A randomized controlled trial of omega-3 fatty acids in dry eye syndrome
A randomized controlled trial of omega-3 fatty acids in dry eye syndrome
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DOI：
10.3980/j.issn.2222-3959.2013.06.13
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发表时间：
2013-12-18
影响因子：
1.4
通讯作者：
Mishra, Anurag
中科院分区：
文献类型：
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作者：
Bhargava, Rahul;Kumar, Prachi;Mishra, Anurag
目的：评价膳食补充omega-3脂肪酸在干眼综合征中的作用。方法：在两个转诊眼科中心进行前瞻性、干预性、安慰剂对照的双盲随机试验。干眼症患者264只眼随机分为omega-3组(omega-3组)，每日2次，每次500 mg，含EPA 325 mg，DHA 175 mg，疗程3个月。Omega-3组与接受安慰剂(安慰剂组)的一组患者(n=254)进行比较。共有4次患者就诊(基线时、1个月、2个月和3个月)。每次就诊均记录矫正远视力(CDVA)、裂隙灯检查及基于问卷的症状评估和评分。症状评分0~6分为轻度干眼，6.1~12分为中度干眼，12.1~18分为重度干眼。通过泪液功能检查如泪液分泌试验、泪膜破裂时间(TBUT)、孟加拉玫瑰染色和结膜印迹细胞学检查来监测干预后的反应。结果：omega-3组和安慰剂组分别有65%和33%的患者在3个月后症状明显改善(P=0.005)。在omega-3组(p<；0.001)中，Schirmer的测试值和tbut值都有显著的变化，这两个比较。然而，与Schirmer的测试值相比，omega-3组的tbut值比安慰剂组有更大的漂移。Omega-3组和安慰剂组的平均tBUT得分分别为2.54+/-2.34和0.13+/-0.16。与安慰剂组相比，omega-3组的症状评分平均降低了2.02+/-0.96，而安慰剂组的症状评分降低了0.48+/-0.22(p<；0.001)。尽管平均得分略有增加，但Schirmer评分与症状改善没有很好的相关性。结论：omega-3脂肪酸对干眼综合征有一定的作用。这种益处似乎在眼缘炎和眉毛腺疾病等疾病中更为明显。Omega脂肪酸在泪液产生和分泌中的作用需要进一步评估。
AIM: To evaluate the role of dietary supplementation of omega-3 fatty acids in dry eye syndrome.METHODS: A prospective, interventional, placebo controlled, double blind randomized trial was done at two referral eye centers. Two hundred and sixty-four eyes of patients with dry eye were randomized to receive one capsule (500mg) two times a day containing 325mg EPA and 175mg DHA for 3 months (omega-3 group). The omega-3 group was compared to a group of patients (n=254) who received a placebo (placebo group). There were 4 patient visits (at baseline, 1 month, 2 months and 3 months). On each visit, recording of corrected distance visual acuity (CDVA), slit lamp examination and questionnaire based symptom evaluation and scoring was done. A symptomatic score of 0-6 was mild, 6.1-12 moderate and 12.1-18 severe dry eye. Response to intervention was monitored by routine tear function tests like Schirmer I test, tear film break-up time (TBUT), Rose Bengal staining and most notably, conjunctival impression cytology.RESULTS: Sixty-five percent of patients in the omega-3 group and 33% of patients in placebo group had significant improvement in symptoms at 3 months (P=0.005). There was a significant change in both Schirmer's test value and TBUT values in the omega-3 group (p < 0.001), both comparisons. However, there was a larger drift in TBUT values in omega-3 than the placebo group, in comparison to Schirmer's test values. The mean TBUT score was 2.54 +/- 2.34 in the omega-3 group and 0.13 +/- 0.16 in placebo group, respectively. The mean reduction in symptom score in omega-3 group was 2.02 +/- 0.96 as compared to 0.48 +/- 0.22 in placebo group (p < 0.001). Despite a slight increase mean score, the Schirmer scores did not correlate well with symptomatic improvement.CONCLUSION: Omega-3 fatty acids have a definite role for dry eye syndrome. The benefit seems to be more marked in conditions such as blepharitis and meibomian gland disease. The role of omega fatty acids in tear production and secretion needs further evaluation.