Dry Eye Treatment: Oral Polyphenol Capsules Best Solo Lubricants

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When eye drops disappoint dry eye sufferers, an encapsulated blend of plant polyphenols and fish oil often succeeds - delivering visual relief where solo lubricants fall short.

This clinical trial found an oral formulation of polyphenols and omega-3 fatty acids decisively outperformed artificial tears alone in alleviating symptoms and ocular surface defects in patients with dry eye disease. After 3 months, recipients showed significant gains in tear breakup time, dry eye surveys, and surface staining versus placebo.

Persistent dry eye symptoms afflict up to a third of adults, especially with aging.1 But consistent use of recommended artificial tear drops for lubricating deficient aqueous layers lags under 11%.2 This non-compliance stems partly from inadequate symptom relief frustrating patients.2,3 Beyond inflammation-suppressing pharmaceuticals with side effects, research now focuses on natural supplements like omega fatty acids and antioxidant polyphenols from berries, green tea and curcumin to quell the underlying immune mechanisms of dry eye.4-6 Though some formula studies show promise, combining polyphenols with surfactants in encapsulated blends proves crucial to enhance absorption past poor bioavailability limiting standalone forms.7 A new randomized, placebo-controlled trial investigated one such stabilizing formulation for dry eye relief.

The investigational product supplied anthocyanins and pterostilbene from blueberry extracts, omega-3 fish oil, lactoferrin, and fat-soluble vitamins - all shielded by an emulsifying excipient within easy-to-swallow gel caps. Researchers first verified its safety in 20 healthy adults over 4 weeks, finding excellent tolerance without liver changes or systemic issues. They then assessed the oral supplement in 102 symptomatic dry eye patients - either alone or coupled with sopping lubricants - against placebos over 3 months. Recipients took two daily capsules with or without additionally applying lubricant drops twice daily if assigned.8

All groups completed dry eye surveys, tear breakup assessments, ocular surface stainings and Schirmer's tear production tests at baseline, months 1 and 3. People taking the investigational capsules consistently showed significant gains in dry eye surveys, tear film stability and surface defects compared to placebo alone - benefits only sometimes enhanced further by supplementary lubricants. For example, oral polyphenol recipients had over 30% better dry eye symptom scores and 25% longer tear film stability times by month 3, plus notably reduced corneal and conjunctival staining in those also applying drops.8

Neither solo nor adjunctive artificial tears relieved subjective surveys or objective eye measures nearly as well after 3 months. The studys oral polyphenol formulation decisively demonstrated meaningful clinical improvements in signs and symptoms of dry eye where available pharmaceutical lubricants often proved inadequate. Though follow-up averaged just 3 months, the oral supplements rapid benefits and exceptional safety suggests lasting value for this irritating, debilitating condition. 

As oxidative stress and inflammation clearly underlie dry eyes, perhaps its unsurprising antioxidant and anti-inflammatory compounds like nutritional polyphenols and omega-3 fatty acids provide therapeutic advantages. Blueberry anthocyanins, green tea flavonoids and curcumin all independently suppress oxidative, inflammatory and tissue degrading pathways worsening the ocular surface in dry eye models - beneficially lowering inflammatory cytokines, matrix metalloproteases and markers of oxidative stress and tissue damage.4,9 Restoring such perturbed biological homeostasis better than artificial lubricants accords with this trials observations. The encapsulating excipient shielding polyphenols and fatty acids until intestinal absorption likely helped maximize this clinical effect.

While requiring larger, longer trials for confirmation, these convincing initial results give reason for dry eye sufferers to consider oral polyphenol supplements - especially when standard lubricating drops falter. Beyond subjective relief, reducing objective ocular inflammation and barricade impairment also promises to minimize dry eyes future complications. Given most supplementation research still focuses on cardiovascular, metabolic and neurological applications, this ocular angle harbors under-recognized potential. Nutritional polyphenols uniquely bridge the gap between foods and medicines - lacking significant side effects, contraindications or prohibitive costs.

For more research on Dry Eye syndrome, visit our database on the subject which covers over 40 natural substances of potential therapeutic value for the condition: https://greenmedinfo.com/disease/dry-eye-syndromes


References  

1. Vehof J, Sneider H, Jansonius NM, Hammond CJ. Prevalence and risk factors of dry eye in 79,866 participants of the population-based Lifelines cohort study in the Netherlands. Ocul Surf. 2021;19:83-93.

2. Uchino M, Yokoi N, Shimazaki J, et al. Adherence to Eye Drops Usage in Dry Eye Patients and Reasons for Non-Compliance: A Web-Based Survey. J Clin Med. 2022;11(2):367. Published 2022 Jan 10.

3. Mukamal R. Why Is Dry Eye So Difficult to Treat? AAO website https://www.aao.org/eye-health/tips-prevention/fix-dry-eye-treatment-eyedrops. Accessed April 23, 2021.

4. Xiong K, Li J, Davis R, et al. Anti-inflammatory Drug Candidates for Treatment of Ocular Surface Inflammation. Invest Ophthalmol Vis Sci. 2021;62(5):7.

5. Alghamdi YA, Mercado C, McClellan AL, et al. Epidemiology and Treatment of Dry Eye Disease: A Review. Med Sci (Basel). 2020;8(3):40. Published 2020 Jun 9.

6. Vehof, J., Sneider, H., Jansonius, N. et al. Prevalence and risk factors of dry eye disease in a British female cohort. Br J Ophthalmol 98, 1712-1717 (2014).

7. Parisi OI, Pividori F, Restuccia D, Farina G, Iemma F, Picci N. Polyphenols and Their Formulations: Different Strategies to Overcome the Drawbacks Associated with Their Poor Stability and Bioavailability. Polyphenols Hum Heal Dis. 2014;1:29-45.

8. Altamirano-Vallejo JC, Gonzalez-De la Rosa A, Navarro-Partida J, Valdez-Garcia JE, Acosta-Gonzalez R, Martinez Camarillo JC, Bustamante-Arias A, Armendariz-Borunda J, Santos A. An Oral Polyphenol Formulation to Modulate the Ocular Surface Inflammatory Process and to Improve the Symptomatology Associated with Dry Eye Disease. Nutrients. 2022 Aug 7;14(15):3236.

9. Li J, Deng R, Hua X, Zhang L, Lu F, Coursey TG, Pflugfelder SC, Li DQ. Blueberry Component Pterostilbene Protects Corneal Epithelial Cells from Inflammation via Oxidative Pathway. Sci Rep. 2016 Dec 16;6:19408.

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