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Duan H, Yan W. Visual fatigue a comprehensive review of mechanisms of occurrence, animal model design and nutritional intervention strategies. Crit Rev Food Sci Nutr 2023:1-25. [PMID: 38153314 DOI: 10.1080/10408398.2023.2298789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
When the eyes work intensively, it is easy to have eye discomfort such as blurred vision, soreness, dryness, and tearing, that is, visual fatigue. Visual fatigue not only affects work and study efficiency, but long-term visual fatigue can also easily affect physical and mental health. In recent years, with the popularization of electronic products, although it has brought convenience to the office and study, it has also caused more frequent visual fatigue among people who use electronic devices. Moreover, studies have reported that the number of people with visual fatigue is showing a trend of increasing year by year. The range of people involved is also extensive, especially students, people who have been engaged in computer work and fine instruments (such as microscopes) for a long time, and older adults with aging eye function. More and more studies have proposed that supplementation with the proper nutrients can effectively relieve visual fatigue and promote eye health. This review discusses the physiological mechanisms of visual fatigue and the design ideas of animal experiments from the perspective of modern nutritional science. Functional food ingredients with the ability to alleviate visual fatigue are discussed in detail.
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Affiliation(s)
- Hao Duan
- College of Biochemical Engineering, Beijing Key Laboratory of Bioactive Substances and Functional Food, Beijing Union University, Beijing, China
| | - Wenjie Yan
- College of Biochemical Engineering, Beijing Key Laboratory of Bioactive Substances and Functional Food, Beijing Union University, Beijing, China
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Duan H, Song W, Zhao J, Yan W. Polyunsaturated Fatty Acids (PUFAs): Sources, Digestion, Absorption, Application and Their Potential Adjunctive Effects on Visual Fatigue. Nutrients 2023; 15:nu15112633. [PMID: 37299596 DOI: 10.3390/nu15112633] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 05/28/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
When the eyes are exposed to the environment, they are easily affected by strong light stimulation and harmful substances. At the same time, prolonged use of the eyes or incorrect eye habits can cause visual fatigue, which mainly manifests as eye dryness, soreness, blurred vision, and various discomforts. The main reason for this is a decline in the function of the eye, especially the cornea and retina on the surface of the eye, which have the greatest impact on the normal function of the eye. Research has found that supplementation with appropriate foods or nutrients can effectively strengthen the eye against external and internal stimuli, thereby alleviating or avoiding visual fatigue. Among these, supplementation with polyunsaturated fatty acids has been found to be effective at protecting eye health and relieving visual fatigue. This article summarizes the sources of polyunsaturated fatty acids (including the main dietary sources and internal synthesis), the mechanisms of digestion and absorption of polyunsaturated fatty acids in the body and the safety of polyunsaturated fatty acid applications. It also reviews the mechanism of action of polyunsaturated fatty acids in aiding the relief of visual fatigue based on the mechanism of impaired function or structure of the ocular surface and fundus in the hope of providing some reference and insight into the development and application of polyunsaturated fatty acids in functional foods for the relief of visual fatigue.
