Polyunsaturated Fatty Acids in Relief of Visual Fatigue

Polyunsaturated Fatty Acids in Relief of Visual Fatigue: Comparison

Please note this is a comparison between Version 2 by Hao Duan and Version 1 by Hao Duan.

研究发现，补充适当的食物或营养素可以有效地增强眼睛对外部和内部刺激的抵抗力，从而缓解或避免视觉疲劳。其中，补充多不饱和脂肪酸已被发现可有效保护眼睛健康和缓解视觉疲劳。Studies have found that supplementation with the right foods or nutrients can be effective in enhancing the eyes' resistance to external and internal stimuli, thereby alleviating or avoiding visual fatigue. Among these, supplementation with polyunsaturated fatty acids has been found to be effective in protecting eye health and relieving visual fatigue.

visual fatigue
PUFAs
retina
ocular surface

1. 简介Introduction

眼睛是一个非常细腻复杂的生物器官，具有精确和集成的光敏和视觉处理功能。同时，眼睛血管化丰富，神经分布广泛，导致对氧气的需求增加，随之而来的代谢产物的产生The eye is a very delicate and complex biological organ with precise and integrated light-sensitive and visual processing functions. At the same time, the eye is richly vascularised and has a wide distribution of nerves, leading to an increased demand for oxygen and the consequent production of metabolic products[1]，以及对氧自由基攻击的敏感性更大。此外，其他因素，如照明、所涉及的工作性质、时间、距离和习惯，会进一步加重眼睛的负担，导致各种形式的不适和视觉疲劳症状，如视力模糊，影响人们的正常视觉功能and a greater sensitivity to oxygen radical attack. In addition, other factors such as lighting, the nature of the work involved, time, distance and habits can further aggravate the eye and lead to various forms of discomfort and visual fatigue symptoms, such as blurred vision, that affect people's normal visual function [2]。视觉疲劳，也称为眼睛疲劳，在经常使用电子产品或有不正确的眼习惯的人群中很常见. Visual fatigue, also known as eye strain, is common in people who use electronic devices regularly or have incorrect eye habits[3]。.

视觉疲劳的主要原因与眼外角膜表面和眼底视网膜的结构损伤或功能下降有关The main causes of visual fatigue are related to structural damage or reduced function of the outer corneal surface and the retina at the base of the eye[24，25，31]。多不饱和脂肪酸缓解视觉疲劳的主要机制详见图.The main mechanisms by which polyunsaturated fatty acids alleviate visual fatigue are detailed in Figure 1。.

图Figure 1.PUFAs缓解眼疲劳的主要机制。AMD=年龄相关性黄斑变性;MMP-9 = 基质金属蛋白酶-9;NPD1 = 神经保护 D1;IL-1β = 白细胞介素-1β;IL-6 = 白细胞介素-6;TNF-α=肿瘤坏死因子-α;AA = 花生四烯酸;NF-κB = 核因子 κ-B;ROS = 活性氧;DHA = 二十二碳六烯酸;EPA = 二十碳五烯酸;LA = 亚油酸。 The main mechanism of PUFAs in relieving asthenopia. AMD = age-related macular degeneration; MMP-9 = matrix metalloproteinase-9; NPD1 = neuroprotection D1; IL-1β = interleukin-1β; IL-6 = interleukin-6; TNF-α = tumor necrosis factor-α; AA = arachidonic acid; NF-κB = nuclear factor kappa-B; ROS = reactive oxygen species; DHA = docosahexaenoic acid; EPA = eicosapentaenoic acid; LA = linoleic acid.

2. 多不饱和脂肪酸改善受损的眼表，作为视觉疲劳缓解剂Polyunsaturated fatty acids improve damaged eye surfaces and act as visual fatigue relievers

