1. Introduction
astigmatism, Keratoconus, corneal thinning, corneal ectasias, keratoconus
CORNEAL ECTASIA, ASTIGMATISM, CORNEAL DISORDER, IRREGULAR ASTIGMATISM, KERATOCONUS, DISEASE, KERATOCONUS, OXIDATIVE STRESS, INTRAOCULAR PRESSURE
A prospective, randomized, single-center preliminary study was performed in patients with keratoconus stages I–III (Amsler–Krumeich), who received a high rich docosahexaenoic acid (DHA) (1000 mg/day) supplement for 3 months versus untreated patients. One eye per patient was evaluated. Thirty-four patients were recruited (75% men, mean age 31 years), with 15 randomized to the control group and 19 to the DHA-treated group. Corneal topography variables and plasma biomarkers of oxidative stress and inflammatory status were evaluated. A panel of fatty acids in blood samples was also assessed. There were significant between-group differences in the astigmatism axis, asphericity coefficient, and intraocular pressure in favor of the DHA group. Additionally, between-group significant differences in total antioxidant capacity (TAC), malondialdehyde (MDA), free glutathione (GSH) and GSH/GSSG ratio, as well as reduced values of inflammatory markers, including interleukin (IL)-4, IL-6, and vascular endothelial growth factor (VEGF-A) were found. These preliminary findings support the usefulness of the antioxidant and anti-inflammatory effects of DHA supplementation for targeting underlying pathophysiological mechanisms of keratoconus. Prolonged duration of DHA supplementation may be needed to detect more noticeable clinical changes in corneal topography.Keratoconus is a multifactorial ectatic corneal disorder, characterized by a progressive process of corneal thinning and steeping leading to irregular astigmatism with decreased visual acuity. Keratoconus is a complex condition, and a wide variety of both genetic and environmental factors have been identified in the etiology of the disease [Regardless of different treatment modalities of corneal surgery, particularly for advanced corneal ectasias [A systematic review and meta-analysis showed that patients with keratoconus, as compared with controls, had significantly lower levels of vitamin D, zinc, and selenium levels [Among omega-3 polyunsaturated fatty acids (PUFAs), docosahexaenoic acid (DHA, C22:6 Based on this experience, it was considered of interest to explore the antioxidant and anti-inflammatory potential of a highly concentrated DHA triglyceride product in patients with keratoconus. For this purpose, a prospective preliminary study was designed to assess the effects of 3-month DHA nutritional supplementation on clinical variables, and inflammatory and oxidative stress biomarkers of patients with early and moderate keratoconus.