Insights & Discussion
Polyunsaturated fatty acids treatment shows improved outcomes for patients with nonspecific typical dry eye disease, in particular as a short-term intervention.
In this research, randomized clinical trials were searched from various databases, which included Cochrane Library, EMBASE, PubMed, and Web of Science, all investigating the impact of polyunsaturated fatty acids (PUFAs) on patients with nonspecific typical dry eye disease. The trials were conducted until March 2019. A total of thirteen eligible clinical trials with 1782 patients were eventually included. Specific data points such as tear breakup time, Schirmer's test, osmolarity, and ocular surface disease index were extracted by two independent reviewers. A pairwise meta-analysis was undertaken using means and standard deviations under a random-effects model for various outcomes.
This research demonstrated that patients who received treatment solely with PUFAs showed significant improvements in specific observations such as tear breakup time, Schirmer's test scores, osmolarity, and ocular surface disease index when compared with patients who only received a placebo. However, it was noted that the positive effects of PUFAs on tear breakup time and ocular surface disease index scores decreased as the duration of treatment increased. Despite this, PUFAs were found to be effective for treating nonspecific typical dry eye disease, especially as a short-term treatment option and displayed few adverse events. The study therefore concluded that PUFA supplements could be beneficial to patients with nonspecific typical dry eye disease who are not using other types of eye medication concurrently.
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The review reveals that nutritional supplements, particularly fish oils, vitamins, trace elements, and phytochemical extracts, show promising therapeutic potential for Dry Eye Disease management.
2024 Frontiers in Pharmacology Recommendations for nutritional supplements for dry eye disease: current advances Cong Y, Zhang Y, Han Y, Wu Y, Wang D, Zhang B
Systematic Review Dry Eye Omega-3 Fatty Acids
The methodology used in the research paper mainly focuses on evaluating different oral nutritional supplements with varied compositions and dosages, in order to assess their impact on Dry Eye Disease symptoms. These supplements include key components like fish oils, vitamins, trace elements, and extracts from plants, recognized for their potential nutritional value. Emphasizing the role of nutrition in combating ocular surface diseases, the research also emphasizes the imbalance caused by deficiencies in polyunsaturated fatty acids and vitamin insufficiencies, which can lead to ocular issues such as inflammation and oxidative stress.
The results discussion outlines considerable benefits of using these supplements, not only for managing Dry Eye Disease symptoms but also potentially for overall ocular health. It was observed that nutrients in these supplements hold promising therapeutic qualities, presenting new perspectives for supplement combinations in Dry Eye Disease treatment. Beyond the well-known nutrients, it was suggested that exploring novel nutrients could help establish even more effective management strategies for Dry Eye Disease.
Chrysanthemum has several active ingredients that can potentially treat dry eye by inhibiting inflammation-related factors and pathways, thus reducing inflammation of lacrimal gland tissue.
2023 TMR Pharmacology Research A network pharmacology-based investigation of the mechanism of action of chrysanthemum in treating dry eye Cao LY, Long Q, Jiang PF, Peng J, Peng QH
Network Pharmacology Chrysanthemum Dry Eye
The study used network pharmacology methods and various databases to further analyze the mechanism of Chrysanthemum in treating dry eye. First, the TCMSP was used to screen for candidate active ingredient molecules of chrysanthemum showcasing requisite oral bioavailability and drug similarity. The active ingredients of chrysanthemum were then identified, followed by target prediction. Cytoscape was used to construct a compound-target network for chrysanthemum. The Online Mendelian Inheritance in Man and DisGeNET databases were utilized to pinpoint pathogenic genes associated with dry eye, and the STRING database produced an interaction network and bar graph to scrutinize protein interactions. Using Venny, a final drug-active ingredient-key target-disease network was created.
The study found that Chrysanthemum has eighty active ingredients corresponding to targets for treating dry eye. These key functional targets primarily regulate gene expression, oxidative stress, immune response, apoptosis, proliferation, regulation of cellular inflammation-related factors, and angiogenesis. The primary pathways associated with these key targets include interleukin signaling, metabolism, cytokine signaling in the immune system, immune system, and signal transduction, thereby improving the condition of dry eye primarily through the inhibition of inflammation-related factors.
