Dataset Information

Changes in Tear Lipid Layer Thickness and Symptoms Following the Use of Artificial Tears with and Without Omega-3 Fatty Acids: A Randomized, Double-Masked, Crossover Study.

ABSTRACT:

Purpose

To determine if an eye drop containing omega-3 fatty acids (Refresh Optive MEGA-3^®, Allergan plc, Dublin, Ireland) increases the lipid layer thickness (LLT) of the tear film versus a non-emollient eye drop (Refresh Optive, Allergan plc).

Methods

Patients (≥30 years) with baseline LLT ≤75 nm completed the Current Symptoms Survey (CSS - a visual analog survey of dry eye symptoms), and LLT was measured pre- and post-instillation (15 and 60 mins) of their randomly assigned treatment. After washout, patients were tested with the other treatment. Primary endpoint: change in LLT from baseline. Secondary endpoint: CSS results.

Results

Of 21 patients enrolled, 19 completed the study. With the omega-3-containing eye drop, the mean (standard deviation) LLT increase from baseline at 15 mins was statistically significant in the overall field (8.8 [11.5] nm; P<0.001), and in each individual zone (superior, central, and inferior). At 1 hr, the LLT change from baseline was statistically significant overall (4.4 [9.7] nm; P<0.02) and in the inferior and central zones. With the aqueous eye drop, LLT change from baseline was only significant at 15 mins in the inferior field. The CSS analysis revealed a ≥8.68-unit decrease in mean average dryness score from baseline at 15 and 60 mins post-instillation of the lipid-based treatment (P≤0.03).

Conclusion

The eye drop containing omega-3 fatty acids increased LLT at 15 mins, maintaining it at 1 hr post-instillation. Dryness symptoms also improved and maintained improved levels 1 hr after instillation, indicating that the product may benefit symptomatic patients with evaporative dry eye.

SUBMITTER: Fogt JS

PROVIDER: S-EPMC6930022 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Changes in Tear Lipid Layer Thickness and Symptoms Following the Use of Artificial Tears with and Without Omega-3 Fatty Acids: A Randomized, Double-Masked, Crossover Study.

Fogt Jennifer S JS Fogt Nick N King-Smith P Ewen PE Liu Haixia H Barr Joseph T JT

Clinical ophthalmology (Auckland, N.Z.) 20191220

<h4>Purpose</h4>To determine if an eye drop containing omega-3 fatty acids (Refresh Optive MEGA-3<sup>®</sup>, Allergan plc, Dublin, Ireland) increases the lipid layer thickness (LLT) of the tear film versus a non-emollient eye drop (Refresh Optive, Allergan plc).<h4>Methods</h4>Patients (≥30 years) with baseline LLT ≤75 nm completed the Current Symptoms Survey (CSS - a visual analog survey of dry eye symptoms), and LLT was measured pre- and post-instillation (15 and 60 mins) of their randomly a ...[more]

PMID: 31908411

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Project description:While cardiovascular and mood benefits of dietary omega-3 fatty acids such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are manifest, direct neurophysiological evidence of their effects on cortical activity is still limited. Hence we chose to examine the effects of two proprietary fish oil products with different EPA:DHA ratios (EPA-rich, high EPA:DHA; DHA-rich) on mental processing speed and visual evoked brain activity. We proposed that nonlinear multifocal visual evoked potentials (mfVEP) would be sensitive to any alteration of the neural function induced by omega-3 fatty acid supplementation, because the higher order kernel responses directly measure the degree of recovery of the neural system as a function of time following stimulation. Twenty-two healthy participants aged 18-34, with no known neurological or psychiatric disorder and not currently taking any nutritional supplementation, were recruited. A double-blind, crossover design was utilized, including a 30-day washout period, between two 30-day supplementation periods of the EPA-rich and DHA-rich diets (with order of diet randomized). Psychophysical choice reaction times and multi-focal nonlinear visual evoked potential (VEP) testing were performed at baseline (No Diet), and after each supplementation period. Following the EPA-rich supplementation, for stimulation at high luminance contrast, a significant reduction in the amplitude of the first slice of the second order VEP kernel response, previously related to activation in the magnocellular pathway, was observed. The correlations between the amplitude changes of short latency second and first order components were significantly different for the two supplementations. Significantly faster choice reaction times were observed psychophysically (compared with baseline performance) under the EPA-rich (but not DHA-rich) supplementation, while simple reaction times were not affected. The reduced nonlinearities observed under the EPA-rich diet suggest a mechanism involving more efficient neural recovery of magnocellular-like visual responses following cortical activation.

Project description:PurposeTo determine the likelihood of and risk factors for tear progression among patients with a symptomatic partial or full-thickness rotator cuff tears (RCTs) who return with continued shoulder pain and obtain subsequent magnetic resonance imaging (MRI) and to identify various patient factors and MRI findings associated with rotator cuff tear progression.MethodsWe performed a retrospective review of MRI studies from Veteran's Affair patients with conservatively treated partial- or full-thickness rotator cuff tears. Patient characteristics and demographics were obtained via chart review. Tear characteristics were measured on MRI obtained a minimum of 1 year apart. We defined progression as either (1) an increase from a partial to a full-thickness tear or (2) an increase in tear width or retraction of at least 5 mm. Statistical analysis using χ2, Fisher exact, Student t, and Mann-Whitney U test was then performed as appropriate, looking for factors involved in RCT progression.ResultsWe evaluated 412 MRI studies from 206 Veteran's Affair patients with conservatively treated partial- or full-thickness rotator cuff tears from October 1999 to March 2020. Overall, 61% of RCTs had progressed at a mean of 3.2 ± 2.3 years follow-up. Among all patients, 74% of full-thickness tears progressed in size, 42% of partial-thickness tears progressed in size, and 29% of partial-thickness tears progressed to full-thickness tears. On univariate analysis, full-thickness tears (P < .001), disruption of the anterior rotator cuff cable (P = .001), subscapularis involvement (P = .004), tear retraction (P < .001), and tear width (P < .001) all increased the likelihood of progression. On multivariate analysis, full-thickness tears (P < .001) and subscapularis involvement (P = .045) were correlated with progression.ConclusionsRCTs progress over time in terms of size of tear and from partial- to full-thickness tears. There is an increased risk of tear progression in patients with full-thickness tears when compared with partial-thickness tears along with subscapularis tear involvement. Rates of progression are larger than previously reported rates for both partial- and full-thickness tears, noting that our study population were those patients who continued to be symptomatic from their tears.Level of evidenceLevel IV, prognostic case series.

Dataset Information

Changes in Tear Lipid Layer Thickness and Symptoms Following the Use of Artificial Tears with and Without Omega-3 Fatty Acids: A Randomized, Double-Masked, Crossover Study.

Purpose

Methods

Results

Conclusion

Publications

Changes in Tear Lipid Layer Thickness and Symptoms Following the Use of Artificial Tears with and Without Omega-3 Fatty Acids: A Randomized, Double-Masked, Crossover Study.

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