PDF(Pubmed)
Abstract：
To explore the efficacy of omega-3 fatty acids (FAs) on patients suffering from dry eye disease (DED), a complex inflammatory condition, we reviewed data from PubMed, Embase, ClinicalTrials.gov, Web of Science, and Cochrane CENTRAL in the past 10 years (2013 to 2023). These sources provided randomized clinical trials (RCTs) that examined the efficacy of omega-3 FAs on DED patients with accessible pre- and post-intervention data, excluding trials with overlapping participants, without omega-3 supplementation, or those lacking placebo control or quantitative assessments. Two independent reviewers extracted data related to dry eye symptom scores, tear break-up time (TBUT), Schirmer\'s tests, osmolarity, and corneal fluorescein staining (CFS), and the results were analyzed by Comprehensive Meta-Analysis software version 4. We incorporated 19 related RCTs assessed by the Cochrane Risk of Bias tool, encompassing 4246 DED patients with various etiologies. Patients given omega-3 treatment demonstrated more significant improvements in dry eye symptoms (Hedges\' g = -1.047; p < 0.001), TBUT [standardized mean difference (SMD) = -0.939; p < 0.001], scores from the Schirmer test (SMD = -0.372; p < 0.001), CFS (SMD = -0.299; p = 0.037), and osmolarity (SMD = -0.721; p < 0.001) compared to those on a placebo regimen. In the meta-regression analysis of DED symptoms, the daily dose of omega-3 (coefficient = -0.0005, p = 0.002), duration of omega-3 intake (coefficient = -0.1399, p = 0.021), and percentage of eicosapentaenoic acid (EPA) (coefficient = -0.0154, p < 0.001) exhibited a significant positive correlation with a reduction in dry eye symptom scores. Apart from CFS, similar trends were noted in TBUT, Schirmer tests, and osmolarity scores. Based on the evidence, omega-3 FAs effectively reduce DED symptoms, especially in high doses, for a long duration, and with increased EPA levels. However, given the heterogeneity in study results and diverse patient characteristics, caution is needed in generalizing these findings. In conclusion, omega-3 FA supplementation is still recommended for DED management in clinical settings.
摘要：
探讨ω-3脂肪酸(FAs)对干眼症(DED)患者的疗效,复杂的炎症,我们回顾了PubMed的数据,Embase,ClinicalTrials.gov,WebofScience,和科克伦中央在过去10年(2013年至2023年)。这些来源提供了随机临床试验（RCTs），检查了omega-3FA对DED患者的疗效，并提供了干预前后的数据。排除有重叠参与者的试验，没有补充omega-3，或缺乏安慰剂对照或定量评估的人。两名独立的评审员提取了与干眼症状评分相关的数据，泪液破裂时间(TBUT),Schirmer的测试,渗透压,和角膜荧光素染色（CFS），结果采用综合Meta分析软件4版进行分析。我们纳入了由Cochrane偏差风险工具评估的19项相关RCT，包括4246名患有各种病因的DED患者。给予omega-3治疗的患者在干眼症状方面表现出更显著的改善(Hedges\'g=-1.047;p<0.001),TBUT[标准化平均差（SMD）=-0.939；p<0.001]，Schirmer测验得分（SMD=-0.372；p<0.001），CFS（SMD=-0.299；p=0.037），和渗透压（SMD=-0.721;p<0.001）与安慰剂方案相比。在DED症状的荟萃回归分析中，omega-3的每日剂量（系数=-0.0005，p=0.002），ω-3摄入量的持续时间(系数=-0.1399，p=0.021)，二十碳五烯酸（EPA）的百分比（系数=-0.0154，p<0.001）与干眼症状评分的降低呈显着正相关。除了CFS，在TBUT中也注意到了类似的趋势，Schirmer测试,和渗透压分数。根据证据,omega-3FAs可有效减轻DED症状，尤其是在高剂量下，很长一段时间，随着EPA水平的提高。然而,鉴于研究结果的异质性和不同的患者特征，在推广这些发现时需要谨慎。总之,Omega-3FA补充剂仍然推荐用于临床环境中的DED管理。
