Re-Esterified Triglyceride ω-3 Fatty Acids in Dry Eye Disease With Meibomian Gland Dysfunction

Author:

Eom Youngsub12,Jun Ikhyun34,Jeon Hyun Sun56,Lim Dong Hui7,Lee Hun8,Hwang Ho Sik9,Chung So-Hyang10,Chung Tae-Young7,Kim Jae Yong8,Kim Sun Woong11,Choi Chul Young12,Song Jong Suk113,Kim Mee Kum514,Seo Kyoung Yul3,Hyon Joon Young56

Affiliation:

1. Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea

2. Department of Ophthalmology, Korea University Ansan Hospital, Ansan, Republic of Korea

3. The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Republic of Korea

4. Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea

5. Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea

6. Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea

7. Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

8. Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

9. Department of Ophthalmology, Yeouido St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

10. Department of Ophthalmology, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

11. Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea

12. Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

13. Department of Ophthalmology, Korea University Guro Hospital, Seoul, Republic of Korea

14. Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Republic of Korea

Abstract

ImportanceTaking ω-3 supplements has been associated with a reduction in symptoms of dry eye disease (DED) associated with meibomian gland dysfunction (MGD). However, a recent relatively large clinical trial concluded that treating DED with ω-3 consumption was ineffective, potentially warranting additional investigations.ObjectivesTo investigate the effect of re-esterified triglyceride (rTG) ω-3 fatty acid supplementation on DED associated with MGD.Design, Setting, and ParticipantsThis double-masked, parallel-group, randomized clinical trial was conducted at 7 institutions from September 2020 to January 2023. Patients with DED associated with MGD were included and randomly assigned to the ω-3 group (received 1680 mg of eicosapentaenoic acid and 560 mg of docosahexaenoic acid), whereas those in the grape-seed group received 3000 mg of grape-seed oil daily.InterventionsrTG ω-3 Fatty acid supplementation vs grape-seed oil.Main Outcome MeasuresThe primary end point was the Ocular Surface Disease Index (OSDI) from baseline to 6 and 12 weeks. The safety parameters were visual acuity and intraocular pressure change.ResultsA total of 132 patients (mean [SD] age, 50.6 [13.8] years; 103 female [78.0%]) were included in this study. The mean (SD) baseline OSDI scores of the ω-3 and grape-seed groups were 43.5 (16.5) and 44.1 (16.6), respectively. A total of 58 patients (87.9%) and 57 patients (86.4%) in the ω-3 and grape-seed groups, respectively, completed 12 weeks of follow-up. There were no differences in compliance with the dietary supplement intake between groups (ω-3, 95.8% and grape-seed, 95.4%). The OSDI (SD) change from baseline to 6 and 12 weeks was −20.5 (16.0) and −22.7 (15.7), respectively, in the ω-3 group and −15.1 (20.2) and −18.8 (21.7), respectively, in the grape-seed control group (difference at 6 weeks = −5.4; 95% CI, −12.15 to 1.33; P = .12 and at 12 weeks = −3.9; 95% CI, −10.90 to 3.13; P = .28). There were no changes in safety parameters or adverse events related to taking the dietary supplement in either group.Conclusions and RelevanceThis randomized clinical trial did not show a benefit of the rTG form of ω-3 for ameliorating symptoms of DED associated with MGD, although fewer than 60 participants were evaluated in each group. Any secondary outcomes from this study should be considered for hypothesis generation of future evaluations of the effect of the rTG form of ω-3 on DED associated with MGD.Trial RegistrationCRIS Identifier: KCT0004927

Publisher

American Medical Association (AMA)

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