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Affiliation(s)
- Hao Duan
- College of Biochemical Engineering, Beijing Union University, Beijing 100023, China
- Beijing Key Laboratory of Bioactive Substances and Functional Food, Beijing Union University, Beijing 100023, China
| | - Wei Song
- Beijing Key Laboratory of Bioactive Substances and Functional Food, Beijing Union University, Beijing 100023, China
| | - Jian Zhao
- Beijing Key Laboratory of Bioactive Substances and Functional Food, Beijing Union University, Beijing 100023, China
| | - Wenjie Yan
- College of Biochemical Engineering, Beijing Union University, Beijing 100023, China
- Beijing Key Laboratory of Bioactive Substances and Functional Food, Beijing Union University, Beijing 100023, China
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Ghezzi M, Ferraboschi I, Delledonne A, Pescina S, Padula C, Santi P, Sissa C, Terenziani F, Nicoli S. Cyclosporine-loaded micelles for ocular delivery: Investigating the penetration mechanisms. J Control Release 2022; 349:744-755. [PMID: 35901859 DOI: 10.1016/j.jconrel.2022.07.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 11/18/2022]
Abstract
Cyclosporine is an immunomodulatory drug commonly used for the treatment of mild-to-severe dry eye syndrome as well as intermediate and posterior segment diseases as uveitis. The ocular administration is however hampered by its relatively high molecular weight and poor permeability across biological barriers. The aim of this work was to identify a micellar formulation with the ability to solubilize a considerable amount of cyclosporine and promote its transport across ocular barriers. Non-ionic amphiphilic polymers used for micelles preparation were tocopherol polyethylene glycol 1000 succinate (TPGS) and Solutol® HS15. Furthermore, the addition of alpha-linolenic acid was assessed. A second aim was to evaluate micelles fate in the ocular tissues (cornea and sclera) to shed light on penetration mechanisms. This was possible by extracting and quantifying both drug and polymer in the tissues, by studying TPGS hydrolysis in a bio-relevant environment and by following micelles penetration with two-photon microscopy. Furthermore, TPGS role as permeation enhancer on the cornea, with possible irreversible modifications of tissue permeability, was analyzed. Results showed that TPGS micelles (approx. 13 nm in size), loaded with 5 mg/ml of cyclosporine, promoted drug retention in both the cornea and the sclera. Data demonstrated that micelles behavior strictly depends on the tissue: micelles disruption occurs in contact with the cornea, while intact micelles diffuse in the interfibrillar pores of the sclera and form a reservoir that can sustain over time drug delivery to the deeper tissues. Finally, cornea quickly restore the barrier properties after TPGS removal from the tissue, demonstrating its potential good tolerability for ocular application.
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Affiliation(s)
- Martina Ghezzi
- ADDRes Lab, Food and Drug Department, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy
| | - Ilaria Ferraboschi
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 17/A, 43124 Parma, Italy
| | - Andrea Delledonne
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 17/A, 43124 Parma, Italy
| | - Silvia Pescina
- ADDRes Lab, Food and Drug Department, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy
| | - Cristina Padula
- ADDRes Lab, Food and Drug Department, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy
| | - Patrizia Santi
- ADDRes Lab, Food and Drug Department, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy
| | - Cristina Sissa
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 17/A, 43124 Parma, Italy
| | - Francesca Terenziani
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 17/A, 43124 Parma, Italy
| | - Sara Nicoli
- ADDRes Lab, Food and Drug Department, University of Parma, Parco Area delle Scienze 27/A, 43124 Parma, Italy.
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Downie LE, Ng SM, Lindsley KB, Akpek EK. Omega-3 and omega-6 polyunsaturated fatty acids for dry eye disease. Cochrane Database Syst Rev 2019; 12:CD011016. [PMID: 31847055 PMCID: PMC6917524 DOI: 10.1002/14651858.cd011016.pub2] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Polyunsaturated fatty acid (PUFA) supplements, involving omega-3 and/or omega-6 components, have been proposed as a therapy for dry eye. Omega-3 PUFAs exist in both short- (alpha-linolenic acid [ALA]) and long-chain (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) forms, which largely derive from certain plant- and marine-based foods respectively. Omega-6 PUFAs are present in some vegetable oils, meats, and other animal products. OBJECTIVES To assess the effects of omega-3 and omega-6 polyunsaturated fatty acid (PUFA) supplements on dry eye signs and symptoms. SEARCH METHODS CENTRAL, Medline, Embase, two other databases and three trial registries were searched in February 2018, together with reference checking. A top-up search was conducted in October 2019, but the results have not yet been incorporated. SELECTION CRITERIA We included randomized controlled trials (RCTs) involving dry eye participants, in which omega-3 and/or omega-6 supplements were compared with a placebo/control supplement, artificial tears, or no treatment. We included head-to-head trials comparing different forms or doses of PUFAs. