Effect of Sunflower Lecithin Supplementation on Meibomian Gland Function in Adults With Dry Eye Disease

Study Overview
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Brief Summary
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This prospective study will evaluate the effect of oral sunflower lecithin dietary supplementation on meibomian gland function in adults with dry eye disease.

Detailed Description
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Enrolled patients in the active arm of the study (n=20) will receive a daily dose of four sunflower lecithin 1,200 mg soft-gel capsules for a duration of 90 days. Patients in the control arm (n=10) will receive four doses of a 1,000 mg placebo soft-gel capsules (containing olive oil). Patients will be evaluated for meibomian gland function and signs and symptoms of dry eye at baseline and at the end of the study using a standardized eye dryness survey (SPEED survey), Tear Breakup Time Measurement, Meibomian Gland Score, and a rapid in-office assessment of years (InflammaDry).

Official Title
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Effect of Sunflower Lecithin Supplementation on Meibomian Gland Function in Adults With Dry Eye Disease

Conditions
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Dry Eye Disease, Meibomian Gland Dysfunction

Intervention / Treatment
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* Dietary Supplement: Sunflower lecithin
* Dietary Supplement: Olive oil


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age greater than18 at the time of informed consent Clinical diagnosis of dry eye in both eyes Fluorescein tear film break-up time (TBUT) less than 10s in both eyes The presence of lid margin scaling, telangiectasia, collarette or meibomian gland plugging on slit-lamp examination Best-corrected visual acuity (BCVA, Snellen) of 20/40 or better in each eye Patient Evaluation of Eye Dryness (SPEED) questionnaire score >6 to <14 Must understand; be willing and able, and likely to fully comply with study procedures, visit schedule, and restrictions Exclusion Criteria: Any pre-existing ocular disease other than dry eye disease Patients with inability to swallow soft gel capsules Severe illness, pregnancy or breastfeeding, smoking, and regular use of strongly anticholinergic drugs. Drastic change of food and/or food supplements within the last month. Other food supplement with fatty acids Evidence of acute ocular infection and⁄or intraocular inflammation within 1 month prior to the onset of this study. Ocular surgery within the last 6 months. Patients treated with topical ocular, steroidal or non-steroidal, anti-inflammatory treatment within the last month. Occlusion therapy with lacrimal or punctum plugs within the last 3 months. Alterations of the lacrimal drainage system Eyelid abnormalities Patients on oral tetracycline or corticosteroids Active allergy or infection at the ocular surface

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Sunflower Lecithin<br>Total 4800 mg sunflower lecithin per day taken in 4 softgel capsules | Dietary Supplement: Sunflower lecithin<br>* Lecithins are a group of essential phospholipids that are involved in a number of biological functions such as lipid-cholesterol transport, transmembrane signaling, and neurological function<br>|
| Placebo Comparator: Olive Oil<br>Total 4000 mg olive oil per day taken in 4 softgel capsules | Dietary Supplement: Olive oil<br>* Extra virgin olive oil<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline of the SPEED questionnaire score at Day 90 | To assess the improvement of dry eye symptoms by SPEED questionnaire. 0 score is the minimum (no dry eye symptom); 64 is the maximum score (most symptomatic). Change = (Day 90 score - Baseline score) | 90 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline of Fluorescein Tear Break-Up Time (Seconds) at Day 90 | Fluorescein Tear Break-Up Time (TBUT) is a measurement in seconds of tear film stability. The shorter the TBUT, the lower the tear film stability. Lower tear film stability is associated with dry eye. Change = (Day 90 value - Baseline value) | 90 days | 
| Change in number of MMP-positive eyes at Day 90 | InflammaDry is a noninvasive immunoassay for detecting the presence of MMP-9 in tears. | 90 days | 
| Least Squares Mean Change from Baseline in Meibomian Gland Score (MGS) at Day 90 | Meibomian glands on the eyelids assessed by the examiner using a Meibomian Gland Evaluator (MGE) and a slit lamp microscope. An MGE instrument applies a standardized force simulating the pressure of a deliberate blink allowing eye care professionals to observe meibomian gland functionality through a slit lamp. 5 glands in 1 zone (nasal) evaluated for each eye and scored from 0 to 3, with a resultant overall score (MGS) of 0 to 15 for each eye. Scoring as follows: 0 = no secretion (worst), 1 = inspissated, 2 = cloudy, 3 = clear liquid (best). A higher change from baseline score indicates an improvement in meibomian gland function. | 90 days |