Role of Omega-3 Fatty Acids for Eye Health
Omega-3 polyunsaturated fatty acids are essential nutrients for healthy individuals. Their beneficial effects in coronary and autoimmune diseases, as well as in diabetes, have been proven numerous times in the past. In addition, their role in maintaining
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Tassos Georgiou and Ekatherine Prokopiou
Introduction Over the last few decades, there is an increasing interest in the role of omega-3 polyunsaturated fatty acids (PUFAs) and chronic inflammation. Numerous evidence exist from preclinical and clinical studies which prove the effectiveness of omega-3 PUFAs against heart disease, cancer, diabetes, neurological and autoimmune diseases [1]. This chapter will mainly focus on the role of omega-3 PUFAs in maintaining or improving the vision of different eye pathologies (either investigated in vivo or in a clinical setting), including age-related macular degeneration, macular dystrophies and severe dry eyes. In particular, emphasis will be given on the anti-inflammatory effect of omega-3 PUFAs. Also, some observational results from our patients are presented and future directions regarding how to benefit from the omega-3 PUFAs are briefly discussed.
Polyunsaturated Fatty Acids Currently, several studies have been focusing on the therapeutic role of omega-3 PUFAs, which are considered anti-inflammatory molecules. The resolution of inflammation is an active process primarily driven by a new family of mediators, termed resolvins, derived from the omega-3 PUFAs, eicosapentaenoic acid (EPA, C20:5x-3) and docosahexaenoic acid (DHA, C22:6x-3) [2]. These PUFAs are highly concentrated in the brain and retina and have an important role in the neuronal development and damage repair [3]. DHA is abundantly expressed in the photoreceptors, and vital retinal functions depend on its existence [4]. T. Georgiou (&) E. Prokopiou Ophthalmos Research and Educational Institute, 48 Morfou, Engomi, Nicosia, 2417, Cyprus e-mail: [email protected] E. Prokopiou e-mail: [email protected]
Among the major mediators of the inflammatory response is the generation of pro-inflammatory eicosanoids generated from the omega-6 PUFA, arachidonic acid (AA, C20:4x-6). These include pro-inflammatory prostaglandins (e.g. PGE2) and leukotrienes (e.g. LTB4), which can act as mediators for leucocyte chemotaxis and inflammatory cytokine production. The balance between the pro- and anti-inflammatory molecules plays a key role in the disease progression and the resolution of an inflammatory response.
Age-Related Macular Degeneration Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly. It is estimated that 200 million people suffer worldwide and the number of these individuals is going to be increased up to 50 % by 2040 [5, 6]. The main symptom of early AMD is blurring of central vision which results in difficulty in reading and recognising faces. There are two different types of AMD: the dry form which is the most common one and occurs in 9 in 10 cases, and the wet form (choroid neovascularisation, CNV) which occurs in about 1 in 10 cases. In dry AMD, the retinal pigment epithelium (RPE) cells of the macula, which are crucial for the function of the rods and cones, will gradually degenerate. In wet AMD, in addition to the RPE cells’ degeneration, newly formed bloo
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