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Guo B, Gopinath B, Watson S, Burlutsky G, Mitchell P, Ooi K. Associations between intake of dietary micro- and macro-nutrients with Dry eye syndrome: Blue Mountains Eye Study. Clin Nutr ESPEN 2023; 54:258-263. [PMID: 36963871 DOI: 10.1016/j.clnesp.2023.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 11/30/2022] [Accepted: 01/17/2023] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND AIMS To report on the relationship between dietary intakes of a broad range of macronutrients and micronutrients, including antioxidants and fatty acids, with the presence of dry eye symptoms. METHODS Population-based cross-sectional study of 1952 urban Sydney residents aged 60 years or greater. Participants completed a validated semi-quantitative 145-item food frequency questionnaire and a dry eye questionnaire. RESULTS A total of 1528 responses were recorded (78.3%) of which 902 (59.0%) were female. 53.8% of participants reported at least one dry eye symptom, more commonly by women (58.2%) compared to men (47.3%). Participants in the highest (8.11 mcg/day) versus lowest quartile of intake of dietary B12 had reduced likelihood of reporting more than 2 dry eye symptoms and 1 or more moderate-severe dry eye symptoms: OR 0.64 (95% CI: 0.41-1.00) and OR 0.63 (95% CI: 0.41-0.97), respectively. Higher dietary intakes of vitamin C, thiamine (vitamin B1), polyunsaturated fats and calcium, were all associated with a reduced likelihood of participants reporting more than 2 dry eye symptoms (p < 0.05 for all). CONCLUSIONS Intakes of a broad range of micro- and macro-nutrients were significantly and independently associated with reduced odds of experiencing dry eye symptoms. These data suggest that clinicians may need to consider current diet in patients presenting with dry eye symptoms.
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Affiliation(s)
- Brad Guo
- Royal Victorian Eye and Ear Hospital, Australia.
| | - Bamini Gopinath
- Macquarie University, NSW, Australia; Save Sight Institute, Discipline of Ophthalmology, Australia
| | | | - George Burlutsky
- Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Paul Mitchell
- Westmead Institute for Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Kenneth Ooi
- The University of Sydney, Sydney, New South Wales, Australia
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Donthineni PR, Shanbhag SS, Basu S. An Evidence-Based Strategic Approach to Prevention and Treatment of Dry Eye Disease, a Modern Global Epidemic. Healthcare (Basel) 2021; 9:healthcare9010089. [PMID: 33477386 PMCID: PMC7830429 DOI: 10.3390/healthcare9010089] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/02/2021] [Accepted: 01/12/2021] [Indexed: 12/03/2022] Open
Abstract
Dry eye disease (DED) is an emerging health concern causing significant visual, psychological, social, and economic impact globally. In contrast to visual rehabilitation undertaken at late stages of DED, measures instituted to prevent its onset, establishment, or progression can alter its natural course and effectively bring down the associated morbidity. This review attempts to present the available literature on preventive strategies of DED at one place, including strategies for risk assessment and mitigation, targeting a wide range of population. A literature search was conducted using PubMed and an extensive literature review on preventive strategies for DED was compiled to put forth a holistic and strategic approach for preventing DED. This can be undertaken at various stages or severity of DED directed at different tiers of the health care system. Conclusion: This review intends to put emphasis on preventive strategies being adopted as an integral part of routine clinical practice by general ophthalmologists and specialists to tackle the burden of DED and improve the quality of the lives of the patients suffering from it.
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Affiliation(s)
- Pragnya R. Donthineni
- The Cornea Institute, L V Prasad Eye Institute, Hyderabad 500034, India; (P.R.D.); (S.S.S.)
| | - Swapna S. Shanbhag
- The Cornea Institute, L V Prasad Eye Institute, Hyderabad 500034, India; (P.R.D.); (S.S.S.)
| | - Sayan Basu
- The Cornea Institute, L V Prasad Eye Institute, Hyderabad 500034, India; (P.R.D.); (S.S.S.)