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methods and assessed the certainty of the evidence using GRADE. MAIN RESULTS We included 34 RCTs, involving 4314 adult participants from 13 countries with dry eye of variable severity and etiology. Follow-up ranged from one to 12 months. Nine (26.5%) studies had published protocols and/or were registered. Over half of studies had high risk of bias in one or more domains. Long-chain omega-3 (EPA and DHA) versus placebo or no treatment (10 RCTs) We found low certainty evidence that there may be little to no reduction in dry eye symptoms with long-chain omega-3 versus placebo (four studies, 677 participants; mean difference [MD] -2.47, 95% confidence interval [CI] -5.14 to 0.19 units). We found moderate certainty evidence for a probable benefit of long-chain omega-3 supplements in increasing aqueous tear production relative to placebo (six studies, 1704 participants; MD 0.68, 95% CI 0.26 to 1.09 mm/5 min using the Schirmer test), although we did not judge this difference to be clinically meaningful. We found low certainty evidence for a possible reduction in tear osmolarity (one study, 54 participants; MD -17.71, 95% CI -28.07 to -7.35 mOsmol/L). Heterogeneity was too substantial to pool data on tear break-up time (TBUT) and adverse effects. Combined omega-3 and omega-6 versus placebo (four RCTs) For symptoms (low certainty) and ocular surface staining (moderate certainty), data from the four included trials could not be meta-analyzed, and thus effects on these outcomes were unclear. For the Schirmer test, we found moderate certainty evidence that there was no intergroup difference (four studies, 455 participants; MD: 0.66, 95% CI -0.45 to 1.77 mm/5 min). There was moderate certainty for a probable improvement in TBUT with the PUFA intervention relative to placebo (four studies, 455 participants; MD 0.55, 95% CI 0.04 to 1.07 seconds). Effects on tear osmolarity and adverse events were unclear, with data only available from a single small study for each outcome. Omega-3 plus conventional therapy versus conventional therapy alone (two RCTs) For omega-3 plus conventional therapy versus conventional therapy alone, we found low certainty evidence suggesting an intergroup difference in symptoms favoring the omega-3 group (two studies, 70 participants; MD -7.16, 95% CI -13.97 to -0.34 OSDI units). Data could not be combined for all other outcomes. Long-chain omega-3 (EPA and DHA) versus omega-6 (five RCTs) For long-chain omega-3 versus omega-6 supplementation, we found moderate certainty evidence for a probable improvement in dry eye symptoms (two studies, 130 participants; MD -11.88, 95% CI -18.85 to -4.92 OSDI units). Meta-analysis was not possible for outcomes relating to ocular surface staining, Schirmer test or TBUT. We found low certainty evidence for a potential improvement in tear osmolarity (one study, 105 participants; MD -11.10, 95% CI -12.15 to -10.05 mOsmol/L). There was low level certainty regarding any potential effect on gastrointestinal side effects (two studies, 91 participants; RR 2.34, 95% CI 0.35 to 15.54). AUTHORS' CONCLUSIONS Overall, the findings in this review suggest a possible role for long-chain omega-3 supplementation in managing dry eye disease, although the evidence is uncertain and inconsistent. A core outcome set would work toward improving the consistency of reporting and the capacity to synthesize evidence.
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Affiliation(s)
- Laura E Downie
- The University of MelbourneDepartment of Optometry and Vision SciencesLevel 4, Alice Hoy BuildingMelbourneVictoriaAustralia3010
| | - Sueko M Ng
- Johns Hopkins Bloomberg School of Public HealthDepartment of Epidemiology615 N. Wolfe Street, W5010c/o Cochrane Eyes and Vision GroupBaltimoreMarylandUSA21205
| | | | - Esen K Akpek
- Johns Hopkins University School of MedicineWilmer Eye Institute600 N. Wolfe Street, Maumenee #317BaltimoreMarylandUSA21287
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Larmo P, Järvinen R, Laihia J, Löyttyniemi E, Maavirta L, Yang B, Kallio H, Sandberg-Lall M. Effects of a sea buckthorn oil spray emulsion on dry eye. Cont Lens Anterior Eye 2018; 42:428-433. [PMID: 30497904 DOI: 10.1016/j.clae.2018.11.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 11/14/2018] [Accepted: 11/15/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the effects of a sea buckthorn oil and sodium hyaluronate-containing eyelid spray emulsion (SB spray) on dry eye. METHODS A randomized controlled study was carried out. Adults (25-70 years) with Ocular Surface Disease Index (OSDI) ≥20 and moderate or severe dryness, burning or grittiness of the eyes were included. In study part one (n = 2), SB spray was used on both closed eyelids four times in one day. In part two (n = 10), SB spray was used on one randomized eyelid, and a commercial reference spray on the other for nine days. In part three (n = 40), eyes were randomized to one eye receiving SB spray and an untreated control for 1.5 months. Dry eye tests were carried out at baseline, during, and at the end of each study section. Symptoms were recorded in questionnaires and daily logs. RESULTS In part one, the SB spray was well tolerated. In part two, OSDI decreased significantly (P = 0.022) in the SB spray eye compared to the reference spray, indicating a beneficial effect on symptoms. In part three, OSDI in the SB spray eye decreased significantly compared to the untreated control (P = 0.0007). The scores for dryness at the study end were lower in the SB spray eye compared to control (P = 0.0070). Symptom sums and frequencies of dryness (sum P = 0.0046, frequency P = 0.0016) and watering (sum P = 0.0003, frequency P = 0.013) in the daily logs were lower in the eye treated with SB spray. CONCLUSIONS SB spray on closed eyelids relieved the symptoms of dry eye.
