Omega-3 Fatty Acids in the Management of Meibomian Gland Disease
Purpose
To study the effect of omega 3 fatty acids [ω-3 FAs] on Ocular Surface Disease Index [OSDI], tear film break up time [TBUT], Schirmer’s test I, meibomian gland expression [MGE], and meibum quality [MQ] in moderate meibomian gland disease [MGD].
Methods
Sixty patients [age 41 to 74 yrs] with moderate MGD were prospectively randomized into 2 groups; 30 patients in study group I and 30 patients in placebo group II [study duration July 2012 to Dec 2013]. Subjects in Group I received 1.2G ω-3 FAs [720mg of eicosapentaenoic acid [EPA] and 480mg of docosahexaenoic acid [DHA] ] and in Group II 400mg of vitamin E, daily for three months. Outcome measures [Primary: OSDI and TBUT, Secondary: Schirmer’s test I, MGE and MQ] were measured at the beginning of the study and reassessed at 3 months.
Results
In treatment group, before intervention, the mean OSDI, TBUT, Schirmer’s test I, MGE and MQ scores were 39.1±17.2, 4.9±1.8 seconds, 15.9±5.1 mm, 1.6±0.5 and 14.3±3.7, respectively, and three months later were 13.8±1.37, 10.2±0.25 seconds, 15.2±0.8 mm, 0.77±0.50, and 7.2±0.6, respectively. In placebo group these values were 33±2.1, 4.9±0.3 seconds, 15.5±1.1mm, 1.7±0.5, and 13.8±0.7 before intervention and 24.1±1.9, 7.4±0.3 seconds, 15.5±0.9 mm, 1.4±0.5, and 12.1± 0.5 after the intervention. Only Group I showed significant improvement in the OSDI, TBUT, MGE and MQ at 3 months (P values 0.01, 0.001, 0.0001, 0.0001, respectively).
Conclusion
This study demonstrated that daily oral intake of 1.2G ω-3 FAs[720mg of eicosapentaenoic acid [EPA] and 480mg of docosahexaenoic acid [DHA] is associated with significant decrease in dry eye symptoms, tear evaporation along with improved meibomian gland expressibility and meibum quality in moderate MGD.