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Cong Y, Zhang Y, Han Y, Wu Y, Wang D, Zhang B. Recommendations for nutritional supplements for dry eye disease: current advances. Front Pharmacol 2024; 15:1388787. [PMID: 38873421 PMCID: PMC11169594 DOI: 10.3389/fphar.2024.1388787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/17/2024] [Indexed: 06/15/2024] Open
Abstract
Dry eye disease (DED) represents a prevalent ocular surface disease. The development of effective nutritional management strategies for DED is crucial due to its association with various factors such as inflammation, oxidative stress, deficiencies in polyunsaturated fatty acids (PUFAs), imbalanced PUFA ratios, and vitamin insufficiencies. Extensive research has explored the impact of oral nutritional supplements, varying in composition and dosage, on the symptoms of DED. The main components of these supplements include fish oils (Omega-3 fatty acids), vitamins, trace elements, and phytochemical extracts. Beyond these well-known nutrients, it is necessary to explore whether novel nutrients might contribute to more effective DED management. This review provides a comprehensive update on the therapeutic potential of nutrients and presents new perspectives for combination supplements in DED treatment.
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Affiliation(s)
| | | | | | | | | | - Bingjie Zhang
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, China
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Sánchez-González JM, Rocha-de-Lossada C, Cerviño A. Exploring the Cutting Edge of Vision Science: New Developments in Diagnostics and Treatment of Ocular Surface in Dry Eye Disease. Life (Basel) 2023; 13:1584. [PMID: 37511959 PMCID: PMC10381868 DOI: 10.3390/life13071584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
The ocular surface refers to the outermost layer of the eye, which includes the cornea, conjunctiva and eyelids [...].
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Affiliation(s)
| | - Carlos Rocha-de-Lossada
- Qvision, Ophthalmology Department, VITHAS Almeria Hospital, 04120 Almeria, Spain
- Ophthalmology Department, VITHAS Malaga, 29016 Malaga, Spain
- Regional University Hospital of Malaga, Hospital Civil Square, 29009 Malaga, Spain
- Surgery Department, Ophthalmology Area, University of Seville, Doctor Fedriani, 41009 Seville, Spain
| | - Alejandro Cerviño
- Department of Optics & Optometry & Vision Sciences, University of Valencia, 46010 Valencia, Spain
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Park SH, Hwang JS, Shin YJ. Effect of multivitamin drug on intractable dry eye symptoms. Front Med (Lausanne) 2022; 9:978107. [PMID: 36148465 PMCID: PMC9486468 DOI: 10.3389/fmed.2022.978107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 07/25/2022] [Indexed: 11/29/2022] Open
Abstract
Dry eye is a disorder of tear film and ocular surface characterized by ocular discomforts. It is associated with multiple causes and sometimes intractable. We investigated the effect of oral multivitamin supplementation (MVG) on dry eyes. Tear break-up time (TBUT), fluorescein ocular surface staining score, and tear secretion Schirmer test were measured in dry eye patients refractory to conventional topical treatment. The ocular surface disease index (OSDI), visual analog pain score (VAS), and modified standardized patient evaluation of eye dryness questionnaire were analyzed. In total, 42 eyes of 42 patients were included. TBUT increased at 1 and 3 months compared to baseline (p < 0.05). OSDI decreased at 1 and 3 months compared to baseline (p < 0.05). VAS score, impact on life, and frequency of total symptoms decreased at 3 months compared to baseline (p < 0.05). Oral administration of MVG, a vitamin complex formulation, was effective in stabilizing tear stability and alleviating symptoms in patients with intractable dry eye. Thus, it may be a viable treatment option for intractable dry eye.
