title: The role of omega-3 dietary supplementation in blepharitis and meibomian gland dysfunction (an AOS thesis).
abstract: OBJECTIVE
  Blepharitis and meibomian gland dysfunction (MGD) are common sources of complaints from patients. To evaluate the effect on ocular symptoms, ocular findings, and serum and meibomian gland contents, patients with blepharitis and MGD were prospectively evaluated to determine the effects of dietary supplementation with omega-3 fatty acids.
  
  
  METHODS
  In a prospective randomized placebo-controlled masked trial, patients with simple obstructive MGD and blepharitis, who had discontinued all topical medications and tetracyclines, received oral omega-3 dietary supplementation consisting of two 1000-mg capsules 3 times a day. Patients were examined every 3 months for 1 year with the Ocular Surface Disease Index (OSDI) objective clinical measures, including tear production and stability, ocular surface and meibomian gland health, and biochemical plasma, red blood cell (RBC), and meibum evaluation. Primary outcome measures were change in tear breakup time (TBUT), meibum score, and overall OSDI score at 1 year.
  
  
  RESULTS
  At 1 year, the omega-3 group had a 36% and 31% reduction in their omega-6 to omega-3 fatty acid ratios in RBCs and plasma, respectively (P = .3), whereas the placebo group demonstrated no change. At 12 months, the omega-3 group had an improvement in TBUT, OSDI score, and meibum score. Changes in meibum content were observed in the omega-3 group (P = .21); the level of meibum saturated fatty acids decreased.
  
  
  CONCLUSIONS
  This trial demonstrated a decrease in the RBC and plasma ratios of omega-6 to omega-3 in patients taking omega-3 dietary supplementation, as compared to controls, and improvements in their overall OSDI score, TBUT, and meibum score. This is the first demonstration of an induced change in the fatty acid saturation content in meibum as a result of dietary supplementation with omega-3 fatty acids.
authors.affiliation: Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors.forename: Marian S
authors.initials: MS
authors.lastname: Macsai
mesh_terms: D000284:Administration, Oral; D001762:Blepharitis / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D002214:Capsules; D004032:Diet; D015930:Diet Records; D019587:Dietary Supplements; D004311:Double-Blind Method; D004910:Erythrocyte Membrane / Q000378:metabolism; D005141:Eyelid Diseases / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000097:blood; D043371:Fatty Acids, Omega-6 / Q000097:blood; D005260:Female; D006801:Humans; D008043:Linseed Oil / Q000008:administration & dosage*; D008297:Male; D008537:Meibomian Glands / Q000187:drug effects* / Q000503:physiopathology; D008875:Middle Aged; D000069463:Olive Oil; D010938:Plant Oils / Q000008:administration & dosage; D011446:Prospective Studies; D013666:Tears / Q000737:chemistry
chemical_list: D002214:Capsules; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D000069463:Olive Oil; D010938:Plant Oils; D008043:Linseed Oil