Written by Joyce Smith, BS. Study demonstrates that a combined treatment of oral and topical hyaluronic acid is more effective in treating Dry Eye Disease than topical hyaluronic acid alone.
Dry eye disease (DED) is characterized by a loss of adequate tear film resulting in eye discomfort and visual impairment 1. Lubricating eye drops or other viscosity-enhancing agents are the usual treatment of choice 2; other available treatment therapies include inflammation reduction, tear conservation, and correction of lid abnormalities. Growing evidence suggests a positive role for antioxidants 3, essential fatty acids 4, lactoferrin 5, nutritional supplementation, and diet as adjunctive therapies. Hyaluronic acid (HA), a macromolecular mucopolysaccharide, has been used as a topical eye lubricant to promote corneal epithelial wound healing 6 and when taken orally, HA’s anti-inflammatory 7 and skin-moisturizing properties 8 properties have reduced arthritic joint pain and hydrated dry skin.
Researchers, prompted to test the oral application of HA for DED, conducted a single-center, non-blinded prospective randomized controlled trial 9 of twenty-four patients (6 males and 18 females; mean age 48.6 ± 13.0) and thirty patients (8 males and 22 females; mean age 53.29 ± 10.8). They were assigned to either a study group (topical + oral HA) or a control group (topical HA). Oral HA consisted of 240 mg of HA: topical HA was a topical lubricant of 0.15% HA ophthalmic suspension. Ocular surface disease index (OSDI), tear breakup time (TBUT), corneal fluorescein staining (CSF), and the Schirmer test (measure of basal tear production) were performed at baseline. OSDI, TBUT, and CSF were repeated at one month and again at three months of intervention.
Compared to baseline, the combined oral and topical HA-treated group showed significant improvement in CFS at both 1 and 3 months, whereas, the topical HA alone-treated group showed significant improvement in CFS only at 3 months. At 3 months the difference in CFS between the two groups was also significant (via the Mann–Whitney U test). OSDI significantly improved continually at 1 and 3 months after treatment in the oral and topical HA-group; however, the topical HA alone-group showed significant improvement in OSDI only at 1 month. At 3 months, the difference in OSDI between two groups was also significant (via the Mann–Whitney U test). These results suggest that in DED, using a combination supplement of both oral and topical HA improves corneal epithelial wound healing and related symptoms more effectively than using topical HA alone.
Source: Kim, Yeseul, Chan Hee Moon, Bo-Yeon Kim, and Sun Young Jang. “Oral Hyaluronic Acid Supplementation for the Treatment of Dry Eye Disease: A Pilot Study.” Journal of ophthalmology 2019 (2019).
Copyright © 2019 Yeseul Kim et al. ‘is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Posted December 16, 2019.
Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.
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- Kim Y, Moon CH, Kim B-Y, Jang SY. Oral Hyaluronic Acid Supplementation for the Treatment of Dry Eye Disease: A Pilot Study. Journal of ophthalmology. 2019;2019.