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Affiliation(s)
- Se Hie Park
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, Seoul, South Korea
| | - Jin Sun Hwang
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, Seoul, South Korea
- Hallym BioEyeTech Research Center, Hallym University College of Medicine, Seoul, South Korea
| | - Young Joo Shin
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, Seoul, South Korea
- Hallym BioEyeTech Research Center, Hallym University College of Medicine, Seoul, South Korea
- *Correspondence: Young Joo Shin,
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Sánchez-González JM, De-Hita-Cantalejo C, Sánchez-González MC. Hyaluronic Acid and Galacto-Xyloglucan Eyedrop Efficacy in Young-Adult Oral Contraceptive Users of Childbearing Age. J Clin Med 2022; 11:jcm11154458. [PMID: 35956073 PMCID: PMC9369423 DOI: 10.3390/jcm11154458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/20/2022] [Accepted: 07/27/2022] [Indexed: 01/25/2023] Open
Abstract
To assess the efficacy of 0.4% hyaluronic acid and 0.2% galacto-xyloglucan for the subjective symptoms of dry eye disease and tear film invasive and noninvasive signs in 34 young-adult oral contraceptive users of childbearing age, a prospective, longitudinal, single-blind, clinical study was performed in a population of childbearing-age oral-contraceptive consumers. Subjective dry eye disease questionnaires, and invasive and noninvasive tear film assessments were reported before and after six weeks of hyaluronic acid with galacto-xyloglucan (HA-GX) treatment versus hyaluronic acid alone (HA). HA-GX treatment resulted in a greater decrease in the ocular surface disease index (17.01 ± 11.36 score points, p < 0.01) than the HA variation (11.61 ± 11.18 score points, p < 0.01). The standard patient evaluation of eye dryness also decreased more in the HA-GX group (4.06 ± 5.50 score points, p < 0.01) than in the HA alone group (0.70 ± 3.16, p = 0.21). Regarding noninvasive break-up time (NIBUT), the HA-GX group’s first NIBUT achieved an increase of 1.75 ± 1.16 s, p < 0.01, while the HA-alone group increased by only 0.54 ± 1.01 s, p < 0.01. The HA-GX group’s mean NIBUT reported an increase of 3.72 ± 5.69 s, p < 0.01; however, the HA-alone group achieved 2.19 ± 5.26 s, p = 0.05. Hyaluronic acid in combination with galacto-xyloglucan significantly decreased subjective dry eye disease symptoms and increased first and mean NIBUT compared to hyaluronic acid alone. Galacto-xyloglucan added efficacy in young-adult childbearing-age oral contraceptive users.
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Sánchez-González MC, De-Hita-Cantalejo C, Martínez-Lara C, Sánchez-González JM. Oral isotretinoin for acne vulgaris side effects on the ocular surface: Hyaluronic acid and galacto-xyloglucan as treatment for dry eye disease signs and symptoms. Front Med (Lausanne) 2022; 9:959165. [PMID: 35935781 PMCID: PMC9353322 DOI: 10.3389/fmed.2022.959165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/06/2022] [Indexed: 11/23/2022] Open
Abstract
The purpose was to assess the efficacy of 0.4% hyaluronic acid and 0.2% galacto-xyloglucan on the subjective symptoms of dry eye disease and invasive and non-invasive tear film signs in oral isotretinoin for acne vulgaris treatment. A prospective, longitudinal, single-blind, clinical study was performed in oral isotretinoin for the acne vulgaris consumer population. Subjective dry eye disease questionnaires and invasive and non-invasive tear film assessments were reported prior to and after 6 weeks of hyaluronic acid with galacto-xyloglucan (HA-GX) treatment vs. hyaluronic acid alone (HA). Participants in the HA-GX group reported a higher decrease in the ocular surface disease index (17.01 ± 11.36 score points) compared to the variation in participants in the HA group (11.61 ± 11.18 score points). Standard patient evaluation of eye dryness also decreased more in participants in the HA-GX group (4.06 ± 5.50 score points) than in participants who received HA alone (0.70 ± 3.16). Regarding non-invasive break-up time (NIBUT), participants in the HA-GX group first NIBUT achieved an increase of 1.75 ± 1.16 s while participants in the HA-alone group demonstrated an increase of only 0.54 ± 1.01 s. The HA-GX group mean NIBUT increased by of 3.72 ± 5.69 s; however, the value for the HA-alone group was 2.19 ± 5.26 s. Hyaluronic acid in combination with galacto-xyloglucan significantly decreased limbal and bulbar conjunctival redness classification and SPEED test outcomes. The inclusion of galacto-xyloglucan also increased BUT and mean NIBUT values compared to those obtained with hyaluronic acid alone.
