Cornea Dietary supplements may help against dry eye

Catherine Creuzot-Garcher

Pippa Wysong At three and six months, patients “Thus dry eye is a risk factor or even prostaglandins.With conjunctival in Fort Lauderdale underwent evaluations for dry eye irritation better to say, it is a predictor for AMD. For inflammation being typical in dry eye, symptoms, irritation inflammatory signs, and AMD it’s very important that we know risk researchers launched a small, pilot study to POLYUNSATURATED fatty acids (PUFAs) tear production - including Schirmer’s tests factors so we can start treatment much investigate whether dietary omega-3 and may be useful for treating the symptoms of and tear break-up time (BUT). Findings earlier.AMD is an incurable disease. In the omega-6 fatty acids would be effective in dry eye, according to two pilot studies showed the patients had significant best cases you can stop the progression, but dry-eye patients. presented at the annual meeting of ARVO. improvement in dry eye irritation symptoms, improvement may be very slight or nothing,” Seventy patients presenting with mild to While some research has suggested inflammatory signs and the frequency of Dr Feher said. moderate dry eye were randomly assigned PUFAs can play a protective role against age- topical treatment use. Schirmer’s test to receive either a PUFA supplement (brand related macular degeneration (AMD), there improved with a borderline statistical Possible aetiological link name, Nutrilarm) or placebo pills twice a day is now increasing evidence that they may significance, while improvement in BUT was for six months. Evaluations were done at protect against dry eye as well, according to The connection between the two conditions not significant. one, three and six months using Schirmer, Janos Feher MD PhD, and his co-workers may lie within the ocular sensory nervous BUT, fluorescein and lissamine green staining. from the University of Rome (Italy) and from system. Some basic research suggests that Impression cytology was periodically the Semmelweis University of Budapest specific stimulation of parts of this system performed to evaluate specific antigens. (Hungary). “For AMD it’s very trigger the release of pro-inflammatory Prostaglandin levels in the tears were also In fact, previous research from his own compounds. measured. Patients were also asked about centre where AMD patients were treated important that we know “Now we know that both AMD and dry subjective dry eye symptoms at each visit to with a combination of omega-3 fatty acids, eye have a very strong inflammatory the clinic. acetyl-L-carnitine (ALC) and coenzyme Q10 risk factors so we can component,” Dr Feher said. Researchers reported that over the six- (CoQ10) (brand name Phototrop®) showed This goes against the traditional model, month period, there were mild that patients had a beneficial side effect – an start treatment much which categorises AMD as a degenerative improvements in Schirmer’s testing, BUT, improvement in dry-eye symptoms among disease – which could still be true. However, fluorescein and lissamine green staining in patients who had dry-eye complaints at earlier. AMD is an “all the degenerative diseases have a strong the treatment group, but none were baseline. inflammatory component. So the connection incurable disease. In the statistically significant.There was a similar, “So, we wanted to see what was behind between the dry eye and the AMD is the small trend in the measures of this observation,” he told EuroTimes in an inflammation, and it’s the inflammation that I best cases you can stop prostaglandins. Subjective reports of dry-eye interview. think has a neurogenic, rather than symptoms had slightly higher improvements, immunogenic, origin,” he said. the progression, but and were almost of statistical significance, Benefit in non-randomised trial “We suppose that this combination of the researchers reported. omega 3, CoQ10 and ALC improves He conducted a non-randomised, improvement may be very “This double-masked, pilot study shows mitochondrial metabolism thus restoring observational trial to evaluate the effect of that PUFAs seem an interesting tool to normal Ca2+ homeostasis, i.e., sensitivity of these three compounds combined in an oral slight or nothing” alleviate the symptoms related to dry-eye the affected neuronal cells. Specifically, those supplement in elderly patients who had mild syndrome.These results should be of the photoreceptor-RPE cells in AMD and to moderate dry eye.A total of 44 newly confirmed using a larger study population,” of the corneal sensory nerves in dry eye,” diagnosed dry eye patients between the ages The researchers reported that after the researchers concluded. he concluded. of 45 to 89 years were enrolled.They vitamin A palmitate was added, both received topical artificial tears as well as a Schirmer’s and BUT improved significantly [email protected] Results of randomised trial more daily supplement containing omega-3 fatty compared to baseline values. [email protected] equivocal acids,ALC and CoQ10 for three months. It is already known that there is a co- After three months, the subjects were morbidity between AMD and dry eye. There A second study, done by researchers in divided into two age-matched groups: one tends to be a decrease in tear production as France, also suggests PUFAs may be of use in that continued the treatment unchanged, people age, although not everyone develops treating dry eye. Catherine Creuzot-Garcher while the second received an additional oral a clinically meaningful dry eye. However, dry MD, PhD and colleagues at the University supplement consisting of vitamin A palmitate. eye symptoms in AMD patients can start Hospital in Dijon, France thought PUFAs Patients continued another three months in about 10 years before their retinal disease might be of use since they are known to be the study. becomes clinically detectable. involved in inflammatory pathways via

7TH EURETINA CONGRESS

MONTE CARLO 17 – 20 MAY 2007

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