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A Journal on Ophthalmology
Minerva Oftalmologica 2016 March;58(1):15-23
The use of cyclosporine 0.5% eye drops in patients with severe ocular surface alterations
Bruno OLDANI 1, Alessandro G. ACTIS 2, 3, Claudia FRUTTERO 4, Raffaele PELLERITO 5
1 Department of Ophthalmology, Umberto I Hospital, Turin, Italy; 2 ASL Torino 1 and ASL Cuneo 1, Servizio Sanitario Nazionale, Regione Piemonte, Italy; 3 Eye Clinic, Department of Surgery, University of Turin, Turin, Italy; 4 Hospital Pharmacy, Umberto I Hospital, Turin, Italy; 5 Department of Rheumatology, Umberto I Hospital, Turin, Italy
BACKGROUND: Aim of this study was to evaluate the efficacy of the treatment with topical 0.5% cyclosporine A (CsA) in patients with severe dry eye syndrome.
METHODS: Out of 125 included patients, 99 could complete the study: 48 (48.48%) had a diagnosis of Sjögren’s Syndrome, 10 (10.1%) of Sjögren’s Syndrome associated with thyroid diseases, 5 (5.05%) of Graves’ ophthalmopathy, 10 (10.1%) of rheumatoid arthritis, 6 (6.06%) of undifferentiated connective tissue disease, 4 (4.04%) of ocular pemphigoid, 16 (16.16%) of idiopathic dry eye or sicca syndrome. Each patient was examined by an ophthalmologist of our department at baseline (t0), evaluating Ocular Surface Disease Index (OSDI), Schirmer’s test, break-up time (BUT), Ocular Staining Score (OSS, evaluating fluorescein and lissamine green staining). After two months of therapy (t1) with cyclosporine 0.5% eye drops twice a day, each patients was re-examined.
RESULTS: After therapy with CsA drops OSDI score and OSS improved in all groups of patients. (P<0.05). BUT improved in all patients (P<0.05) except patients affected by ocular pemphigoid and Graves’ ophthalmopathy. Schirmer’s test improved only in Sjögren’s Syndrome patients (associated or not with thyroid diseases) and in idiopathic dry eye or sicca syndrome patients (P<0.05).
CONCLUSIONS: Our study suggest that anti-inflammatory therapy with cyclosporine A eye drops significantly improves subjective symptoms and objective signs in patients with severe dry eye disease providing a good safety profile.