眼表角膜富含感觉神经，是重要的屈光介质，也是维持眼表稳态的关键The corneal surface of the eye is rich in sensory nerves, an important refractive medium and key to maintaining ocular surface homeostasis[23]。然而，眼表高度暴露在外界，环境中的强光和氧气刺激往往会损害角膜的结构和功能，导致泪液量减少，角膜敏感性增加However, the ocular surface is highly exposed to the outside world and environmental stimuli of bright light and oxygen often damage the structure and function of the cornea, resulting in reduced tear volume, increased corneal sensitivity [23，24，25，85]和进一步干眼症，这可能导致一系列视觉疲劳症状的发作，and further dry eye, which can lead to a range of episodes of visual fatigue symptoms such as photophobia and blurred 如畏光和视力模糊。ω-3多不饱和脂肪酸和ω-6多不饱和脂肪酸是细胞磷脂膜的重要组成部分，被认为对维持细胞功能至关重要vision.ω-3 polyunsaturated fatty acids and ω-6 polyunsaturated fatty acids are important components of cellular phospholipid membranes and are thought to be essential for maintaining cellular function [86]。据报道，摄入. It has been reported that intake of ω-3多不饱和脂肪酸可能会影响角膜的神经结构，对角膜健康有重要作用 polyunsaturated fatty acids may affect the neural structure of the cornea and have an important role in corneal health[87]。膳食补充ω-6多不饱和脂肪酸的.Dietary supplementation with LA和GLA也被证明可促进屈光性角膜切除术后眼表泪液的产生并减少干眼症 and GLA of omega-6 polyunsaturated fatty acids has also been shown to promote ocular surface tear production and reduce dry eye after refractive keratectomy [88，89]，从而缓解视觉疲劳的发作。目前，大多数研究支持高水平的ω, thereby alleviating episodes of visual fatigue.Currently, most studies support that high levels of omega-3多不饱和脂肪酸与干眼症的发生呈负相关，而高ω-6：ω-3比值与干眼症和眼部不适的频繁发生呈正相关 polyunsaturated fatty acids are negatively associated with the development of dry eye, while high omega-6:omega-3 ratios are positively associated with the frequent occurrence of dry eye and ocular discomfort[90]。临床研究表明，ω.Clinical studies have shown that omega-3多不饱和脂肪酸可减少干眼人群眼表炎症 polyunsaturated fatty acids can reduce ocular surface inflammation in dry eye populations[91，92]，从而有效缓解视觉疲劳。同时，一项双盲临床试验发现，连续口服ω, thereby effectively reducing visual fatigue.Meanwhile, a double-blind clinical trial found that continuous oral administration of omega-3多不饱和脂肪酸（360 polyunsaturated fatty acids (360 mg/d EPA + 240 mg/d DHA）30 d可显著降低干眼症患者的泪液蒸发率并增加眼表泪液分泌，有效缓解干眼症和眼部不适) for 30 d significantly reduced tear evaporation and increased ocular surface tear production in patients with dry eye, effectively relieving dry eye and eye discomfort[93]。此外，口服.In addition, oral administration of ω-3 PUFAs显著改善了干眼人群泪液渗透压和TBUT评分的降低，表明s significantly improved the reduction in tear osmolarity and TBUT scores in the dry eye population, suggesting that ω-3 PUFAs提高了泪膜的内在稳定性。数据显示，基质金属蛋白酶-9（MMP-9）是一种蛋白水解酶，在眼表诱导炎性细胞因子和炎症反应，在干眼症和眼表疾病中起重要作用 improved the intrinsic stability of the tear film. The data show that matrix metalloproteinase-9 (MMP-9) is a protein hydrolase that induces inflammatory cytokines and inflammatory responses in the ocular surface and plays an important role in dry eye and ocular surface diseases[94]。该试验还表明，口服.This trial also showed that oral administration of ω-3多不饱和脂肪酸可显着降低MMP-9和眼表疾病指数（OSDI）评分。这支持 polyunsaturated fatty acids significantly reduced MMP-9 and Ocular Surface Disease Index (OSDI) scores. This supports the idea that ω-3 PUFAs减少眼表上皮的高渗应激，同时直接减少眼表炎症 reduce hyperosmotic stress in the ocular surface epithelium, while directly reducing ocular surface inflammation [95]，从而有效减少视觉疲劳和眼部不适。同时，越来越多的证据证实，与单次补充, thereby effectively reducing visual fatigue and ocular discomfort.At the same time, a growing body of evidence confirms that combined supplementation with omega-6 polyunsaturated fatty acids and omega-3 polyunsaturated fatty acids has a more significant effect on improving ocular surface health and relieving ocular surface dryness than single supplementation with omega-3 polyunsaturated fatty acids. An animal study showed that combined supplementation with ω-3多不饱和脂肪酸相比，联合补充ω-6多不饱和脂肪酸和ω-3多不饱和脂肪酸对改善眼表健康和缓解眼表干燥有更显着的作用。一项动物研究表明，与单次补充多不饱和脂肪酸（EPA和DHA或GLA）相比，联合补充ω-3多不饱和脂肪酸和ω-6多不饱和脂肪酸（EPA+DHA和GLA）可显著改善大鼠眼内压升高（IOP），并进一步防止眼压升高诱导的视网膜细胞结构和神经胶质细胞活化 polyunsaturated fatty acids and ω-6 polyunsaturated fatty acids (EPA+DHA and GLA) significantly improved elevated intraocular pressure (IOP) and further prevented IOP-induced retinal cell structure and glial cell activation in rats compared to single supplementation with polyunsaturated fatty acids (EPA and DHA or GLA)[96].在一项双盲、随机和对照试验中，In a double-blind, randomised and controlled trial, 138名干眼症患者被给予富含ω patients with dry eye were given capsules of a supplement enriched with omega-3 PUFAs和ω and omega-6 PUFAs、维生素和锌的补充剂胶囊，每天服用三次，持续三个月。结果显示，富含ω, vitamins and zinc, three times daily for three months. The results showed that supplementation enriched with omega-3 PUFAs和ω and omega-6 PUFAs的补充剂可显著降低干眼症人群中人白细胞抗原-DR（s significantly reduced the expression of human leukocyte antigen-DR (HLA-DR）的表达，HLA-DR是结膜上皮的炎症标志物，干眼症不适有所改善), an inflammatory marker of the conjunctival epithelium, in the dry eye population, and that dry eye discomfort was improved[97]。.

