OBJECTIVE: Best disease is a slowly progressive macular dystrophy that typically has an onset in early childhood. Multiple lines of evidence suggest that dietary docosahexaenoic acid (DHA) protects against the development of macular degeneration. Our trial tested the effect of an oral supplement of DHA on visual function in patients with Best disease. DESIGN: Double-masked, randomized, placebo-controlled, crossover clinical trial. PARTICIPANTS: Eight patients with Best disease. METHODS: Patients were given either an oral supplement of DHA (20 mg/kg daily) or placebo. Primary outcome measures were the multifocal electroretinogram (mfERG) and electro-oculogram (EOG). Plasma DHA was tracked along with visual acuity (Early Treatment Diabetic Retinopathy Study chart), VF-14 scores, and Humphrey visual fields. RESULTS: All 8 patients had increased plasma DHA levels (2-3 fold) during periods of DHA supplementation compared with periods without supplementation. Differences in visual acuity, VF-14 scores, and EOG Arden ratios during periods with and without DHA supplementation were all statistically insignificant. A positive correlation was found between the plasma concentration of DHA and mfERG amplitudes, but amplitude changes during the treatment periods were not significant. A carryover effect of DHA supplementation was a confounding error. CONCLUSIONS: Our pilot trial of DHA supplementation in 8 patients with Best disease did not demonstrate an improvement in macular function. An expanded trial would be needed to examine the full effects of DHA supplementation on visual function in Best disease.
RCT Entities:
OBJECTIVE:Best disease is a slowly progressive macular dystrophy that typically has an onset in early childhood. Multiple lines of evidence suggest that dietary docosahexaenoic acid (DHA) protects against the development of macular degeneration. Our trial tested the effect of an oral supplement of DHA on visual function in patients with Best disease. DESIGN: Double-masked, randomized, placebo-controlled, crossover clinical trial. PARTICIPANTS: Eight patients with Best disease. METHODS:Patients were given either an oral supplement of DHA (20 mg/kg daily) or placebo. Primary outcome measures were the multifocal electroretinogram (mfERG) and electro-oculogram (EOG). Plasma DHA was tracked along with visual acuity (Early Treatment Diabetic Retinopathy Study chart), VF-14 scores, and Humphrey visual fields. RESULTS: All 8 patients had increased plasma DHA levels (2-3 fold) during periods of DHA supplementation compared with periods without supplementation. Differences in visual acuity, VF-14 scores, and EOG Arden ratios during periods with and without DHA supplementation were all statistically insignificant. A positive correlation was found between the plasma concentration of DHA and mfERG amplitudes, but amplitude changes during the treatment periods were not significant. A carryover effect of DHA supplementation was a confounding error. CONCLUSIONS: Our pilot trial of DHA supplementation in 8 patients with Best disease did not demonstrate an improvement in macular function. An expanded trial would be needed to examine the full effects of DHA supplementation on visual function in Best disease.
Authors: Silvia Lorente-Cebrián; André G V Costa; Santiago Navas-Carretero; María Zabala; Laura M Laiglesia; J Alfredo Martínez; María J Moreno-Aliaga Journal: J Physiol Biochem Date: 2015-03-11 Impact factor: 4.158
Authors: N Brito-García; T Del Pino-Sedeño; M M Trujillo-Martín; R M Coco; E Rodríguez de la Rúa; I Del Cura-González; P Serrano-Aguilar Journal: Eye (Lond) Date: 2016-12-09 Impact factor: 3.775
Authors: Dennis R Hoffman; Dianna K Hughbanks-Wheaton; N Shirlene Pearson; Gary E Fish; Rand Spencer; Alison Takacs; Martin Klein; Kirsten G Locke; David G Birch Journal: JAMA Ophthalmol Date: 2014-07 Impact factor: 7.389
Authors: Asmaa S Abdelhamid; Tracey J Brown; Julii S Brainard; Priti Biswas; Gabrielle C Thorpe; Helen J Moore; Katherine Ho Deane; Fai K AlAbdulghafoor; Carolyn D Summerbell; Helen V Worthington; Fujian Song; Lee Hooper Journal: Cochrane Database Syst Rev Date: 2018-11-30
Authors: Asmaa S Abdelhamid; Tracey J Brown; Julii S Brainard; Priti Biswas; Gabrielle C Thorpe; Helen J Moore; Katherine Ho Deane; Fai K AlAbdulghafoor; Carolyn D Summerbell; Helen V Worthington; Fujian Song; Lee Hooper Journal: Cochrane Database Syst Rev Date: 2018-07-18
Authors: Rosa Dolz-Marco; Roberto Gallego-Pinazo; M Dolores Pinazo-Duran; Sheila Pons-Vázquez; Joan Carles Domingo-Pedro; Manuel Díaz-Llopis Journal: PLoS One Date: 2014-05-08 Impact factor: 3.240