PMID- 30046817
OWN - NLM
STAT- MEDLINE
DCOM- 20190315
LR  - 20190315
IS  - 1552-5783 (Electronic)
IS  - 0146-0404 (Linking)
VI  - 59
IP  - 8
DP  - 2018 Jul 2
TI  - Modulating Contact Lens Discomfort With Anti-Inflammatory Approaches: A
      Randomized Controlled Trial.
PG  - 3755-3766
LID - 10.1167/iovs.18-24758 [doi]
AB  - Purpose: To assess the efficacy of anti-inflammatory approaches, comprising a
      topical corticosteroid and omega-3 supplements, for modulating the inflammatory
      overlay associated with contact lens discomfort (CLD). Methods: This randomized
      controlled trial involved 72 adults with CLD, randomized (1:1:1:1) to one of the 
      following: placebo (oral olive oil), oral fish oil (900 mg/d eicosapentaenoic
      acid [EPA] + 600 mg/d docosohexaenoic acid [DHA]), oral combined fish+flaxseed
      oils (900 mg/d EPA + 600 mg/d DHA + 900 mg/d alpha-linolenic acid), or omega-3
      eye-drops (0.025% EPA + 0.0025% DHA four times per day [qid]) for 12 weeks, with 
      visits at baseline, weeks 4 and 12. At week 12, participants who received placebo
      were assigned a low-potency corticosteroid (fluorometholone [FML] 0.1%, drops,
      three times per day [tid]) for 2 weeks (week 14). Results: Sixty-five
      participants completed the primary endpoint. At week 12, contact lens dry-eye
      questionnaire (CLDEQ-8) score was reduced from baseline with oral fish oil (-7.3 
      +/- 0.8 units, n = 17, P < 0.05), compared with placebo (-3.5 +/- 0.9 units, n = 
      16). FML produced significant reductions in tear IL-17A (-71.1 +/- 14.3%, n = 12)
      and IL-6 (-47.6 +/- 17.5%, n = 12, P < 0.05) relative to its baseline (week 12). 
      At week 12, tear IL-17A levels were reduced from baseline in the oral fish oil
      (-63.2 +/- 12.8%, n = 12, P < 0.05) and topical omega-3 (-76.2 +/- 10.8%, n = 10,
      P < 0.05) groups, compared with placebo (-3.8 +/- 12.7%, n = 12). Tear IL-6 was
      reduced with all omega-3 interventions, relative to placebo (P < 0.05) at week
      12. Conclusions: CLD was attenuated by oral long-chain omega-3 supplementation
      for 12 weeks. Acute (2 week) topical corticosteroids and longer-term (12 week)
      omega-3 supplementation reduced tear levels of the proinflammatory cytokines
      IL-17A and IL-6, demonstrating parallels in modulating ocular inflammation with
      these approaches.
FAU - Downie, Laura E
AU  - Downie LE
AD  - Department of Optometry and Vision Sciences, The University of Melbourne,
      Parkville, Victoria, Australia.
FAU - Gad, Anne
AU  - Gad A
AD  - Department of Optometry and Vision Sciences, The University of Melbourne,
      Parkville, Victoria, Australia.
FAU - Wong, Chinn Yi
AU  - Wong CY
AD  - Department of Microbiology and Immunology at the Peter Doherty Institute of
      Infection and Immunity, The University of Melbourne, Parkville, Victoria,
      Australia.
FAU - Gray, John Henry V
AU  - Gray JHV
AD  - Department of Microbiology and Immunology at the Peter Doherty Institute of
      Infection and Immunity, The University of Melbourne, Parkville, Victoria,
      Australia.
FAU - Zeng, Weiguang
AU  - Zeng W
AD  - Department of Microbiology and Immunology at the Peter Doherty Institute of
      Infection and Immunity, The University of Melbourne, Parkville, Victoria,
      Australia.
FAU - Jackson, David C
AU  - Jackson DC
AD  - Department of Microbiology and Immunology at the Peter Doherty Institute of
      Infection and Immunity, The University of Melbourne, Parkville, Victoria,
      Australia.
FAU - Vingrys, Algis J
AU  - Vingrys AJ
AD  - Department of Optometry and Vision Sciences, The University of Melbourne,
      Parkville, Victoria, Australia.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Invest Ophthalmol Vis Sci
JT  - Investigative ophthalmology & visual science
JID - 7703701
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Cytokines)
RN  - 0 (Glucocorticoids)
RN  - 0 (Plant Oils)
RN  - 25167-62-8 (Docosahexaenoic Acids)
SB  - IM
MH  - Administration, Topical
MH  - Adult
MH  - Anti-Inflammatory Agents/*administration & dosage
MH  - *Contact Lenses
MH  - Cytokines/metabolism
MH  - Docosahexaenoic Acids/*administration & dosage
MH  - Double-Blind Method
MH  - Dry Eye Syndromes/metabolism/*therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Glucocorticoids/*administration & dosage
MH  - Humans
MH  - Male
MH  - Plant Oils/*administration & dosage
MH  - Prospective Studies
MH  - Surveys and Questionnaires
MH  - Tears/metabolism
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2018/07/27 06:00
MHDA- 2019/03/16 06:00
CRDT- 2018/07/27 06:00
PHST- 2018/07/27 06:00 [entrez]
PHST- 2018/07/27 06:00 [pubmed]
PHST- 2019/03/16 06:00 [medline]
AID - 2695024 [pii]
AID - 10.1167/iovs.18-24758 [doi]
PST - ppublish
SO  - Invest Ophthalmol Vis Sci. 2018 Jul 2;59(8):3755-3766. doi:
      10.1167/iovs.18-24758.