综上所述，口服多不饱和脂肪酸，特别是In summary, oral administration of polyunsaturated fatty acids, particularly ω-3多不饱和脂肪酸与DHA和EPA，可能具有改善泪膜稳定性和泪液体积的作用，减少MMP-9在眼表的表达量，降低炎症程度，从而起到缓解视觉疲劳的作用。此外，与单次补充ω-3多不饱和脂肪酸相比，ω-6多不饱和脂肪酸与ω-3多不饱和脂肪酸的联合补充显示出更好的眼表改善，这表明ω-3多不饱和脂肪酸与ω-6多不饱和脂肪酸的配给摄入量更有利于帮助眼睛健康。 polyunsaturated fatty acids with DHA and EPA, may have the effect of improving tear film stability and tear volume, reducing the amount of MMP-9 expression on the ocular surface and decreasing the degree of inflammation, thus providing relief from visual fatigue. In addition, combined supplementation of omega-6 polyunsaturated fatty acids with omega-3 polyunsaturated fatty acids showed better ocular surface improvement compared to single supplementation of omega-3 polyunsaturated fatty acids, suggesting that rationed intake of omega-3 polyunsaturated fatty acids with omega-6 polyunsaturated fatty acids is more beneficial in aiding eye health.

3. PUFAs改善受损的眼底，缓解视觉疲劳 improve damaged eye fundus and relieve visual fatigue

多不饱和脂肪酸是维持视网膜稳态以及促进其健康发育的重要组成部分之一Polyunsaturated fatty acids are one of the most important components in maintaining the homeostasis of the retina and promoting its healthy development[98]。视网膜富含几种多不饱和脂肪酸，例如.The retina is rich in several polyunsaturated fatty acids, such as DHA和AA，前者对于维持感光细胞的存活很重要 and AA, the former of which is important for the survival of photoreceptor cells [19]，通过激活and promotes the survival of rat retinal photoreceptors in vitro and under oxidative stress by activating the ERK / MAPK信号通路促进大鼠视网膜光感受器在体外和氧化应激条件下的存活/MAPK signalling pathway[99].或者，它通过调节Alternatively, it selectively protects photoreceptors from oxidative stress by regulating the levels of Bcl-2家族促凋亡蛋白和抗凋亡蛋白的水平，选择性地保护光感受器免受氧化应激 family pro- and anti-apoptotic proteins[100]。此外，.In addition, DHA可以通过1-脂氧合酶-1转化为神经保护D15（NPD1），进而进一步诱导抗凋亡并抑制促凋亡蛋白，从而对光感受器发挥细胞保护、抗炎和促生存修复信号。此外，在视网膜受损小鼠的眼睛中可以观察到DHA的显着降低和 can exert cytoprotective, anti-inflammatory and pro-survival repair signals on photoreceptors through the conversion of 1-lipoxygenase-1 to neuroprotective D15 (NPD1), which in turn further induces anti-apoptotic and inhibits pro-apoptotic proteins. In addition, a significant decrease in DHA and a significant increase in the ω-6/ω-3比率的显着增加 ratio were observed in the eyes of retina-damaged mice[19]。这反映了.This reflects the fundamental and important role of DHA在视网膜中的基本和重要作用。相反，花生四烯酸（包括前列腺素、凝血剂、白三烯和脂氧合酶）的AA代谢与炎症途径的激活和小胶质细胞的调节有关 in the retina. In contrast, AA metabolism of arachidonic acid (including prostaglandins, coagulants, leukotrienes and lipoxygenases) is associated with activation of inflammatory pathways and regulation of microglia[101，102，103]。.

由于人体合成的ωDietary supplementation routes for polyunsaturated fatty acids are particularly important as the body does not synthesize enough omega-3多不饱和脂肪酸不足以维持生物体的所有重要活动，因此多不饱和脂肪酸的膳食补充途径尤为重要 polyunsaturated fatty acids to sustain all the vital activities of the organism[104]。据报道，膳食补充ω.Dietary supplementation with omega-3多不饱和脂肪酸可有效预防视网膜损伤，从而进一步发挥其对视觉疲劳的作用。据报道，富含ω-3多不饱和脂肪酸的亚麻籽油通过激活 polyunsaturated fatty acids has been reported to be effective in preventing retinal damage, thereby furthering its effect on visual fatigue. Flaxseed oil rich in ω-3 polyunsaturated fatty acids has been reported to protect visual function by activating Nrf2-HO-1信号传导和下调 signalling and down-regulating NF-κB p65表达来保护视觉功能，以减少可见光诱导的氧化应激和视网膜炎症损伤 expression to reduce visible light-induced oxidative stress and retinal inflammatory damage[105]。临床研究进一步证实，.The clinical study further confirmed that in 30例视觉疲劳个体在补充亚麻籽油软胶囊101 d后，视觉疲劳症状明显减轻，双眼视力持续性为70.3%，总有效率为51%，差异显著，证实膳食补充 individuals with visual fatigue, after 101 d of supplementation with flaxseed oil softgels, the symptoms of visual fatigue were significantly reduced, and the persistence of visual acuity in both eyes was 70.3%, with an overall effective rate of 51%, a significant difference, confirming that dietary supplementation with ω-3 PUFAs可有效缓解视觉疲劳 can effectively relieve visual fatigue[106]。.Fuminori等人 et al.[28]连续补充富含ωContinuous supplementation with omega-3多不饱和脂肪酸的ω-3多不饱和脂肪酸，特别是鱼油（ polyunsaturated fatty acids rich in omega-3 polyunsaturated fatty acids, specifically a combination preparation of fish oil (DHA 783 mg/d和d and EPA 162 mg/d）、越橘提取物（含花青素), lingonberry extract (containing anthocyanins 59 mg/d）和木犀草素（) and lignan (17.5 mg/d）的组合制剂，连续4周显著改善视觉疲劳患者的症状。因此，越来越多的研究支持增加ω-3多不饱和脂肪酸的饮食水平可以促进人类健康。研究还证实，膳食中补充ω-3多不饱和脂肪酸对预防或减少眼部炎症很重要，例如，补充富含DHA和EPA的鱼油已被证明可以减少早产儿的视网膜损伤，从而修复婴儿视力功能受损), significantly improved symptoms in patients with visual fatigue for 4 consecutive weeks. Thus, there is a growing body of research supporting that increasing dietary levels of omega-3 polyunsaturated fatty acids can promote human health. Research also confirms that dietary supplementation with omega-3 polyunsaturated fatty acids is important in preventing or reducing eye inflammation, for example, supplementation with fish oil rich in DHA and EPA has been shown to reduce retinal damage in premature infants, thereby repairing impaired vision function in infants[107]。此外，鱼油的膳食补充途径也有效减少.In addition, the dietary supplementation route of fish oil is also effective in reducing the production of ROS的产生，减少促炎因子的释放，从而有效抑制视网膜血管内皮中炎症因子的水平 and the release of pro-inflammatory factors, thereby effectively suppressing the levels of inflammatory factors in the retinal vascular endothelium [21]。临床研究还表明，口服. Clinical studies have also shown that 3个月 months of oral omega-3（EPA和DHA）可显著抑制年轻和老年女性血液中白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）的产生 (EPA and DHA) significantly inhibited the production of interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) in the blood of young and older women [21]。促炎因子的表达，如白细胞介素. Expression of pro-inflammatory factors, such as interleukin-1β（IL-1β）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α） (IL-1β), interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α)[108]。此外，在动物研究中观察到，在膳食中补充EPA.In addition, a significant reduction in plasma production + DHA或鱼油1-6周后，C57BL/6小鼠血浆中IL-5β、IL-6和TNF-α的产生显着降低of IL-5β, IL-6 and TNF-α in C57BL/6 mice was observed in animal studies after 1-6 weeks of dietary supplementation with EPA + DHA or fish oil[109，110]。.