- Center for Ocular Regeneration (CORE), L V Prasad Eye Institute, Hyderabad 500034, India
- Correspondence: ; Tel.: +91-040-30612555
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Drouault-Holowacz S, Bieuvelet SÉV, Burckel A, Rigal D, Dubray C, Lichon JL, Bringer P, Pilon F, Chiambaretta F. Antioxidants Intake and Dry Eye Syndrome: A Crossover, Placebo-Controlled, Randomized Trial. Eur J Ophthalmol 2018; 19:337-42. [DOI: 10.1177/112067210901900302] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | - Danièle Rigal
- CHU Clermont-Ferrand, Service d'Opthalmologie, Hôpital Gabriel
- Université Clermont 1, UFR Médecine Clermont-Ferrand
| | | | | | | | - François Pilon
- CHU Clermont-Ferrand, Service d'Opthalmologie, Hôpital Gabriel
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Nassiri N, Rodriguez Torres Y, Meyer Z, Beyer MA, Vellaichamy G, Dhaliwal AS, Chungfat N, Hwang FS. Current and emerging therapy of dry eye disease. Part A: pharmacological modalities. EXPERT REVIEW OF OPHTHALMOLOGY 2017. [DOI: 10.1080/17469899.2017.1327350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Nariman Nassiri
- Kresge Eye Institute - Department of Ophthalmology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Yasaira Rodriguez Torres
- Kresge Eye Institute - Department of Ophthalmology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Zachary Meyer
- Kresge Eye Institute - Department of Ophthalmology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Michael A. Beyer
- Kresge Eye Institute - Department of Ophthalmology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Gautham Vellaichamy
- Kresge Eye Institute - Department of Ophthalmology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Amar S. Dhaliwal
- Kresge Eye Institute - Department of Ophthalmology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Neil Chungfat
- Department of Ophthalmology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Frank S. Hwang
- Kresge Eye Institute - Department of Ophthalmology, School of Medicine, Wayne State University, Detroit, MI, USA
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Huang JY, Yeh PT, Hou YC. A randomized, double-blind, placebo-controlled study of oral antioxidant supplement therapy in patients with dry eye syndrome. Clin Ophthalmol 2016; 10:813-20. [PMID: 27274185 PMCID: PMC4869783 DOI: 10.2147/opth.s106455] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose To evaluate the efficacy of oral antioxidant supplementation in the treatment of patients with dry eye syndrome (DES). Methods A prospective, randomized, double-blinded study compared the effects of an antioxidant supplement (containing anthocyanosides, astaxanthin, vitamins A, C, and E, and several herbal extracts, including Cassiae semen and Ophiopogonis japonicus) with placebo on patients with DES. We assessed dry eye symptoms, visual acuity, Schirmer’s test, tear film breakup time, cornea and conjunctiva fluorescein staining, serum anti-SSA/anti-SSB antibodies, and the level of reactive oxygen species (ROS) in tears. The supplementation period was 8 weeks and patients were followed up every 4 weeks for 16 weeks. A linear mixed model was used to compare the groups, while within-group differences were tested by repeated-measures analysis of variance. Results Forty-three patients, 20 and 23 in treatment and placebo groups, respectively, completed the study. Liver and renal functions were normal. Diastolic blood pressure decreased in the treatment group. There were no significant differences in systolic blood pressure, dry eye symptoms, serum anti-SSA and anti-SSB, visual acuity, intraocular pressure, or fluorescein corneal staining between the groups. Tear film breakup time scores and Schirmer’s test without topical anesthesia significantly improved in the treatment group. Tear ROS level differed between the groups and decreased after treatment. Overall subjective impression revealed a significant improvement with treatment compared with placebo. Conclusion Oral antioxidant supplementations may increase tear production and improve tear film stability by reducing tear ROS. The vegetable-based antioxidant supplement used in this study is safe and can be utilized as an adjuvant therapy to conventional artificial tear therapy for patients with DES.
