{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T11:02:11Z","timestamp":1789556531341,"version":"build-2803163510"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To assess the impact of omega-3 fatty acid (O3FA) supplements on tear inflammatory cytokines in dry eye patients with an omega-3 index below 4%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This randomized controlled study involved 102 dry eye patients with an omega-3 index below 4%. Participants received either four capsules of O3FAs (325 mg eicosapentaenoic acid, 175 mg docosahexaenoic acid) or a placebo containing olive oil twice daily for 6 months. Patients were evaluated at baseline and 1, 3, and 6 months. The primary outcome measured changes in tear cytokines (IL-1\u03b2, IL2, IL4, IL5, IL6, IL8, IL10, IF-\u03b3, and TNF-\u03b1). Secondary outcomes included improvements in dry eye symptoms, Nelson grade, goblet cell density, Schirmer test values, and tear film breakup time. Group means (pretreatment, 1, 3, and 6 months) were compared using repeated measure analysis of variance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      At baseline, impression cytology revealed that mRNA levels of IL-1\u03b2, IL-6, IL-8, and TNF-\u03b1 were elevated by 1.6- to 2.4-fold in the O3FA group and 1.74 to 2.6-fold in the placebo group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.123). The O3FA group experienced a statistically significant reduction (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05) in tear cytokines. This group showed a 60% increase in the omega-3 index at 6 months, indicating high adherence to treatment. The dry eye symptom score, goblet cell density, and Nelson grade improved significantly in the O3FA group. However, these changes were not significant in the placebo group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study underscores the potential advantages of O3FA supplementation in decreasing tear inflammatory cytokines in dry eye patients with an omega-3 index below 4%.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_1506_25","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T16:02:02Z","timestamp":1773331322000},"page":"1033-1039","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Omega-3 fatty acids and tear cytokines modulation in dry eye patients with low omega-3 index. Have the beneficiaries been pinpointed?"],"prefix":"10.4103","volume":"74","author":[{"given":"Kriti","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, GS Medical College, Pilkhuwa, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisha","family":"Bathla","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Niranjana Health Care, Khatima, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shikha","family":"Pawaiya","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Rama Medical College Hospital and Research Center, Hapur, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavya","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, GS Medical College, Pilkhuwa, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooja","family":"Badgujar","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, GS Medical College, Pilkhuwa, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Bhargava","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, GS Medical College, Pilkhuwa, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smiti","family":"Juyal","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, GS Medical College, Pilkhuwa, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"R1-20260630","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.jtos.2020.07.016","article-title":"Association of dry eye disease and sun exposure in geographically diverse adult (>\/=40 years) populations of India: The SEED (sun exposure, environment and dry eye disease) study-Second report of the ICMR-EYE SEE study group","volume":"18","author":"Tandon","year":"2020","journal-title":"Ocul Surf Oct"},{"key":"R2-20260630","doi-asserted-by":"crossref","first-page":"207","DOI":"10.4103\/ijo.IJO_698_17","article-title":"Prevalence, and risk factors of dry eye disease in North India: Ocular surface disease index-based cross-sectional hospital study","volume":"66","author":"Titiyal","year":"2018","journal-title":"Indian J Ophthalmol"},{"key":"R3-20260630","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.jtos.2017.05.011","article-title":"TFOS DEWS II pathophysiology report","volume":"15","author":"Bron","year":"2017","journal-title":"Ocul Surf"},{"key":"R4-20260630","doi-asserted-by":"crossref","first-page":"29629","DOI":"10.1038\/srep29629","article-title":"Proteomics analysis of human tears from aqueous-deficient and evaporative dry eye patients","volume":"6","author":"Perumal","year":"2016","journal-title":"Sci Rep"},{"key":"R5-20260630","doi-asserted-by":"crossref","first-page":"64","DOI":"10.3126\/nepjoph.v14i2.38928","article-title":"Safety and efficacy of cyclosporine (0.05% versus 0.09%) in dry eye disease. 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