此外，衰老伴随着In addition, ageing is accompanied by a decline in RPE细胞活力的下降，导致其抗氧化和自愈能力减弱，使视网膜黄斑更容易受到不良反应，导致AMD，从而进一步加剧视觉疲劳 cell viability, leading to a reduction in their antioxidant and self-healing capacity, making the retinal macula more susceptible to adverse reactions, leading to AMD, which further exacerbates visual fatigue[24，111]。流行病学、临床和实验研究表明，补充ω.Epidemiological, clinical and experimental studies have shown that supplementation with omega-3多不饱和脂肪酸与AMD呈负相关，而ω-6多不饱和脂肪酸的增加会增加这种风险 polyunsaturated fatty acids is negatively associated with AMD and that an increase in omega-6 polyunsaturated fatty acids increases this risk[112]。较高水平的.Higher intakes of both EPA和DHA摄入量均有助于在中期预防或延缓AMD的发作 and DHA can help prevent or delay the onset of AMD in the medium term[113]。.

据报道，ωCombined intake of omega-6和ω-3联合摄入可显著调节体内PUFAs的数量或比例，从而降低视网膜损伤程度 and omega-3 has been reported to significantly modulate the amount or ratio of PUFAs in the body, thereby reducing the extent of retinal damage[114，115]。膳食补充.Dietary supplementation with DHA和EPA可有效调节体内AA、DHA和EPA的比例 and EPA can effectively regulate the ratio of AA, DHA and EPA in the body[116]。高水平的.High levels of LA摄入量可以显着降低AMD的风险;相反，高水平的DHA摄入与AMD的风险呈负相关 intake significantly reduce the risk of AMD; conversely, high levels of DHA intake are negatively associated with the risk of AMD[117]。此外，与单独补充.In addition, the EPA + DHA或GLA相比， + GLA diet significantly reduced the activation of glial cells in rats with retinal damage compared to EPA + DHA + GLA饮食显着降低了视网膜受损大鼠神经胶质细胞的活化，并且可有效保护视网膜的结构完整性or GLA supplementation alone, and was effective in protecting the structural integrity of the retina[96]。这些研究表明，与单一.These studies suggest that diets with different combinations of ω-3 PUFAs或ω-6and ω-6 PUFAs may be more helpful in improving damaged retinas than single ω-3 PUFAs补充剂相比，不同ω-3和ω- or ω-6 PUFAs组合的饮食可能更有助于改善受损视网膜，这表明 supplementation, suggesting that regulation of ω-3 PUFAs水平的调节和 levels and the ratio of ω-6/ω-3 PUFAs的比率在视网膜保护功能中很重要。据报道，在动物和人类的饮食中，稳定的 are important in retinal protective function. A stable ω-6/ω-3比值在1：1-4：1范围内是适当的平衡比值，更有利于机体的健康 ratio in the range of 1:1-4:1 has been reported to be an appropriate balance ratio in animal and human diets and more beneficial to the health of the organism[118]。然而，在眼睛研究中尚未明确报告.However, the optimal range of ω-6 / ω-3比值的最佳范围。/ω-3 ratios has not been clearly reported in ocular studies.