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Affiliation(s)
| | | | | | | | | | - Baoru Yang
- Food Chemistry and Food Development, Department of Biochemistry, University of Turku, Finland
| | - Heikki Kallio
- Food Chemistry and Food Development, Department of Biochemistry, University of Turku, Finland
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Geerling G, Baudouin C, Aragona P, Rolando M, Boboridis KG, Benítez-Del-Castillo JM, Akova YA, Merayo-Lloves J, Labetoulle M, Steinhoff M, Messmer EM. Emerging strategies for the diagnosis and treatment of meibomian gland dysfunction: Proceedings of the OCEAN group meeting. Ocul Surf 2017; 15:179-192. [PMID: 28132878 DOI: 10.1016/j.jtos.2017.01.006] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 01/20/2017] [Accepted: 01/23/2017] [Indexed: 01/01/2023]
Abstract
Meibomian gland dysfunction (MGD) is a common and chronic disorder that has a significant adverse impact on patients' quality of life. It is a leading cause of evaporative dry eye disease (DED), as meibomian glands play an important role in providing lipids to the tear film, which helps to retard the evaporation of tears from the ocular surface. MGD is also often present in conjunction with primary aqueous-deficient DED. Obstructive MGD, the most commonly observed type of MGD, is the main focus of this article. MGD is probably caused by a combination of separate conditions: primary obstructive hyperkeratinization of the meibomian gland, abnormal meibomian gland secretion, eyelid inflammation, corneal inflammation and damage, microbiological changes, and DED. Furthermore, skin diseases such as rosacea may play a part in its pathology. Accurate diagnosis is challenging, as it is difficult to differentiate between ocular surface diseases, but is crucial when choosing treatment options. Ocular imaging has advanced in recent years, providing ophthalmologists with a better understanding of ocular diseases. This review presents a literature update on the 2011 MGD workshop and an optimized approach to accurate diagnosis of MGD using currently available methods and tests. It also outlines the emerging technologies of interferometry, non-contact meibography, keratography and in vivo confocal laser microscopy, which offer exciting possibilities for the future. Selected treatment options for MGD are also discussed.
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Affiliation(s)
- Gerd Geerling
- Department of Ophthalmology, University Hospital Duesseldorf, Heinrich-Heine University, Duesseldorf, Germany.
| | - Christophe Baudouin
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, University Paris-Saclay, Paris, France.
| | - Pasquale Aragona
- Institute of Ophthalmology, Department of Biomedical Sciences, University of Messina, Messina, Italy
| | | | - Kostas G Boboridis
- Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Yonca A Akova
- Department of Ophthalmology, Bayındır Hospital, Ankara, Turkey
| | - Jesús Merayo-Lloves
- Instituto Universitario Fernández-Vega, University of Oviedo, Asturias, Spain
| | - Marc Labetoulle
- Service d'Ophtalmologie, CHU Bicêtre, APHP, Université Paris-Sud, Le Kremlin-Bicêtre, Paris, France
| | - Martin Steinhoff
- Department of Dermatology and UCD Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland
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Bae HW, Kim JH, Kim S, Kim M, Lee N, Hong S, Seong GJ, Kim CY. Effect of Korean Red Ginseng supplementation on dry eye syndrome in glaucoma patients - A randomized, double-blind, placebo-controlled study. J Ginseng Res 2014; 39:7-13. [PMID: 25535471 PMCID: PMC4268561 DOI: 10.1016/j.jgr.2014.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 07/16/2014] [Accepted: 07/16/2014] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Many patients with glaucoma have difficulty using antiglaucoma eye drops because of dry eye symptom. In this prospective, randomized, double-blind, placebo-controlled study, we evaluated the effect of Korean Red Ginseng on dry eye syndrome in patients with glaucoma treated with antiglaucoma eye drops. METHODS Forty-nine participants were allocated to the Korean Red Ginseng (3 g/day; n = 24) or placebo (n = 25) groups for 8 weeks. Tear film stability, fluorescein corneal staining, conjunctival hyperemia, tear production, grade of meibomian gland dysfunction, and dry eye questionnaire (Ocular Surface Disease Index) were evaluated at baseline and on completion of the treatment. RESULTS Almost all patients displayed dry eye symptoms and signs at baseline. After the 8-week intervention, Korean Red Ginseng supplementation significantly improved the tear film stability and total Ocular Surface Disease Index score, as compared to placebo (p < 0.01). CONCLUSION Korean Red Ginseng supplementation may provide an additional treatment option for dry eye and patients with glaucoma using antiglaucoma eye drops.