Omega-3 fatty acid supplements can effectively alleviate symptoms of dry eye disease, especially when consumed in high doses for a long term and with high eicosapentaenoic acid levels.
2023 Journal of Clinical Medicine Efficacy of Omega-3 Intake in Managing Dry Eye Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Wang WX, Ko ML
Meta-Analysis Dry Eye Eicosapentaenoic Acid Omega-3 Fatty Acids
The methodology of this study involved an intensive review of data from multiple reliable sources like PubMed, Embase, and others covering the timespan from 2013 to 2023. The focus was on randomized clinical trials that studied the impact of omega-3 fatty acids on patients with dry eye disease and provided accessible pre- and post-intervention data. Studies with overlapping participants were excluded, as were studies without omega-3 supplementation or not featuring a placebo control or quantitative assessments. Independent reviewers extracted data pertaining to dry eye symptom scores and other related metrics.
The results showed that patients who were administered omega-3 treatment demonstrated considerable improvement in symptoms of dry eye disease compared to those on a placebo treatment. The meta-regression analysis deduced positive correlations between the daily dose of omega-3, duration of omega-3 intake, and percentage of eicosapentaenoic acid, with a reduction in dry eye symptom scores. Similar trends were observed with other dry eye related metrics. These findings provide substantial evidence on the beneficial effect of omega-3 fatty acid supplements in managing dry eye disease. However, due to the diversity in patient characteristics and the heterogeneity in study results, care should be taken in widely applying these findings.
Traditional Chinese medicine (TCM) can effectively treat dry eye disease (DED), and combining TCM with Western medicine can significantly enhance therapeutic effects and reduce treatment costs.
2021 Tzu Chi Medical Journal Retrospective evaluation of the curative effect of traditional Chinese medicine on dry eye disease Yang CC, Su SH, Ho TJ
Systematic Review Dry Eye
The researchers carried out a comprehensive review of studies conducted from 2001 to 2020, focusing on the use of Traditional Chinese Medicine (TCM) and an integration of Chinese and Western medicine for the treatment of DED. Four categories of Chinese medicines were identified for their application in treating DED: anti-oxidants, anti-inflammatory agents, hormone-like agents, and cell-repairing agents. In addition, they also acknowledged the usage of compound herbs like Chi-Ju-Di-Huang-Wan and Qiming granule for alleviating dry eye symptoms.
The researchers arrived at significant findings from their examination of multiple studies. The use of Traditional Chinese Medicine (TCM) has shown effective results in the treatment of Dry Eye Disease (DED). Moreover, the integration of TCM with Western medicine has amplified the therapeutic effects in patients while making the treatment cost-effective. This suggests that not only can TCM be a promising approach for treating DED, but a combined treatment strategy with Western medicine can also lead to substantial improvements in curing the condition.
A botanical formula of lutein ester, zeaxanthin, and extracts from blackcurrant, chrysanthemum, and goji berry can effectively lessen eye fatigue and improve macular function.
2020 The American Journal of Clinical Nutrition A novel botanical formula improves eye fatigue and dry eye: a randomized, double-blind, placebo-controlled study Kan J, Wang M, Liu Y, Liu H, Chen L, Zhang X, et al.
Randomised Controlled Trial Blackcurrant Chrysanthemum Dry Eye
Research methodology involved the distribution of 360 randomly selected participants into four groups where they received placebos and three varied doses of a botanical formula. This formula, given in chewable tablets comprised of 6 mg, 10 mg, or 14 mg of lutein. Each participant was administered these once daily over a period of 90 days, and had three check-ins at the beginning, at day 45, and finally on day 90 of the study.
The results of the study indicated that the botanical formula effectively improved the individual scores of participants on eye fatigue symptoms like eye soreness, blurred vision, dry eyes, foreign body sensation, and tearing. Using the formula resulted in a notable decrease in the total score of eye fatigue symptoms at both the 45-day and 90-day intervals as compared to the placebo while also significantly improving visuognosis persistence time. Tear secretion improvement was observed in the groups having 10mg and 14mg lutein formula, supported by the Schirmer test. Furthermore, the results showed an increase in macular pigment optical density with all three doses of the formula, but no significant alterations were observed in the retinal thickness and retinal volume among all the groups at both check-ins.
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