总之，口服补充In conclusion, oral supplementation with ω-3多不饱和脂肪酸，尤其是DHA和EPA，不仅能有效缓解视觉疲劳，还能改善干眼症 polyunsaturated fatty acids, particularly DHA and EPA, is effective not only in reducing visual fatigue but also in improving dry eye [119]或眼睛出现的其他不良反应or other adverse reactions that occur in the eye[120]。这些研究还再次表明，膳食补充ω. These studies also suggest again that dietary supplementation with omega-3多不饱和脂肪酸可以通过多种途径对视觉疲劳产生影响，包括抗氧化和抗炎以及抗凋亡，ω-3多不饱和脂肪酸与ω-6多不饱和脂肪酸摄入量的比例对眼睛健康和视觉疲劳缓解程度具有重要意义，但似乎没有报道研究检查两者在眼睛健康方面的最佳比例。这可能是未来研究的一个方向。表1总结了PUFAs改善眼表和眼底损伤程度，从而发挥视觉疲劳缓解作用的机制。 polyunsaturated fatty acids can have an impact on visual fatigue through a variety of pathways, including antioxidant and anti-inflammatory as well as anti-apoptotic, and that the ratio of omega-3 polyunsaturated fatty acids to omega-6 polyunsaturated fatty acids intake is important for eye health and the degree of visual fatigue relief, but no studies appear to have been reported examining the optimal ratio of the two in terms of eye health. This may be a direction for future research. Table 1 summarises the mechanisms by which PUFAs improve the extent of ocular surface and fundus damage, and thus exert a visual fatigue-relieving effect.

表Table 1. Mechanisms by which PUFAs减少眼表和眼底损伤程度的机制，发挥其缓解视觉疲劳的作用。 reduce the extent of damage to the ocular surface and fundus, exerting their effects on the relief of visual fatigue.