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Affiliation(s)
- María Carmen Sánchez-González
- Vision Sciences Research Group (CIVIUS), Department of Physics of Condensed Matter, Optics Area, Pharmacy School, University of Seville, Seville, Spain
- *Correspondence: María Carmen Sánchez-González,
| | - Concepción De-Hita-Cantalejo
- Vision Sciences Research Group (CIVIUS), Department of Physics of Condensed Matter, Optics Area, Pharmacy School, University of Seville, Seville, Spain
| | - Concepción Martínez-Lara
- Department of Nursing, University Hospital Virgen Macarena, Universidad de Sevilla, Seville, Spain
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - José-María Sánchez-González
- Vision Sciences Research Group (CIVIUS), Department of Physics of Condensed Matter, Optics Area, Pharmacy School, University of Seville, Seville, Spain
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Sánchez-González JM, De-Hita-Cantalejo C, Martínez-Lara C, Sánchez-González MC. Lipid, Aqueous and Mucin Tear Film Layer Stability and Permanence within 0.15% Liposome Crosslinked Hyaluronic Acid versus 0.15% Non-Crosslinked Hyaluronic Acid Measured with a Novel Non-Invasive Ocular Surface Analyzer. J Clin Med 2022; 11:jcm11133719. [PMID: 35807004 PMCID: PMC9267243 DOI: 10.3390/jcm11133719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/19/2022] [Accepted: 06/23/2022] [Indexed: 12/04/2022] Open
Abstract
To evaluate the stability and permanence of the liquid film created after the instillation of 0.15% crosslinked hyaluronic acid with liposomes and crocin versus the effect of 0.15% standard hyaluronic acid, a prospective, longitudinal, single-blind, single-center study was conducted in symptomatic populations with a novel noninvasive ocular surface analyzer. Limbal and bulbar redness classification, lipid layer thickness, tear meniscus height, and first and mean noninvasive break-up time (FNIBUT and MNIBUT) were performed before and 30 and 45 min after liposome-crosslinked hyaluronic acid (LCHA) and standard hyaluronic acid (HA) eye drop instillations. LCHA had a higher lipid layer thickness than HA (grades 2.00 ± 0.83 and 1.17 ± 0.63 on the Guillon pattern, respectively). LCHA achieved a better tear meniscus height than HA (0.23 ± 0.02 and 0.21 ± 0.02 mm, respectively). LCHA improved FNIBUT and MNIBUT more than HA (for FNIBUT, 6.30 ± 0.94 and 4.77 ± 0.89 s, respectively. For MNIBUT, 17.23 ± 5.11 and 12.41 ± 4.18 s, respectively). Crosslinking hyaluronic acid with liposomes and crocin significantly increases the permanence and stability of the lipid, aqueous, and mucin tear film layers. In a short-term period, liposome and crosslinked hyaluronic acid achieved better first and mean noninvasive break-up times than standard hyaluronic acid.
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Affiliation(s)
- José-María Sánchez-González
- Department of Physics of Condensed Matter, Optics Area, Vision Sciences Research Group (CIVIUS), Pharmacy School, University of Seville, 41012 Seville, Spain; (C.D.-H.-C.); (M.C.S.-G.)
- Correspondence: ; Tel.: +34-9554-20861
| | - Concepción De-Hita-Cantalejo
- Department of Physics of Condensed Matter, Optics Area, Vision Sciences Research Group (CIVIUS), Pharmacy School, University of Seville, 41012 Seville, Spain; (C.D.-H.-C.); (M.C.S.-G.)
| | - Concepción Martínez-Lara
- Department of Nursing, University Hospital Virgen Macarena, University of Seville, 41009 Seville, Spain;
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain
| | - María Carmen Sánchez-González
- Department of Physics of Condensed Matter, Optics Area, Vision Sciences Research Group (CIVIUS), Pharmacy School, University of Seville, 41012 Seville, Spain; (C.D.-H.-C.); (M.C.S.-G.)
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Abstract
Dry eye disease (DED) is a major public health problem worldwide that seriously impairs the quality of life, reduces work productivity, and poses significant economic burden. In DED, tear film instability or hyperosmolarity activates a self-perpetuating vicious cycle that may aggravate ocular surface inflammation and damage. Thus, treatment approaches should focus on interrupting this cycle and ameliorating inflammation. In addition to anti-inflammatory medications, such as corticosteroids, cyclosporine, and lifitegrast, nutrients with anti-inflammatory and anti-oxidative properties may also be effective for the treatment of DED. Evidence indicates that vitamin deficiencies may be associated with an increased risk of DED and that vitamin supplementation can be an effective treatment for DED. In the present review, we introduce the results of clinical and experimental studies on the association between vitamin deficiencies and DED. The potential efficacy of systemic and topical supplementation in the treatment of DED is also discussed.
