Cochrane · systematic review · CD011016
Omega‐3 and omega‐6 polyunsaturated fatty acids for dry eye disease
Downie, LE, Ng, SM, Lindsley, KB, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
Eyes and VisionAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
24
current version
GRADE rated
19
No studies
5
Included studies
NR
No studies 5 · 20.8%Ungraded 0 · 0%Very low 0 · 0%Low 14 · 58.3%Moderate 5 · 20.8%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Oral long‐chain omega‐3 PUFAs (ie, EPA and DHA) versus placebo or no treatment
Population: people with dry eyea
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in dry eye symptoms, measured using the OSDI score (ranging from 0 to 100 units, with a reduction in scores indicating clinical improvement) at 1‐month (with actual Oral long‐chain omega‐3 PUFAs (ie, EPA and DHA) vs placebo or no treatment | no estimate extracted | 7 studies · 1785 participants | Low |
Change in ocular surface staining at 1‐month (with actual Oral long‐chain omega‐3 PUFAs (ie, EPA and DHA) vs placebo or no treatment | MD 0.1 | 4 studies · 681 participants | Low |
Change in Schirmer test (aqueous tear production, measured in mm/5 min, with higher scores indicating more tear production) at 1‐month (with actual Oral long‐chain omega‐3 PUFAs (ie, EPA and DHA) vs placebo or no treatment | MD 0.68 | 7 studies · 1730 participants | Moderate |
Change in tear film stability, measured using tear break‐up time (TBUT) with fluorescein (in seconds, with higher scores indicating greater tear film stability) at 1‐month (with actual Oral long‐chain omega‐3 PUFAs (ie, EPA and DHA) vs placebo or no treatment | no estimate extracted | 5 studies · 1640 participants | Low |
Change in tear osmolarity (measured in mOsmol/L, with reductions in osmolarity indicating clinical improvement) at 1‐month (with actual Oral long‐chain omega‐3 PUFAs (ie, EPA and DHA) vs placebo or no treatment | no estimate extracted | 1 study · 54 participants | Low |
Adverse event: gastrointestinal disorders at 1‐month (with actual Oral long‐chain omega‐3 PUFAs (ie, EPA and DHA) vs placebo or no treatment | no estimate extracted | 3 studies · 719 participants | Low |
Combined oral omega‐3 and omega‐6 PUFAs versus placebo
Population: people with dry eyea
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptoms of dry eye at 1‐month (with actual Combined oral omega‐3 and omega‐6 PUFAs vs placebo | no estimate extracted | 4 studies · 4 participants | Low |
Ocular surface staining at 1‐month (with actual Combined oral omega‐3 and omega‐6 PUFAs vs placebo | no estimate extracted | 3 studies · 3 participants | Moderate |
Schirmer test (aqueous tear production, measured in mm/5 min, with higher scores indicating more tear production) at 1‐month (with actual Combined oral omega‐3 and omega‐6 PUFAs vs placebo | MD 0.66 | 4 studies · 455 participants | Moderate |
Change in tear film stability, measured using tear break‐up time (TBUT) with fluorescein (in seconds, with higher scores indicating greater tear film stability) at 1‐month (with actual Combined oral omega‐3 and omega‐6 PUFAs vs placebo | MD 0.55 | 4 studies · 455 participants | Moderate |
Change in tear osmolarity (measured in mOsmol/L, with reductions in osmolarity indicating clinical improvement) at 1‐month (with actual Combined oral omega‐3 and omega‐6 PUFAs vs placebo | no estimate extracted | 1 study · 83 participants | Low |
Adverse event: gastrointestinal disorders at 1‐month (with actual Combined oral omega‐3 and omega‐6 PUFAs vs placebo | no estimate extracted | 1 study · 138 participants | Low |
Oral omega‐3 PUFAs plus conventional therapy versus conventional therapy alone
Population: people with dry eyea
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dry eye symptoms, measured using the OSDI score (ranging from 0 to 100 units, with a reduction in scores indicating clinical improvement) at 1‐month (with actual Oral omega‐3 PUFAs plus conventional therapy vs conventional therapy alone | no estimate extracted | 2 studies · 70 participants | Low |
Change in ocular surface staining at 1‐month Oral omega‐3 PUFAs plus conventional therapy vs conventional therapy alone | no estimate extracted | NR | No studies |
Change in Schirmer test (aqueous tear production, measured in mm/5 min) at 1‐month of Oral omega‐3 PUFAs plus conventional therapy vs conventional therapy alone | no estimate extracted | NR | No studies |
Change in tear film stability, measured using tear break‐up time (TBUT) with fluorescein (in seconds) at 1‐month Oral omega‐3 PUFAs plus conventional therapy vs conventional therapy alone | no estimate extracted | NR | No studies |
Change in tear osmolarity (measured in mOsmol/L, with reductions in osmolarity indicating clinical improvement) at 1‐month Oral omega‐3 PUFAs plus conventional therapy vs conventional therapy alone | no estimate extracted | NR | No studies |
Adverse events at 1‐month Oral omega‐3 PUFAs plus conventional therapy vs conventional therapy alone | no estimate extracted | NR | No studies |
Oral long‐chain omega‐3 PUFAs versus oral omega‐6 PUFAs
Population: people with dry eyea
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in dry eye symptoms, measured using the OSDI score (ranging from 0 to 100 units, with a reduction in score indicating clinical improvement) at 1‐month (with actual Oral long‐chain omega‐3 PUFAs vs oral omega‐6 PUFAs | no estimate extracted | 4 studies · 1144 participants | Moderate |
Change in ocular surface staining at 1‐month Oral long‐chain omega‐3 PUFAs vs oral omega‐6 PUFAs | no estimate extracted | 4 studies · 709 participants | Low |
Change in Schirmer test (aqueous tear production, measured in mm/5 min, with higher scores indicating more tear production) at 1‐month (with actual Oral long‐chain omega‐3 PUFAs vs oral omega‐6 PUFAs | MD 2.6 | 5 studies · 1205 participants | Low |
Change in tear film stability, measured using tear break‐up time (TBUT) with fluorescein (in seconds, with higher scores indicating greater tear film stability) at 1‐month (with actual Oral long‐chain omega‐3 PUFAs vs oral omega‐6 PUFAs | no estimate extracted | 5 studies · 1205 participants | Low |
Change in tear osmolarity (measured in mOsmol/L, with reductions in osmolarity indicating clinical improvement) at 1‐month (with actual Oral long‐chain omega‐3 PUFAs vs oral omega‐6 PUFAs | no estimate extracted | 1 study · 105 participants | Low |
Adverse event: gastrointestinal disorders at 1‐month (with actual Oral long‐chain omega‐3 PUFAs vs oral omega‐6 PUFAs | RR 2.34 | 2 studies · 91 participants | Low |