O'Byrne Ciara, O'Keeffe Michael
Medical Retina Department, Moorfields Eye Hospital, London, UK.
Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
Acta Ophthalmol. 2022 Sep 22. doi: 10.1111/aos.15255.
The purpose of this study was to examine the effectiveness of omega-3 fatty acids in comparison to a placebo in the management of dry eye disease.
A systematic literature search was performed including randomised controlled trials (RCTs) comparing omega-3 versus placebo in the management of dry eye disease in human subjects. There were no language or time restrictions. Eligible trials were assessed for bias and assigned a risk-of-bias score. Data extraction was carried out using a standardised data extraction form, and meta-analysis was performed using a random effects model for continuous data. The outcome measures were Ocular Surface Disease Index (OSDI) scores, tear breakup time (TBUT) measurements, corneal staining and Schirmer's score. Statistical heterogeneity was defined as substantial if the I test achieved a value >60%.
Eight parallel RCTs including 1107 subjects met eligibility criteria. None of the included studies achieved low risk of bias. Data synthesis demonstrated an improvement in the mean change in OSDI score from baseline to final assessment. Omega-3 supplementation conferred no evident improvement in corneal staining, TBUT or Schirmer's score. There was considerable statistical heterogeneity in all four outcome measures.
This updated systematic review and meta-analysis indicates that omega-3 supplementation improves subjective symptoms in patients with dry eye disease.
本研究旨在比较ω-3脂肪酸与安慰剂在治疗干眼症方面的有效性。
进行了一项系统的文献检索，纳入了比较ω-3脂肪酸与安慰剂治疗人类干眼症的随机对照试验（RCT）。没有语言或时间限制。对符合条件的试验进行偏倚评估，并赋予偏倚风险评分。使用标准化的数据提取表进行数据提取，并对连续数据采用随机效应模型进行荟萃分析。结局指标包括眼表疾病指数（OSDI）评分、泪膜破裂时间（TBUT）测量、角膜染色和泪液分泌试验评分。如果I²检验值>60%，则定义为存在显著的统计异质性。
八项平行RCT（共1107名受试者）符合纳入标准。所有纳入研究均未达到低偏倚风险。数据综合分析显示，从基线到最终评估，OSDI评分的平均变化有所改善。补充ω-3脂肪酸在角膜染色、TBUT或泪液分泌试验评分方面未显示出明显改善。所有四项结局指标均存在相当大的统计异质性。
这项更新的系统评价和荟萃分析表明，补充ω-3脂肪酸可改善干眼症患者的主观症状。