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Affiliation(s)
- Hyoung Won Bae
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | | | - Sangah Kim
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Minkyo Kim
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Naeun Lee
- Department of Ophthalmology, Hallym Hospital, Incheon, Korea
| | - Samin Hong
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Gong Je Seong
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Chan Yun Kim
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
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Jalbert I. Diet, nutraceuticals and the tear film. Exp Eye Res 2013; 117:138-46. [DOI: 10.1016/j.exer.2013.08.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Revised: 08/21/2013] [Accepted: 08/23/2013] [Indexed: 01/26/2023]
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Brignole-Baudouin F, Baudouin C, Aragona P, Rolando M, Labetoulle M, Pisella PJ, Barabino S, Siou-Mermet R, Creuzot-Garcher C. A multicentre, double-masked, randomized, controlled trial assessing the effect of oral supplementation of omega-3 and omega-6 fatty acids on a conjunctival inflammatory marker in dry eye patients. Acta Ophthalmol 2011; 89:e591-7. [PMID: 21834921 DOI: 10.1111/j.1755-3768.2011.02196.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To determine whether oral supplementation with omega-3 and omega-6 fatty acids can reduce conjunctival epithelium expression of the inflammatory marker human leucocyte antigen-DR (HLA-DR) in patients with dry eye syndrome (DES). METHODS This 3-month, double-masked, parallel-group, controlled study was conducted in nine centres, in France and Italy. Eligible adult patients with mild to moderate DES were randomized to receive a placebo containing medium-chain triglycerides or treatment supplement containing omega-3 and omega-6 fatty acids, vitamins and zinc. Treatment regimen was three capsules daily. Impression cytology (IC) was performed at baseline and at month 3 to assess the percentage of cells expressing HLA-DR and to evaluate fluorescence intensity, an alternate measure of HLA-DR. Dry eye symptoms and objective signs were also evaluated. Analyses were performed on the full analysis set (FAS) and per-protocol set (PPS). RESULTS In total, 138 patients were randomized; 121 patients with available IC were included in the FAS, and of these, 106 patients had no major protocol deviations (PPS). In the PPS, there was a significant reduction in the percentage of HLA-DR-positive cells in the fatty acids group (p = 0.021). Expression of HLA-DR as measured by fluorescence intensity quantification was also significantly reduced in the fatty acids group [FAS (p = 0.041); PPS (p = 0.017)]. No significant difference was found for the signs and symptoms, but there was a tendency for improvement in patients receiving the fatty acids treatment. CONCLUSION This study demonstrates that supplementation with omega-3 and omega-6 fatty acids can reduce expression of HLA-DR conjunctival inflammatory marker and may help improve DES symptoms.