受试者/动物	Subjects/Animals	科目	Subjects	周期性	Periodicity	结果	Results	结论/潜在机制	Conclusions/Potential Mechanisms	裁判。	Ref.
有视觉疲劳的人	People with visual fatigue	EPA：162毫克/天/DHA：783毫克/ 天和越橘提取物和叶黄素	EPA:162 mg/d/ DHA:783 mg/d and lingonberry extract and lutein	4 V	4 w	富含Omega-3的膳食补充剂可以安全地改善人类眼睛疲劳和精神疲劳的主观症状。	Omega-3-rich dietary supplements can safely improve the subjective symptoms of eye strain and mental fatigue in humans.	富含omega-3脂肪酸的膳食补充剂可以帮助缓解视觉疲劳的发作。	Dietary supplements rich in omega-3s can help alleviate the onset of visual fatigue.	[28]
干眼症小鼠	Dry eye mice	阿拉或洛杉矶	ALA or LA	5~10 天	5~10 d	角膜荧光素染色增加;角膜IL-1 β和TNF-α表达增加;以及结膜 IL-1 β、TNF-β、IFN-β、IL-2、IL-6 和 IL-10。另一方面，ALA组显示角膜荧光素染色，角膜IL-1和TNF-α表达显着降低，结膜TNF-α相关表达显着降低。	Increased corneal fluorescein staining; increased corneal IL-1 β and TNF-α expression; and conjunctival IL-1 β, TNF-β, IFN-β, IL-2, IL-6 and IL-10. The ALA group, on the other hand, showed significantly reduced corneal fluorescein staining, corneal IL-1 and TNF-α expression and a significant reduction in conjunctival TNF-α associated.	ALA有助于缓解眼睛干涩和眼睛不适，并减少眼表炎症因子的表达，从而缓解眼睛疲劳症状，如眼睛干涩。	ALA helps to relieve dry eyes and eye discomfort, and it reduces the expression of inflammatory factors on the ocular surface, thus relieving eye strain symptoms such as dry eyes.	[91]
干眼症患者	Dry eye people	美国环保署：1680毫克/天/DHA：560毫克/ 天	EPA:1680 mg/d/ DHA:560 mg/d	2 /	2 m	两个月的omega-3补充剂显着改善了干眼症人群中OSDI和DEQ的主观症状评分，显着抑制了眼表促炎因子MMP-9水平的增加。	Two months of omega-3 supplementation significantly improved the subjective symptom scores of OSDI and DEQ in the dry eye population, significantly inhibiting the increase in levels of the ocular surface pro-inflammatory factor MMP-9.	Omega-3 可能通过减少眼表炎症来缓解干眼症的发作。	Omega-3 may have alleviated the onset of dry eye by reducing ocular surface inflammation.	[92]
干眼症患者	Dry eye people	美国环保署：360毫克/天/DHA：240毫克/ 天	EPA:360 mg/d/ DHA:240 mg/d	1 /	1 m	ω-3干预一个月后，干眼症人群的TBUT、OSDI和Schirmer评分显著改善。干预组和安慰剂组在TBUT方面差异显著，分别为71%和3.3%，干眼症状变化分别为26%和4%，Schirmer评分变化分别为22.3%和5.1%。	One month after the ω-3 intervention, the dry eye population showed significant improvement in TBUT, OSDI and Schirmer scores than the placebo group. The intervention and placebo groups showed significant differences in TBUT with changes of 71%, and 3.3%, dry eye symptoms changes of 26% and 4% and Schirmer score changes of 22.3% and 5.1%, respectively.	Omega-3可有效降低泪液蒸发率;改善眼睛干涩和眼睛不适，有效增加泪液产生。	Omega-3 is effective at reducing the rate of tear evaporation; improving dry eyes and eye discomfort and effectively increasing tear production.	[93]
干眼症患者	Dry eye people	美国环保署：1680毫克/天/DHA：560毫克/ 天	EPA:1680 mg/d/ DHA:560 mg/d	12 V	12 w	在第6周，ω-3干预组显示泪液渗透压显著降低。12周时ω-3指数水平和TBUT均显著，ω-12指数水平和TBUT均显著改善，眼表MMP-3表达降低。	At week 6, the ω-3 intervention group showed a significant reduction in tear osmolarity. At 12 weeks, both ω-3 index levels and TBUT were significant at 12 weeks, both ω-3 index levels and TBUT significantly improved and had reduced ocular surface MMP-9 expression.	ω-3与泪液渗透压、ω-3指数水平、TBUT、MMP-9和OSDI症状评分的统计学显着改善相关。	ω-3 was associated with statistically significant improvements in tear osmolality, ω-3 index levels, TBUT, MMP-9 and OSDI symptom scores.	[95]
