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

초록

IMPORTANCE Taking omega-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 omega-3 consumption was ineffective, potentially warranting additional investigations. OBJECTIVES To investigate the effect of re-esterified triglyceride (rTG) omega-3 fatty acid supplementation on DED associated with MGD. DESIGN, SETTING, AND PARTICIPANTS This 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 omega-3 group (received1680 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. INTERVENTIONS rTG omega-3 Fatty acid supplementation vs grape-seed oil. MAIN OUTCOME MEASURES The 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 omega-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 omega-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(omega-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 omega-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 nochanges in safety parameters or adverse events related to taking the dietary supplement in either group. CONCLUSIONS AND RELEVANCE This randomized clinical trial did not show a benefit of the rTG form of omega-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 omega-3 on DED associated with MGD

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