Abstract
Purpose:
The incidence of self-reported dry eye disease (DED) has been linked to low omega-3 fatty acid consumption and high omega-6:omega-3 fatty acid ratios. Meibomian gland dysfunction (MGD) and its association with omega fatty acid intake, however, is currently unknown. A cross-sectional, clinical study on postmenopausal women was conducted to evaluate the relationship between omega fatty acid consumption and clinically confirmed cases of both DED and MGD.
Methods:
Four hundred thirty-nine postmenopausal women (≥ 50 years of age) whose last menstrual periods were twelve months prior to enrollment were examined. All subjects answered research-validated dry eye questions, underwent a comprehensive ocular surface evaluation, and completed the Vio Food Frequency Questionnaire (Princeton, NJ) to estimate their dietary intake of omega-3 (n-3) and omega-6 (n-6) fatty acids. Subjects were categorized into two binary classifications based upon (1) whether they were symptomatic for dry eye (DED vs non-DED) and (2) whether they had clinically confirmed MGD as determined by the MGD Workshop diagnostic algorithm (MGD vs non-MGD). Mean intake of dietary fatty acids were compared between groups with two-sample t-tests. Logistic regression models were used to estimate the odds ratios and 95% CIs associated with n-3 intake, n-6 intake, and n-6:n-3 ratio.
Results:
For DED vs non-DED, there were no statistically significant differences in mean n-3 intake (1.95 ± 1.31 g vs 1.87 ± 1.25, p=0.54), n-6 intake (15.28 ± 9.24 g vs 15.32 ± 11.55, p=0.97), and n-6:n-3 ratio (8.27 ± 2.67 vs 8.36 ± 2.81, p=0.71). For MGD vs non-MGD, there were no statistically significant differences in mean n-3 intake (1.97 ± 1.15 vs 1.90 ± 1.30, p=0.63), n-6 intake (15.27 ± 9.47 vs 15.31 ± 10.69, p=0.98), and n-6:n-3 ratio (7.93 ± 2.21 vs 8.39 ± 2.82, p=0.12). Logistic regression models were used to adjust for age, race, BMI, total fat intake, presence or absence of an eye exam within 12 months, and presence or absence of other comorbidities. The odds ratios and 95% CIs for DED and MGD did not differ significantly from 1.00 among any of the quintiles for n-3 intake, n-6 intake, or n-6:n-3 ratio.
Conclusions:
Self-reported dietary consumption of omega-3 and omega-6 fatty acids conferred no increased or decreased association of clinically confirmed dry eye disease or meibomian gland dysfunction in this large sample of postmenopausal women.