眼压高的大鼠	Rats with high eye pressure	欧米伽-3多不饱和脂肪酸组：EPA + DHA ω-6 多不饱和脂肪酸组：GLA ω-3 + ω-6 多不饱和脂肪酸组：EPA + DHA + GLA	Omega-3 PUFAs group: EPA + DHA ω-6 PUFAs group: GLA ω-3 + ω-6 PUFAs group: EPA + DHA + GLA	6 /	6 m	在高IOP对照大鼠的眼睛中观察到神经胶质细胞的显着活化，而ω-3 + ω-6 PUFAs组饮食中的动物表现出显着改善。	Significant activation of glial cells was observed in the eyes of control rats with high IOP, while animals in the ω-3 + ω-6 PUFAs group diet showed significant improvement.	研究结果表明，ω-3 + ω-6 PUFAs组合在预防大鼠IOP升高诱导的视网膜细胞结构和神经胶质细胞活化方面比单次补充更有效。	The results of the study showed that the effects of the combination of ω-3 + ω-6 PUFAs were more effective than single supplementation in preventing retinal cell structure and glial cell activation induced by elevated IOP in rats.	[96]
干眼症患者	Dry eye people	EPA：427.5毫克/天/DHA：285毫克/ 天和其他维生素和锌	EPA:427.5 mg/d/ DHA:285 mg/d and other vitamins and zinc	3 /	3 m	ω-3显著降低了HLA-DR阳性细胞的百分比。	ω-3 significantly reduced the percentage of HLA-DR-positive cells.	补充omega-3可能会减少HLA-DR结膜炎症标志物的表达，并可能有助于改善干眼症和眼部不适。	Supplementation with omega-3 may reduce the expression of HLA-DR conjunctival inflammatory markers and may help improve dry eye and ocular discomfort.	[97]
有视网膜损伤的兔子	Rabbit with retinal damage	藻油（含33.34%DHA）	Algae oil (contains 33.34% DHA)	3 V	3 w	干预组显著降低视网膜中IL-1β、TNF-α、IL-8和COX-2水平，下调NF-κB表达，显著减弱光诱导的视网膜凋亡和新生血管。	The intervention group significantly reduced the levels of IL-1β, TNF-α, IL-8 and COX-2 in the retina, downregulated NF-κB expression and significantly attenuated light-induced retinal apoptosis and neovascularization.	含有欧米茄-3多不饱和脂肪酸的饮食可以防止可见光引起的视网膜损伤。该机制可能与减少受损视网膜中炎症因子的表达有关。	Diets containing omega-3 PUFA may protect against visible light-induced retinal damage. The mechanism may be related to reducing the expression of inflammatory factors in the damaged retina.	[105]
有视觉疲劳的人	People with visual fatigue	亚麻籽油胶囊	Flaxseed oil capsules	30 天	30 d	30 d后，试验食物组视觉疲劳明显减轻，双眼视力持续性改善70.3%，平均改善11.2±7.3%，总体有效率51%。	After 30 d, the test food group showed a significant reduction in visual fatigue and a 70.3% improvement in the persistence of binocular vision, with a mean improvement of 11.2 ± 7.3% and an overall effective rate of 51%.	研究表明，富含omega-3的亚麻籽油软胶囊可有效缓解人类视觉疲劳。	It is shown that omega-3 rich flaxseed oil softgels are effective in relieving human visual fatigue.	[106]
AMD 人群	AMD crowd	富含EPA和DHA的饮食	EPA- and DHA-rich diet	3 /	3 m	较高的EPA和DHA摄入量可预防或延缓中度AMD的发作，但晚期ADM似乎只有改善的趋势。研究结果不可用，但没有显着差异。	Higher intakes of EPA and DHA prevented or delayed the onset of moderate AMD, but there appeared to be only a trend towards improvement for late-stage ADM. The results of the study were not available but not with significant differences.	摄入较高的EPA和DHA可以预防或延缓中度AMD的发作	Higher intake of EPA and DHA may prevent or delay the onset of moderate AMD	[113]

