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- Title
Re-Esterified Triglyceride ω-3 Fatty Acids in Dry Eye Disease With Meibomian Gland Dysfunction: A Randomized Clinical Trial.
- Authors
Eom, Youngsub; Jun, Ikhyun; Jeon, Hyun Sun; Lim, Dong Hui; Lee, Hun; Hwang, Ho Sik; Chung, So-Hyang; Chung, Tae-Young; Kim, Jae Yong; Kim, Sun Woong; Choi, Chul Young; Song, Jong Suk; Kim, Mee Kum; Seo, Kyoung Yul; Hyon, Joon Young
- Abstract
This randomized clinical trial investigates the efficacy of systemic re-esterified triglyceride (rTG) ω-3 fatty acids compared with grape-seed oil in the treatment of dry eye disease with meibomian gland dysfunction (MGD). Key Points: Question: Is systemic re-esterified triglyceride (rTG) ω-3 fatty acid effective in treating dry eye disease (DED) with meibomian gland dysfunction (MGD) compared with grape-seed oil? Findings: In this randomized clinical trial including 132 patients, the rTG form of ω-3 was not shown to be superior to grape-seed oil for ameliorating symptoms of DED with MGD from baseline 6 or 12 weeks, although no adverse events were noted with taking the dietary supplements. Meaning: The primary outcome results do not support potential benefits of the rTG form of ω-3 for safely ameliorating the symptoms of DED with MGD. Importance: Taking ω-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 ω-3 consumption was ineffective, potentially warranting additional investigations. Objectives: To investigate the effect of re-esterified triglyceride (rTG) ω-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 ω-3 group (received 1680 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 ω-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. Results: A 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 ω-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 ω-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 (ω-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 ω-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 no changes 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 ω-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 ω-3 on DED associated with MGD. Trial Registration: CRIS Identifier: KCT0004927
- Publication
JAMA Ophthalmology, 2024, Vol 142, Issue 7, p617
- ISSN
2168-6165
- Publication type
Article
- DOI
10.1001/jamaophthalmol.2024.1482