July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Anti-inflammatory approaches to treat contact lens discomfort: a randomized, controlled trial
Author Affiliations & Notes
  • Laura Elizabeth Downie
    Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
  • Anne Gad
    Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
  • Chinn Yi Wong
    Department of Microbiology and Immunology at the Peter Doherty Institute of Infection and Immunity, The University of Melbourne, Parkville, Victoria, Australia
  • John Henry V Gray
    Department of Microbiology and Immunology at the Peter Doherty Institute of Infection and Immunity, The University of Melbourne, Parkville, Victoria, Australia
  • Weiguang Zeng
    Department of Microbiology and Immunology at the Peter Doherty Institute of Infection and Immunity, The University of Melbourne, Parkville, Victoria, Australia
  • David C Jackson
    Department of Microbiology and Immunology at the Peter Doherty Institute of Infection and Immunity, The University of Melbourne, Parkville, Victoria, Australia
  • Algis J Vingrys
    Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
  • Footnotes
    Commercial Relationships   Laura Downie, CooperVision Pty Ltd (F); Anne Gad, None; Chinn Yi Wong, None; John Gray, None; Weiguang Zeng, None; David Jackson, CooperVision Pty Ltd (F); Algis Vingrys, CooperVision Pty Ltd (F)
  • Footnotes
    Support  This study was funded by an investigator-initiated grant from CooperVision (LED, 2015).
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2994. doi:
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    • Get Citation

      Laura Elizabeth Downie, Anne Gad, Chinn Yi Wong, John Henry V Gray, Weiguang Zeng, David C Jackson, Algis J Vingrys; Anti-inflammatory approaches to treat contact lens discomfort: a randomized, controlled trial. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2994.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Growing evidence supports the presence of a low-grade, ocular inflammatory response in people who report contact lens discomfort (CLD). We sought to assess the efficacy of anti-inflammatory approaches, comprising a topical corticosteroid and omega-3 supplements, for modulating this response.

Methods : This randomized controlled trial was registered on the Australian and New Zealand Clinical Trials Registry (ACTRN12615000173594; 23rd February 2015). Adults (n=72) with CLD were randomized (1:1:1:1) to one of: placebo (oral olive oil 1500mg/day), oral fish oil (900mg/day eicosapentaenoic acid [EPA] + 600mg/day docosohexaenoic acid [DHA]), oral combined fish+flaxseed oils (900mg/day EPA + 600mg/day DHA + 900mg/day alpha-linolenic acid) or omega-3 eye drops (0.025% EPA + 0.0025% DHA, four times/day) for 12 weeks, with visits at baseline, Week 4 and Week 12. At Week 12, participants assigned to the placebo group received a topical corticosteroid (fluorometholone alcohol [FML] 0.1% eye drop, three times/day, for a further two weeks, Week 14). The pre-specified primary outcomes were mean change from baseline, at the study end-point, in: contact lens dry-eye questionnaire (CLDEQ-8) score, tear osmolarity and tear cytokine levels (interleukin (IL)-2, IL-4, IL-6, IL-10, IL-17A, interferon (IFN)-γ and tumor necrosis factor (TNF)-α).

Results : A total of 65 participants completed the study. At Week 12, CLDEQ-8 was reduced from baseline with oral fish oil (mean±SEM: -7.3±0.8 units, n=17, p<0.05) compared with placebo (-3.5±0.9 units, n=16). Tear osmolarity was unchanged, between and within groups, over the study duration (p>0.05 for all comparisons). Topical FML 0.1% reduced tear IL-17A (-71.1±14.3%, n=12, p<0.05) and IL-6 (-47.6±17.5%, n=12, p<0.05) levels, relative to Week 12. At Week 12, tear IL-17A levels were reduced from baseline in the oral fish oil (-63.2±12.8%, n=12, p<0.05) and topical omega-3 (-76.2±10.8%, n=10, p<0.05) groups, compared with placebo (-3.8±12.7%, n=12). The change from baseline in tear IL-6 was less (p<0.05) in all of the omega-3 supplement groups (mean change: 6.7±8.5%), relative to placebo (240.2±128.1%), at Week 12.

Conclusions : Oral fish oil supplementation for 12 weeks reduces CLD. Acute (2-week) topical FML 0.1% and longer-term (12-week) omega-3 supplementation decrease tear IL-17A and IL-6 levels, demonstrating parallels in modulating ocular inflammation with these approaches.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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