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Affiliation(s)
- Jehn-Yu Huang
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Po-Ting Yeh
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Chih Hou
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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Cheishvili D, Maayan C, Holzer N, Tsenter J, Lax E, Petropoulos S, Razin A. Tocotrienol Treatment in Familial Dysautonomia: Open-Label Pilot Study. J Mol Neurosci 2016; 59:382-91. [PMID: 27129499 DOI: 10.1007/s12031-016-0760-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 04/22/2016] [Indexed: 10/21/2022]
Abstract
Familial dysautonomia (FD) is an autosomal recessive congenital neuropathy, primarily presented in Ashkenazi Jews. The most common mutation in FD patients results from a single base pair substitution of an intronic splice site in the IKBKAP gene which disrupts normal mRNA splicing and leads to tissue-specific reduction of IKBKAP protein (IKAP). To date, treatment of FD patients remains preventative, symptomatic and supportive. Based on previous in vitro evidence that tocotrienols, members of the vitamin E family, upregulate transcription of the IKBKAP gene, we aimed to investigate whether a similar effects was observed in vivo. In the current study, we assessed the effects of tocotrienol treatment on FD patients' symptoms and IKBKAP expression in white blood cells. The initial daily doses of 50 or 100 mg tocotrienol, doubled after 3 months, was administered to 32 FD patients. Twenty-eight FD patients completed the 6-month study. The first 3 months of tocotrienol treatment was associated with a significant increase in IKBKAP expression level in FD patients' blood. Despite doubling the dose after the initial 3 months of treatment, IKBKAP expression level returned to baseline by the end of the 6-month treatment. Clinical improvement was noted in the reported clinical questionnaire (with regard to dizziness, bloching, sweating, number of pneumonia, cough episodes, and walking stability), however, no significant effect was observed in any clinical measurements (weight, height, oxygen saturation, blood pressure, tear production, histamine test, vibration threshold test, nerve conduction, and heart rate variability) following Tocotrienol treatment. In conclusion, tocotrienol treatment appears significantly beneficial by clinical evaluation for some FD patients in a few clinical parameters; however it was not significant by clinical measurements. This open-label study shows the complexity of effect of tocotrienol treatment on FD patients' clinical outcomes and on IKBKAP expression level compared to in vitro results. A longitudinal study with an increased sample size is required in the future to better understand tocotrienol affect on FD patients.
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Affiliation(s)
- David Cheishvili
- The Israeli Familial Dysautonomia Center at the Department of Pediatrics, Hadassah University Hospital Mount Scopus, Hebrew University-Hadassah Medical School, Jerusalem, Israel. .,Department of Rehabilitation, Hadassah University Hospital Mount Scopus, Hebrew University-Hadassah Medical School, Jerusalem, Israel. .,Department of Pharmacology & Therapeutics, McGill University Medical School, 3655 Promenade Sir William Osler, Montreal, QC, H3G 1Y6, Canada. .,Department of Developmental Biology and Cancer Research, The Hebrew University, Hadassah School of Medicine, Jerusalem, Israel.
| | - Channa Maayan
- The Israeli Familial Dysautonomia Center at the Department of Pediatrics, Hadassah University Hospital Mount Scopus, Hebrew University-Hadassah Medical School, Jerusalem, Israel.,Department of Rehabilitation, Hadassah University Hospital Mount Scopus, Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Naama Holzer
- The Israeli Familial Dysautonomia Center at the Department of Pediatrics, Hadassah University Hospital Mount Scopus, Hebrew University-Hadassah Medical School, Jerusalem, Israel.,Department of Rehabilitation, Hadassah University Hospital Mount Scopus, Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Jeanna Tsenter
- Department of Developmental Biology and Cancer Research, The Hebrew University, Hadassah School of Medicine, Jerusalem, Israel
| | - Elad Lax
- Department of Pharmacology & Therapeutics, McGill University Medical School, 3655 Promenade Sir William Osler, Montreal, QC, H3G 1Y6, Canada
| | - Sophie Petropoulos
- Department of Pharmacology & Therapeutics, McGill University Medical School, 3655 Promenade Sir William Osler, Montreal, QC, H3G 1Y6, Canada
| | - Aharon Razin
- Department of Developmental Biology and Cancer Research, The Hebrew University, Hadassah School of Medicine, Jerusalem, Israel
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Jalbert I. Diet, nutraceuticals and the tear film. Exp Eye Res 2013; 117:138-46. [DOI: 10.1016/j.exer.2013.08.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Revised: 08/21/2013] [Accepted: 08/23/2013] [Indexed: 01/26/2023]
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Saccà SC, Roszkowska AM, Izzotti A. Environmental light and endogenous antioxidants as the main determinants of non-cancer ocular diseases. Mutat Res 2013; 752:153-171. [PMID: 23337404 DOI: 10.1016/j.mrrev.2013.01.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 01/10/2013] [Accepted: 01/11/2013] [Indexed: 02/03/2023]
Abstract
The human eye is constantly exposed to sunlight and artificial lighting. Exogenous sources of reactive oxygen species (ROS) such as UV light, visible light, ionizing radiation, chemotherapeutics, and environmental toxins contribute to oxidative damage in ocular tissues. Long-term exposure to these insults places the aging eye at considerable risk for pathological consequences of oxidative stress. Furthermore, in eye tissues, mitochondria are an important endogenous source of ROS. Over time, all ocular structures, from the tear film to the retina, undergo oxidative stress, and therefore, the antioxidant defenses of each tissue assume the role of a safeguard against degenerative ocular pathologies. The ocular surface and cornea protect the other ocular tissues and are significantly exposed to oxidative stress of environmental origin. Overwhelming of antioxidant defenses in these tissues clinically manifests as pathologies including pterygium, corneal dystrophies, and endothelial Fuch's dystrophy. The crystalline lens is highly susceptible to oxidative damage in aging because its cells and their intracellular proteins are not turned over or replaced, thus providing the basis for cataractogenesis. The trabecular meshwork, which is the anterior chamber tissue devoted to aqueous humor drainage, has a particular susceptibility to mitochondrial oxidative injury that affects its endothelium and leads to an intraocular pressure increase that marks the beginning of glaucoma. Photo-oxidative stress can cause acute or chronic retinal damage. The pathogenesis of age-related macular degeneration involves oxidative stress and death of the retinal pigment epithelium followed by death of the overlying photoreceptors. Accordingly, converging evidence indicates that mutagenic mechanisms of environmental and endogenous sources play a fundamental pathogenic role in degenerative eye diseases.