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Polyunsaturated fatty acids induce modification in the lipid composition and the prostaglandin production of the conjunctival epithelium cells. Graefes Arch Clin Exp Ophthalmol 2011; 250:211-22. [DOI: 10.1007/s00417-011-1801-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Revised: 07/08/2011] [Accepted: 08/04/2011] [Indexed: 10/17/2022] Open
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Scientific Opinion on the substantiation of health claims related to linoleic acid (LA) in combination with gamma-linolenic acid (GLA) and reduction of ocular dryness (ID 4274) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA J 2011. [DOI: 10.2903/j.efsa.2011.2230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Die Bedeutung ungesättigter Fettsäuren für das Trockene Auge. SPEKTRUM DER AUGENHEILKUNDE 2011. [DOI: 10.1007/s00717-011-0469-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Larmo PS, Järvinen RL, Setälä NL, Yang B, Viitanen MH, Engblom JRK, Tahvonen RL, Kallio HP. Oral sea buckthorn oil attenuates tear film osmolarity and symptoms in individuals with dry eye. J Nutr 2010; 140:1462-8. [PMID: 20554904 DOI: 10.3945/jn.109.118901] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Dry eye is a common condition that can severely impair the quality of life. We aimed to find out whether oral sea buckthorn (SB) oil, containing (n-3) and (n-6) fatty acids and antioxidants, affects dry eye. In this double-blind, randomized, parallel trial, 20- to 75-y-old women and men experiencing dry eye symptoms consumed 2 g of SB or placebo oil daily for 3 mo from fall to winter. One hundred participants were recruited and 86 completed the study. Clinical dry eye tests and symptom follow-ups were performed. Tear film hyperosmolarity is a focal factor in dry eye. There was a general increase in the osmolarity from baseline to the end of the intervention. Compared with the placebo group, the increase was significantly less in the SB group when all participants were included [intention to treat (ITT), P = 0.04] and when only participants consuming the study products for at least 80% of the intervention days were included [per protocol (PP), P = 0.02]. The maximum intensities of redness and burning tended to be lower in the SB group. In the ITT participants, the group difference was significant for redness (P = 0.04) but not for burning (P = 0.05). In the PP participants, the group difference was significant for burning (P = 0.04) but not for redness (P = 0.11). In conclusion, SB oil attenuated the increase in tear film osmolarity during the cold season and positively affected the dry eye symptoms.
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Affiliation(s)
- Petra S Larmo
- Department of Biochemistry and Food Chemistry, University of Turku, Turku, Finland
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Viau S, Maire MA, Pasquis B, Grégoire S, Acar N, Bron AM, Bretillon L, Creuzot-Garcher CP, Joffre C. Efficacy of a 2-month dietary supplementation with polyunsaturated fatty acids in dry eye induced by scopolamine in a rat model. Graefes Arch Clin Exp Ophthalmol 2009; 247:1039-50. [DOI: 10.1007/s00417-009-1080-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2008] [Revised: 03/12/2009] [Accepted: 04/06/2009] [Indexed: 12/20/2022] Open
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Querques G, Russo V, Barone A, Iaculli C, Delle Noci N. [Efficacy of omega-6 essential fatty acid treatment before and after photorefractive keratectomy]. J Fr Ophtalmol 2008; 31:282-6. [PMID: 18404122 DOI: 10.1016/s0181-5512(08)74806-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE Following PRK, a regression or the appearance of haze is often observed. This type of problem may be caused by an anomalous response by the stroma, probably mediated by keratocytes. Controlling keratocyte apoptosis therefore affects the outcome and stability of PRK. Inhibiting the transmission of the apoptosis signal from the damaged corneal epithelium to the keratocytes attenuates cell activation. This can be achieved by using a systemic product that will control the release of the mediators of the inflammation and stimulate tear production. The aim of this prospective, randomized study was to test the effects of a supplement containing omega-6 fatty acids (linoleic and (-linolenic acid), (-carotene, group B vitamins and trace elements (copper, zinc), when administered both before and after PRK. METHODS Eighty subjects undergoing PRK were randomly divided into two groups. The group treated with omega-6 fatty acids included 18 females and 22 males, with a mean age of 32 years; the control group comprised 20 females and 20 males (mean age, 30 years). Statistical evaluation of the results was carried out on Schirmer test and fluorescein staining values and the state of the epithelium. RESULTS In the Schirmer tests, a comparison between the two groups of patients who underwent surgery (groups 1 and 2) showed a statistically significant difference after 7, 15, and 30 days' treatment in favor of the group treated with omega-6 fatty acids. The values relating to the fluorescein staining test and the state of the epithelium showed a statistically significant difference in favor of the group treated with omega-6 fatty acids. CONCLUSION These results confirm the real advantages of using omega-6 essential fatty acids to optimize and stabilize the outcome of PRK.
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Affiliation(s)
- G Querques
- Service d'Ophtalmologie, Policlinico Riuniti di Foggia, Université de Foggia, Foggia, Italie.
