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 People who took 3,000 milligrams of omega-3 fatty acids each day for
12 months - the highest dose ever used in a trial of fish oil -
experienced no more relief from their dry eye than a second group
that received olive oil placebo capsules.
The findings were published online by the New England Journal of
Medicine and reported at the annual meeting of the American Society
of Cataract and Refractive Surgery in Washington, D.C.
Dry eye, also known as keratoconjunctivitis sicca, is estimated to
cost the U.S. economy more than $55 billion a year in medical care
and lost productivity as people struggle to cope with the pain,
itchiness, burning, fatigue and vision problems that occur when the
surface of the eye becomes too dessicated.
"This study is significant because dry eye disease is a very common
condition especially among women and older individuals, and is
likely the most common reason to see an eye doctor," said Dr. Joann
Kang of the division of ophthalmology and visual sciences at
Montefiore Health System in New York in an email to Reuters Health.
The result "contradicts a popular and common treatment of dry eye
disease as the study did not find any significantly better outcomes
of patients treated with omega-3 fatty acids," said Kang, who was
not involved in the research.
Other treatments doctors may recommend include over-the-counter
lubricating eye drops, eyelid-cleansing regimens, tear duct plugs to
slow the drainage of the eye's natural lubricant and two
prescription drugs, including the widely-advertised Restasis
prescription drops that cost more than $500 a month. The other
prescription drop, Xiidra, carries a similar price tag.
In contrast, fish oil therapy costs roughly $30 to $150 per month.
But even the highest dose of fish oil didn't produce more relief
than placebo, according to the team from 27 sites, led by Maureen
Maguire, a professor of ophthalmology at the University of
Pennsylvania in Philadelphia.
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All of the study's participants had been dealing with moderate to
severe dry eye for at least six months, and were allowed to continue
their current treatments during the fish oil trial. Neither patients
nor their doctors knew which type of oil they were getting.
More than half the patients in both groups reported improvement in
the symptoms yet fish oil consumers didn't score significantly
higher than placebo recipients.
This illustrates that it's very difficult for clinicians to tell
whether a treatment is being beneficial, Maguire said in a telephone
interview, or whether it's random variability in the patient's
condition from one week to the next, or the patient wanting to
believe the treatment is working, that accounts for improvement.
Maguire said optometrists and ophthalmologists frequently suggest
fish oil to their dry eye patients, although "many make the
recommendation saying, 'I don't know if this will work, but you
might try it.'"
How a patient will respond to a specific treatment, Maguire noted,
"is really quite variable, which is one of the problems with this
eye condition. Some people get relief from all of the various
treatments, from lid hygiene to artificial tears, where different
formulations work for different people. It's a difficult condition
to manage."
Based on the new results, if patients are looking for relief of
their dry-eye symptoms, she said, "they may want to look at other
alternatives."
SOURCE: https://bit.ly/2HjALGF New England Journal of Medicine,
online April 13, 2018.
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