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Affiliation(s)
- Sergio C Saccà
- Department of Head/Neck Pathologies, St Martino Hospital, Ophthalmology unit, Genoa, Italy
| | - Anna Maria Roszkowska
- Department of Specialized Surgery, University Hospital, Ophthalmology Unit, Messina, Italy
| | - Alberto Izzotti
- Department of Health Sciences, University of Genoa, Via A. Pastore 1, I-16132, Genoa, Italy.
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Brignole-Baudouin F, Baudouin C, Aragona P, Rolando M, Labetoulle M, Pisella PJ, Barabino S, Siou-Mermet R, Creuzot-Garcher C. A multicentre, double-masked, randomized, controlled trial assessing the effect of oral supplementation of omega-3 and omega-6 fatty acids on a conjunctival inflammatory marker in dry eye patients. Acta Ophthalmol 2011; 89:e591-7. [PMID: 21834921 DOI: 10.1111/j.1755-3768.2011.02196.x] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To determine whether oral supplementation with omega-3 and omega-6 fatty acids can reduce conjunctival epithelium expression of the inflammatory marker human leucocyte antigen-DR (HLA-DR) in patients with dry eye syndrome (DES). METHODS This 3-month, double-masked, parallel-group, controlled study was conducted in nine centres, in France and Italy. Eligible adult patients with mild to moderate DES were randomized to receive a placebo containing medium-chain triglycerides or treatment supplement containing omega-3 and omega-6 fatty acids, vitamins and zinc. Treatment regimen was three capsules daily. Impression cytology (IC) was performed at baseline and at month 3 to assess the percentage of cells expressing HLA-DR and to evaluate fluorescence intensity, an alternate measure of HLA-DR. Dry eye symptoms and objective signs were also evaluated. Analyses were performed on the full analysis set (FAS) and per-protocol set (PPS). RESULTS In total, 138 patients were randomized; 121 patients with available IC were included in the FAS, and of these, 106 patients had no major protocol deviations (PPS). In the PPS, there was a significant reduction in the percentage of HLA-DR-positive cells in the fatty acids group (p = 0.021). Expression of HLA-DR as measured by fluorescence intensity quantification was also significantly reduced in the fatty acids group [FAS (p = 0.041); PPS (p = 0.017)]. No significant difference was found for the signs and symptoms, but there was a tendency for improvement in patients receiving the fatty acids treatment. CONCLUSION This study demonstrates that supplementation with omega-3 and omega-6 fatty acids can reduce expression of HLA-DR conjunctival inflammatory marker and may help improve DES symptoms.