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Kokke KH, Morris JA, Lawrenson JG. Oral omega-6 essential fatty acid treatment in contact lens associated dry eye. Cont Lens Anterior Eye 2008; 31:141-6; quiz 170. [PMID: 18313350 DOI: 10.1016/j.clae.2007.12.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2007] [Revised: 11/09/2007] [Accepted: 12/31/2007] [Indexed: 11/17/2022]
Abstract
PURPOSE Symptoms of dry eye are commonly reported in contact lens wearers and are a frequent cause of non-tolerance. The purpose of the present study is to evaluate the effects of oral treatment with particular omega-6 fatty acids in the form of evening primrose oil (EPO) on subjective symptoms, ocular surface signs and tear film characteristic in patients with contact lens associated dry eye. METHODS The study design was randomised, double-masked and placebo controlled. 76 female soft contact lens wearers were treated for 6 months with either EPO or placebo (olive oil). Subjects underwent three examinations (baseline, 3 and 6 months). At each examination subjects were given a questionnaire relating to lens comfort and dry eye symptoms and underwent a series of tests of tear film characteristics (tear meniscus height, break-up time), meibomian gland function (lipid layer thickness and quality) and ocular surface parameters (hyperaemia and staining). RESULTS The EPO group showed a significant improvement in the specific symptom of 'dryness' at 3 and 6 months (p<0.01) and also a significant improvement in overall lens comfort at 6 months (p<0.01). Tear meniscus height was increased in the EPO group at 6 months relative to baseline (p<0.01), although all other objective signs were unchanged. CONCLUSION This study provides evidence for a beneficial effect of particular orally administered omega-6 fatty acids in alleviating dry eye symptoms and improving overall lens comfort in patients suffering from contact lens associated dry eye.
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Creuzot C, Passemard M, Viau S, Joffre C, Pouliquen P, Elena PP, Bron A, Brignole F. Amélioration de la symptomatologie chez des patients atteints de sécheresse oculaire et traités oralement par des acides gras polyinsaturés. J Fr Ophtalmol 2006; 29:868-73. [PMID: 17075501 DOI: 10.1016/s0181-5512(06)70106-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
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.
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Affiliation(s)
- C Creuzot
- Service d'Ophtalmologie, CHU, Dijon.
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Saab BR, Pashayan N, El-Chemaly S, Sabra R. Sesame oil use in ameliorating cough in children: A randomised controlled trial. Complement Ther Med 2006; 14:92-9. [PMID: 16765847 DOI: 10.1016/j.ctim.2006.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2005] [Accepted: 03/15/2006] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To examine the role of sesame oil (SO) in reducing the frequency and severity of acute cough in children 2-12 years of age. DESIGN Double blind, placebo controlled randomised trial. SETTING Seven primary health care centres/clinics in Lebanon. A total of 107 children between the age of 2 and 12 years with cough secondary to common cold were enrolled. INTERVENTION Five milliliters of SO or placebo by mouth at bed time. OUTCOME MEASURES Cough strength and frequency as judged by parents on a four points Likert scale after giving three syrup doses over three consecutive nights. Analysis was performed on an intention to treat basis. RESULTS At day 1, the effect size for cough frequency and cough strength were +0.26 (95%CI -0.64,+0.12) and +0.15 (95%CI -0.53, +0.23), respectively. SO decreased cough symptoms more than placebo but these were not statistically significant. The effect size decreased from days 1 to 3. Cough symptoms improved over the 3 days both in SO and placebo group. No evidence of undesirable effects were noted to SO. CONCLUSION Like other over the counter antitussives, SO did not result in marked improvement in cough symptoms.
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Affiliation(s)
- Bassem-Roberto Saab
- American University of Beirut, Department of Pharmacology and Therapeutics, P.O. Box 113-6044, Beirut, Lebanon.
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Miljanović B, Trivedi KA, Dana MR, Gilbard JP, Buring JE, Schaumberg DA. Relation between dietary n-3 and n-6 fatty acids and clinically diagnosed dry eye syndrome in women. Am J Clin Nutr 2005; 82:887-93. [PMID: 16210721 PMCID: PMC1360504 DOI: 10.1093/ajcn/82.4.887] [Citation(s) in RCA: 191] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
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.
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Affiliation(s)
- Biljana Miljanović
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA 02215, USA
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