Docosahexaenoic Acid, Protectins and Dry Eye

Purpose of review o report recent data on the potential role of omega‐3 fatty acids, in particular ocosahexaenoic acid (DHA) and its derivatives, in the treatment of dry eye syndrome. Td Recent findings Dietary supplementation with polyunsaturated fatty acids (PUFAs) yields positive results in the improvement of dry eye signs and symptoms. Although several studies have shown this, evidence is still lacking as to which fatty acid or what combination constitutes the most effective treatment. Studies show that treatment with alpha‐linoleic acid reduces dry eye‐induced inflammation. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) derivatives, particularly resolvin E1 (RvE1) and neuroprotectin D1 (NPD1), appear to be responsible for DHA’s anti‐inflammatory effect. This is supported in a study where topical RvE1 resulted in decreased inflammation in a mouse dry eye model. Topical administration of pigment epithelium derived factor (PEDF) in combination with DHA accelerates the regeneration of corneal nerves after their damage during corneal surgery, promoting the eturn of sensitivity and reducing the signs of dry eye. This combined treatment also educes objective signs of dry eye, such as rose bengal staining. rr Summary No firm recommendations can be made regarding optimal dietary supplementation of essential fatty acids that benefit dry eye patients. Based on animal data and preliminary human studies, DHA and its derivatives appear to be a safe, effective topical treatment for dry eye patients. This may result from their role in the resolution of inflammation and the regeneration of damaged corneal nerves.