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Choy CKM, Cho P, Benzie IFF. Antioxidant content and ultraviolet absorption characteristics of human tears. Optom Vis Sci 2011; 88:507-11. [PMID: 21336228 DOI: 10.1097/opx.0b013e31820e9fe2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Dry eye syndrome is a common age-related disorder, and decreased antioxidant/ultraviolet (UV) radiation protection in tears may be part of the cause. This study aimed to compare the tear antioxidant content and flow rate in young and older adults. The total antioxidant content and UV absorbing properties of various commercially available ophthalmic solutions used to alleviate dry eye symptoms were also examined. METHODS Minimally stimulated tears were collected from 120 healthy Chinese adults with no ocular pathology. Two age groups were studied: 19 to 29 years (n = 58) and 50 to 75 years (n = 62). Tear samples from each subject and 13 ophthalmic solutions were analyzed for total antioxidant content (as the Ferric Reducing/Antioxidant Power value). Tear flow rates were estimated from time taken to collect a fixed volume of tear fluid. UV absorbance spectra of pooled fresh reflex tear fluid and the ophthalmic solutions were determined. RESULTS Results showed that the antioxidant content of minimally stimulated tears from older subjects (398 ± 160 μmol/l) was not significantly lower than that of younger subjects (348 ± 159 μmol/l; p = 0.0915). However, there was a significant difference in the tear flow rates between the two groups (p < 0.0001), with the younger group having three to four fold higher flow rate. None of the commercial preparations tested had detectable antioxidant content, and none showed the UV absorption characteristics of natural reflex tears. CONCLUSIONS The effect of low flow rate on the dynamic antioxidant supply to the corneal surface indicates that older subjects have poorer overall defense against photooxidative and other oxidative processes. This could predispose older persons to corneal stress and development of dry eye syndrome. The commercially available artificial tears tested lack both the antioxidant content and UV absorbing characteristics of natural tears. Artificial tears formulations that help restore natural antioxidant and UV absorbing properties to the tear film of the aging eye may help prevent or improve dry eye symptoms and promote ocular health.
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Affiliation(s)
- Camus Kar Man Choy
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong SAR, China.
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Peponis V, Papathanasiou M, Kapranou A, Magkou C, Tyligada A, Melidonis A, Drosos T, Sitaras NM. Protective role of oral antioxidant supplementation in ocular surface of diabetic patients. Br J Ophthalmol 2002; 86:1369-73. [PMID: 12446368 PMCID: PMC1771432 DOI: 10.1136/bjo.86.12.1369] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
AIM To investigate the effect of vitamin C and E supplementation in the levels of nitrite, nitric oxide (NO) related metabolite, and ocular surface parameters in diabetic patients. METHODS 50 patients with non-insulin dependent diabetes mellitus were given vitamin C (1000 mg/day) and vitamin E (400 IU/day) supplementation for 10 days. Nitrite levels in tears were measured by photometric determination before and after vitamin supplementation. Tear function parameters (Schirmer test I, BUT, ocular ferning test) and brush cytology analysis of the conjunctival epithelium were also evaluated. RESULTS Nitrite levels were found to be significantly reduced (p<0.05) after 10 days of vitamin C and E supplementation. Improved values for Schirmer test, BUT test, and ocular ferning test were also found. Goblet cell density and grading of squamous metaplasia showed a significant improvement. CONCLUSIONS Oxidative stress and free radical production are elevated in diabetes mellitus. Antioxidants, such as vitamin C and vitamin E, probably have an important role in reducing the oxidative damage produced by nitric oxide and other free radicals and improving the ocular surface milieu.
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Affiliation(s)
- V Peponis
- Department of Ophthalmology, General Hospital of Piraeus Tzaneion, Greece
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Blades KJ, Patel S, Aidoo KE. Oral antioxidant therapy for marginal dry eye. Eur J Clin Nutr 2001; 55:589-97. [PMID: 11464232 DOI: 10.1038/sj.ejcn.1601186] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2000] [Revised: 01/02/2001] [Accepted: 01/10/2001] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess the efficacy of an orally administered antioxidant dietary supplement for managing marginal dry eye. DESIGN A prospective, randomised, placebo controlled trial with cross-over. SETTING Eye Clinic, Department of Vision Sciences, Glasgow Caledonian University. SUBJECTS Forty marginal dry eye sufferers composed of 30 females and 10 males (median age 53 y; range 38-69 y). INTERVENTIONS Baseline assessments were made of tear volume sufficiency (thread test), tear quality (stability), ocular surface status (conjunctival impression cytology) and dry eye symptoms (questionnaire). Each subject was administered courses of active treatment, placebo and no treatment, in random order for 1 month each and results compared to baseline. RESULTS Tear stability and ocular surface status were significantly improved following active treatment (P<0.05). No changes from baseline were detected following administration of placebo and no treatment (P>0.05). Absolute increase in tear stability correlated with absolute change in goblet cell population density. Tear volume was not improved following any treatment period and dry eye symptom responses were subject to placebo effect. CONCLUSIONS Oral antioxidants improved both tear stability and conjunctival health, although it is not yet understood whether increased ocular surface health mediates increased tear stability or vice versa. SPONSORS This study was supported by a PhD scholarship funded by the Department of Vision Sciences, Glasgow Caledonian University, Scotland. Antioxidant supplements and placebos were kindly donated by Vitabiotics.
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Affiliation(s)
- K J Blades
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
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