ki-67-positive cells, a marker
of cell proliferation, was observed in the DHA plus NGF-and NGF-treated groups
compared with DHA alone or the control. Eight weeks after PRK, tubulin-positive
and CGRP-positive epithelial and subbasal nerve bundle areas were significantly
higher in the DHA plus NGF group than in the control and NGF or DHA alone. No
differences were noted in the SP-positive nerve bundles between the different
treatments and the control treatment. CONCLUSIONS: NGF plus DHA treatment after
PRK in rabbits is associated with increased corneal nerve surface area, increased
epithelial proliferation, and decreased rose bengal staining compared with NGF,
DHA, or vehicle control alone. The combination of NGF plus DHA yields faster
nerve recovery after PRK and may have therapeutic usefulness in the treatment of
post-PRK dry eye and other neurotrophic keratopathies.
Publication Types:
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
PMID: 16123410 [PubMed - indexed for MEDLINE]
9: J Zoo Wildl Med. 1999 Jun;30(2):222-7.
Whole body cholesterol, fat, and fatty acid concentrations of mice (Mus
domesticus) used as a food source.
Crissey SD, Slifka KA, Lintzenich BA.
Department of Zoo Nutrition Services, Daniel F. and Ada L. Rice Conservation
Biology and Research Center, Chicago Zoological Society, Brookfield Zoo, Illinois
60513, USA.
The concentrations of dry matter, cholesterol, saturated fat, monounsaturated
fat, and 29 fatty acids were measured in four size categories of whole mice (Mus
domesticus) that are commonly fed to zoo animals. Dry matter increased with
age/size of mice, whereas cholesterol decreased with age/size. Significant
differences in fatty acid content were found among mice categories with capric,
lauric, and myristic acids. Mice categories had similar levels of palmitic,
palmitoleic, heptadecenoic, stearic, oleic, linoleic, gamma linolenic, alpha
linolenic, eicosenoic, eicosadienoic, arachidonic, docosahexaenoic, and
lignoceric acids. Analyzed lipid content of mice exceeded domestic carnivorous
animal requirements for linoleic and arachidonic acids. The fatty acid levels in
mice were high, falling between published values in beef and fish. Generally,
mice contained higher levels of polyunsaturated fatty acids, including the
omega-3 fatty acids, and lower levels of saturated fatty acids than beef.
Although fatty acid levels met or exceeded some dietary requirements for
carnivores and omnivores, a possibility of excessive levels exists that could
lead to eye and tissue abnormalities. Furthermore, as the intake of dietary
polyunsaturated fatty acids increases, the dietary requirement for vitamin E
increases. Thus, it is important that lipid profiles of feeder mice be known and
considered when examining captive animal diets.
Publication Types:
Research Support, Non-U.S. Gov't
PMID: 10484136 [PubMed - indexed for MEDLINE]
10: Eye. 1998;12 ( Pt 1):127-33.
Nutrition supplements and the eye.
Brown NA, Bron AJ, Harding JJ, Dewar HM.
Clinical Cataract Research Unit, Nuffield Laboratory of Ophthalmology, Oxford,
UK.
PURPOSE: A review of the role of vitamins, minerals, carotenoids and essential
fatty acids in relation to eye health. The mode of action may be directly on the
eye or by promoting bodily health on which the eye depends. RESULTS: The lens and
retina suffer oxidative damage and the anti-oxidant vitamins A, C and E are
implicated as protective. Studies in man give indifferent support to the role of
nutrition in the development of cataract. In the elderly, vitamin intake may be
inadequate, so that a vitamin supplement may be reasonable. Zinc has a role in
retinal metabolism and may be beneficial in macular degeneration. Selenium has an
anti-oxidant role. Other minerals including copper have a less defined role.
Carotenoids are concentrated at the macula and have an anti-oxidant role. A
reduced risk of macular degeneration is found in relation to a high serum level.
The essential fatty acid, gamma-linolenic acid (GLA), is useful in Sjögren's
syndrome and may help in other dry eye conditions. Omega-3 fatty acids are
important in retinal development and have a role in preventing cardiovascular
disease. CONCLUSION: All persons should be encouraged to maintain healthy
nutrition. Middle-aged and elderly patients may benefit from a supplement. An
intake in excess of the recommended daily intake may be beneficial, but this is
not proven. Further clinical trials are indicated to define the advisability of
vitamin, mineral and other supplements. Dosages for recommended intake and for
supplements are given.
Publication Types:
Review
PMID: 9614529 [PubMed - indexed for MEDLINE]