Omega-3 Supplementation Helps Meibomian Gland Dysfunction

Laird Harrison

April 20, 2015

SAN DIEGO — Omega-3 fatty acid supplementation improves the signs and symptoms of meibomian gland dysfunction, a new study shows.

This study supports the potential of omega-3 fatty acids to prevent dry eye syndrome, said Arun Jain, MD, from the Post-Graduate Institute of Medical Education and Research in Chandigarh, India.

"This is the purest level 1 evidence you can see," he told Medscape Medical News. It is "very strong," Dr Jain said here at the World Cornea Congress.

The prevalence of meibomian gland dysfunction ranges from 30.3% to 63.3% and, in Asia, the prevalence is at the top of that range, he reported. The dysfunction is found in 86.0% of patients with dry eyes.

Previous research has shown that omega-3 fatty acids can reduce the symptoms of dry eye by stabilizing tear film and increasing tear secretion.

In their study, Dr Jain and his team recruited 60 patients with moderate signs and symptoms of meibomian gland dysfunction who were not being treated for the syndrome.

Because severe meibomian gland dysfunction can alter the lid margin structure, confounding efforts to assess outcomes, only patients with moderate dysfunction were included in the analysis, Dr Jain explained.

The 30 patients in the treatment group took two capsules of fish oil twice daily. The 1.2 g daily dose of omega-3 fatty acid consisted of eicosapentaenoic acid 720 mg and docosahexaenoic acid 480 mg.

The 30 patients in the placebo group took vitamin E 400 mg daily.

At baseline, scores on the Ocular Surface Disease Index, a subjective measure of the dysfunction, were similar in the two groups. On the objective measures of tear breakup time, Schirmer's test, meibum expressibility, and meibum quality, scores were also similar.

Over the study period, improvement was seen in all measures of meibomian gland dysfunction in the two groups, except the Schirmer's test, but changes were greater in the omega-3 group.

Table. Mean Change From Baseline to 12 Weeks

Measure of Dry Eye Omega-3 Group, % Placebo Group, % P Value
Tear breakup time 105.0 51.0 <.001
Ocular Surface Disease Index score 67.0 27.0 <.001
Schirmer's test –4.8 –0.2 .595
Meibum expressibility 51.8 14.4 <.001
Meibum quality 49.8 12.1 <.001


Because of careful patient selection, this study provides strong evidence that omega-3 fatty acids are effective in the treatment of meibomian gland dysfunction, said Dr Jain.

He did acknowledge a couple of study weaknesses, however. Patients knew whether they were getting the treatment or the placebo, and diet was not evaluated. "The Indian diet, especially the North Indian diet, does not have a lot of polyunsaturated fatty acids," he explained.

The study needs to be reproduced before physicians can be certain that omega-3 fatty acid supplementation will improve the symptoms of dry eye, he pointed out. Recent studies have called into question previous findings of a protective effect of omega-3 fatty acids in ischemic heart disease, he reported.

More studies are needed on the nutrient's role in dry eye syndrome, agreed session discussant Bennie Jeng, MD, from the University of Maryland in Baltimore.

"But for the size of the study, it was statistically pretty convincing," he told Medscape Medical News.

Dr Jain has disclosed no relevant financial relationships. Dr Jeng reports financial relationships with Santen Pharmaceutical, Kedrion Biopharma, and Jade Therapeutics.

World Cornea Congress (WCC) VII. Presented April 17, 2015.


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