RESUMO
Purpose: To evaluate effectiveness of omega?3 fatty acid supplements in relieving dry eye symptoms and signs in symptomatic visual display terminal users (VDT). Methods: A randomized controlled study was done; eyes of 470 VDT users were randomized to receive four capsules twice daily for 6 months (O3FAgroup), each containing 180 mg of eicosapentaenoic acid and 120 mg docosahexaenoic acid. The O3FA group was compared with another group (n = 480) who received four capsules of a placebo (olive oil) twice daily. Patients were evaluated at baseline, 1, 3, and 6 months, respectively. The primary outcome was improvement in omega?3 index (a measure of EPA and DHA ratio in RBC membrane). Secondary outcomes were improvement dry eye symptoms, Nelson grade on conjunctival impression cytology, Schirmer test values, tear film breakup time (TBUT), and tear film osmolarity. Means of groups (pre?treatment, 1, 3, and 6?months) were compared with repeated measure analysis of variance. Results: At baseline, 81% patients had low omega?3 index. In the O3FA group, a significant increase in omega?3 index, improvement in symptoms, reduction in tear film osmolarity, and increase in Schirmer, TBUT, and goblet cell density was observed. These changes were not significant in the placebo group. Improvement in test parameters was significantly (P < 0.001) better in patients with low omega3 index (<4%) subgroup. Conclusion: Dietary omega?3 fatty acids are effective for dry eye in VDT users; omega?3 index appears to be the predictor to identify potential dry eye patients who are likely to benefit from oral omega?3 dietary intervention
RESUMO
Conjunctival goblet cells are thought to be the main source of tear mucin, and it is believed that this mucin plays an important role on increasing the tear film stability and the wettability of the ocular surface. The measurement of the conjunctival goblet cell density is useful for the differential diagnosis among the various ocular surface diseases, and for the evaluation of the efficacy of the treatment. This method can be checked simply and rapidly, but the normal conjunctival goblet cell density in Korean has not been reported. We examined the goblet cell density in the 68 eyes (57 patients) of normal subjects using an impression cytological technique on the palpebral and bulbar conjunctiva. The results were as follows: 1. Normal goblet cell density was 1316.9 +/- 491.7 cells/mm2 in the inferior palpebral conjunctiva, 57.9 +/- 67.9 cells/mm2 in the superor bulbar conjunctiva. 2. There was no significant difference in goblet cell density according to sex and age ( p>0.05, t-test). 3. The goblet cell density was increased as a rise of break-up time(BUT), but was not correlated with BUT(r=0.24, 0.05). Also there was no correlation between the goblet cell density and Schirmer test value (r=-0.10, 0.09), (r=regression coefficient). It is suggested that the above findings would aid in the diagnosis of the dry eye syndrome and allow differential diagnosis among the various ocular surface diseases.