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Sánchez-González MC, Sánchez-González JM, De-Hita-Cantalejo C. Ocular Surface Impairment After Coronavirus Disease 2019: A Cohort Study. Cornea 2022; 41:e1. [PMID: 34743090 DOI: 10.1097/ico.0000000000002819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Efficacy of hyaluronic acid 0.3%, cyanocobalamin, electrolytes, and P-Plus in menopause patients with moderate dry eye disease. Graefes Arch Clin Exp Ophthalmol 2021; 260:529-535. [PMID: 34562113 PMCID: PMC8786773 DOI: 10.1007/s00417-021-05415-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 07/08/2021] [Accepted: 09/10/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose To study the treatment efficacy of hyaluronic acid 0.3%, cyanocobalamin (vitamin B12), electrolytes, and P-Plus in menopausal patients with moderate dry eye disease. Methods Thirty female patients of mean age 53.06 ± 5.20 years (45–65) were enrolled in this prospective longitudinal study. Meibomian gland loss assessment was determined using a scale with four levels. The Ocular Surface Disease Index (OSDI) questionnaire, phenol red thread (PRT) test, and tear film break-up time (TFBUT) were also completed by the patients. Tear eye drops were formulated with 0.3 g of sodium hyaluronate, P-Plus ™, vitamin B12, sodium chloride, potassium chloride, calcium chloride, magnesium chloride, and SCO® (stabilized complex oxychloride). After 30 days, the patients were re-evaluated. Results The mean meibomian gland loss percentage was 37.97 ± 19.02 % (7.20 to 88.30%). Before treatment, the OSDI was 22.53 ± 14.03 score points (6.25 to 77.08). Posterior OSDI decreased to 16.26 ± 13.69 score points (0.00 to 70.83) (W = 58.00, P < 0.01). Before treatment, PRT was 10.31 ± 4.48 mm (4.00 to 21.00). Posterior PRT increased to 15.41 ± 6.27 mm (4.00 to 21.00) (W = 1520.50, P < 0.01). Before treatment, TFBUT was 6.23 ± 1.75 s (3.00 to 9.00). The posterior TFBUT increased to 8.10 ± 2.06 s (4.00 to 14.00) (W= 1382.50, P < 0.01). Conclusion The hyaluronic acid 0.3% and vitamin B12 eye drops effectively decreased dry eye symptoms in menopausal women and improved tear stability and volume. ![]()
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Fogagnolo P, De Cilla’ S, Alkabes M, Sabella P, Rossetti L. A Review of Topical and Systemic Vitamin Supplementation in Ocular Surface Diseases. Nutrients 2021; 13:nu13061998. [PMID: 34200595 PMCID: PMC8228525 DOI: 10.3390/nu13061998] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/24/2021] [Accepted: 06/08/2021] [Indexed: 02/06/2023] Open
Abstract
In the homeostasis of the ocular surface, vitamins play a critical role in regulating inflammatory responses and promoting cell differentiation, development and correct function. Systemic vitamin supplementation has been available for many decades; in recent years, thanks to pharmacological advancements, topical vitamin delivery has also become available in an attempt to better treat ocular surface disease (OSD) and dry eye disease (DED). In this paper, we reviewed the current evidence on the role of vitamin supplementation in OSD and DED. We originally searched the PubMed archive, inspected the references and restricted the search to pertinent papers. The body of evidence was evaluated using the amelioration of both signs and symptoms as the outcome, when available. We found that in patients with vitamin deficiency, systemic supplementation of Vitamin A is effective in treating OSD, reducing both DED signs and symptoms. Additionally, systemic supplementation of vitamin D is useful in reducing DED symptoms and increasing tear volume. Vitamin A is also effective in reducing DED signs and symptoms when administered locally. The efficacy of supplementation with other vitamins is still not fully proven. In conclusion, the inclusion of vitamins into the treatment strategies for OSD and DED allows for better treatment customization and better outcomes in these patients.
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Affiliation(s)
- Paolo Fogagnolo
- Ophthalmology Unit, Department of Health Sciences, San Paolo Hospital, Università degli Studi di Milano, 20142 Milan, Italy; (P.S.); (L.R.)
- Correspondence:
| | - Stefano De Cilla’
- Ophthalmology Unit, Ospedale Maggiore della Carita, 28100 Novara, Italy; (S.D.C.); (M.A.)
| | - Micol Alkabes
- Ophthalmology Unit, Ospedale Maggiore della Carita, 28100 Novara, Italy; (S.D.C.); (M.A.)
| | - Pierfilippo Sabella
- Ophthalmology Unit, Department of Health Sciences, San Paolo Hospital, Università degli Studi di Milano, 20142 Milan, Italy; (P.S.); (L.R.)
| | - Luca Rossetti
- Ophthalmology Unit, Department of Health Sciences, San Paolo Hospital, Università degli Studi di Milano, 20142 Milan, Italy; (P.S.); (L.R.)
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