Abstract
The hereditary retinal dystrophies (HRDs) are a group of genetically determined disorders that result in loss of the visual function. There is a lack of standard pharmacological treatments or widely accepted nutritional recommendations. The objective of this review is to summarise the scientific evidence on the effectiveness and safety of nutritional supplements for the treatment of HRDs. We conducted a scientific literature search on Medline and PreMedline, EMBASE, SCI-EXPANDED, SSCI, and The Cochrane Library up to August 2014. Experimental, quasi-experimental and controlled observational studies were selected. Eight studies were ultimately included, seven on retinitis pigmentosa (RP) and one on Best disease. Vitamin A, vitamin E, docosahexaenoic acid (DHA), lutein and β-carotene were assessed. A 15 000 IU daily dose of vitamin A was reported to have shown a small protective effect on the progression of RP, as was the use of the carotenoids lutein and β-carotene. Different DHA doses has no effect on RP or Best disease. No supplement showed severe adverse effects in the selected studies although strong evidence of toxicity exists for high doses of vitamin A and β-carotene in certain populations. The selected studies concluded that there may be a small beneficial effect of vitamin A, lutein and β-carotene on the progression of RP. The limited evidence available indicates some well-designed additional studies on combined supplements strategies may achieve more robust conclusions. Moreover, the scarcity of evidence available on the treatment of HRD other than RP with nutritional supplements supports the need for further research efforts.
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Acknowledgements
This work was supported by the Institute of Health Carlos III, an autonomous organisation of the Spanish Ministry of Economy and Finance, in cooperation with the Evaluation Service of the Canary Islands Health Service (SESCS), in the framework of the activities developed by the Spanish Network of Agencies for Health Technology Assessment for the National Health Service financed by the Spanish Ministry of Health, Social Services and Equality. We thank the information specialist Mrs Leticia Cuellar Pompa for the development of the search strategies for electronic literature databases. We also thank Ms Rowan Maxwell for her assistance in improving the English language of the present manuscript.
Search terms and databases
Electronic searches were performed on Medline and PreMedline, EMBASE, SCI-EXPANDED, SSCI, and The Cochrane Library. The search strategy was developed initially in MEDLINE using controlled vocabulary and free text terms and then it was adapted for each of the other databases. Searches were limited to the English and Spanish languages and no date restriction was imposed. The Medline search strategy is presented in Table 1 and the full search strategy is available from the study authors.
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Brito-García, N., del Pino-Sedeño, T., Trujillo-Martín, M. et al. Effectiveness and safety of nutritional supplements in the treatment of hereditary retinal dystrophies: a systematic review. Eye 31, 273–285 (2017). https://doi.org/10.1038/eye.2016.286
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DOI: https://doi.org/10.1038/eye.2016.286
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