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Cited by 160Ocular Surface and Contact LensFatty Acid Research and HealthRetinal Diseases and Treatments

A Randomized, Double-Masked, Placebo-Controlled Clinical Trial of Two Forms of Omega-3 Supplements for Treating Dry Eye Disease

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Deinema, Laura A., Vingrys, Algis J., Wong, Chinn Yi, Jackson, David C., Chinnery, Holly R., Downie, Laura E.·2017·Ophthalmology
DOI 10.1016/j.ophtha.2016.09.023
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Abstract

Purpose To assess the efficacy of 2 forms of oral long-chain omega-3 (ω-3) essential fatty acid (EFA) supplements, phospholipid (krill oil) and triacylglyceride (fish oil), for treating dry eye disease (DED). Design Randomized, double-masked, placebo-controlled clinical trial. Participants This study was conducted at a single site and involved 60 participants with mild to moderate DED who were randomized (1:1:1) to 1 of 3 groups: placebo (olive oil), krill oil, or fish oil supplements. Methods Participants received 1 of the 3 interventions: placebo (olive oil 1500 mg/day), krill oil (945 mg/day eicosapentaenoic acid [EPA], + 510 mg/day docosahexaenoic acid [DHA]), or fish oil (1000 mg/day EPA + 500 mg/day DHA) for 90 days, with monthly study visits. Main outcome measures Primary outcome measures were mean change in (1) tear osmolarity and (2) DED symptoms (Ocular Surface Disease Index [OSDI] score) between days 1 and 90. Secondary outcomes included mean change in key clinical signs (tear stability, tear production, ocular surface staining, bulbar and limbal redness, tear volume, anterior blepharitis, meibomian gland capping) and tear inflammatory cytokine levels. Results In total, 54 participants completed the study. At day 90, tear osmolarity was reduced from baseline with both krill oil (mean ± standard error of the mean: -18.6±4.5 mOsmol/l; n = 18; P < 0.001) and fish oil (-19.8±3.9 mOsmol/l; n = 19; P < 0.001) supplements, compared with placebo (-1.5±4.4 mOsmol/l; n = 17). OSDI score was significantly reduced at day 90 relative to baseline in the krill oil group only, compared with placebo (-18.6±2.4 vs. -10.5±3.3; P = 0.02). At day 90, there were also relative improvements in tear breakup time and ocular bulbar redness, compared with placebo, for both forms of ω-3 EFAs. Basal tear levels of the proinflammatory cytokine interleukin 17A were significantly reduced in the krill oil group, compared with placebo, at day 90 (-27.1±10.9 vs. 46.5±30.4 pg/ml; P = 0.02). Conclusions A moderate daily dose of both forms of long-chain ω-3 EFAs, for 3 months, resulted in reduced tear osmolarity and increased tear stability in people with DED. Omega-3 EFAs in a predominantly phospholipid form (krill oil) may confer additional therapeutic benefit, with improvements in DED symptoms and lower basal tear levels of interleukin 17A, relative to placebo.

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  • Most previous randomized, placebo-controlled trials of n-3 fatty acids for dry eye disease showed significantly greater improvement in symptoms or in at least one sign in the n-3 group than in the placebo group.

    “Most of these trials showed significantly greater improvement in symptoms or in at least one of several signs of dry eye disease in the n–3 fatty acid group than in the placebo group.15,18–22,24,26”

    From n−3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease (2018) · cites this paper as [19]

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Authors
Deinema, L. A., Vingrys, A. J., Wong, C. Y., Jackson, D. C., Chinnery, H. R., & Downie, L. E.
Affiliations
The University of Melbourne (AU)
Corresponding author
Downie, Laura E.
ORCID
Venue
Ophthalmology
Publisher
Elsevier BV
Published
2017-01
Volume
124
Issue
1
Pages
43-52
ISSN
0161-6420 (ISSN-L)
DOI
10.1016/j.ophtha.2016.09.023
OpenAlex
W2547255159
Cited by
160
References
3
Citations by year
2026: 13 · 2025: 13 · 2024: 12 · 2023: 16 · 2022: 19 · 2021: 14 · 2020: 17 · 2019: 21 · 2018: 22 · 2017: 13
FWCI
15.94
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Ophthalmology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ocular Surface and Contact Lens
  • Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
Keywords
dry eye, omega-3 supplementation, krill oil, fish oil, eicosapentaenoic acid, docosahexaenoic acid, tear osmolarity, tear film break-up time, meibomian gland dysfunction, meibography
MeSH terms
Adult, Animals, Double-Blind Method, Female, Fish Oils, Humans, Male, Middle Aged, Osmolar Concentration, Phospholipids, Tears, Visual Acuity, Dry Eye Syndromes, Fatty Acids, Omega-3, Cytokines, Dietary Supplements, Euphausiacea

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