w = 周;d = 天;m = 月;ALA = α-亚麻酸;LA = 亚油酸;TNF-α=肿瘤坏死因子-α;IL-1β = 白细胞介素-1β;TNF-β=肿瘤坏死因子-β;IFN-β=干扰素-β;IL-2 = 白细胞介素-2;IL-6 = 白细胞介素-6;IL-10-白细胞介素-10;DHA = 二十二碳六烯酸;EPA = 二十碳五烯酸;OSDI = 眼表疾病指数;DEQ = 干眼症问卷;MMP-9 = 基质金属蛋白酶-9;Nrf2 = 核因子红系 2 相关因子 2;血红素HO-1=加氧酶-1;COX-2 = 环氧合酶-2;NF-κB = 核因子 κ-B;AMD = 年龄相关性黄斑变性。

w = Week; d = day; m = month; ALA = alpha-linolenic acid; LA = linoleic Acid; TNF-α = tumor necrosis factor-α; IL-1β = interleukin-1β; TNF-β = tumor necrosis factor-β; IFN-β = interferon-β; IL-2 = interleukin-2; IL-6 = interleukin-6; IL-10-interleukin-10; DHA = docosahexaenoic acid; EPA = eicosapentaenoic acid; OSDI = ocular surface disease index; DEQ = dry eye questionnaire; MMP-9 = matrix metalloproteinase-9; Nrf2 = nuclear factor erythroid 2-related factor 2; Heme HO-1 = Oxygenase-1; COX-2 = cyclooxygenase-2; NF-κB = nuclear factor kappa-B; AMD = age-related macular degeneration.