Short Term Effects of Topical Cyclosporine and Viscoelastic on the Ocular Surfaces in Patients with Dry Eye
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Purpose: To compare the short term effects of topical 0.05% cyclosporine (CsA) and a mixture of 0.08% chondroitin sulfate and 0.06% sodium hyaluronate (CS-HA) on dry eye ocular surfaces. Methods: 36 patients with moderate to severe dry eye (5 mm/5 min or less with Schirmer's test or tear break up time (BUT) less than 6 seconds), were treated with topical application of CS-HA on one eye and CsA on the other 4 times a day for 6-8 weeks. BUT, Schirmer's test without anesthesia, and conjunctival impression cytology (CIC; goblet cell density, nucleus to cytoplasmic ratio, and epithelial cell morphology) were evaluated and compared between eyes before and after treatment (repeated measurement of ANOVA). Results: After treatment, BUT and tear wettings were significantly prolonged in each group. Topical CsA treated eyes had greater increase in BUT (p=0.026); there was no significant difference in tear wetting (p=0.132). While the 3 parameters of CIC improved in both groups, goblet cell density was significantly higher in eyes treated with CsA (p=0.033). Conclusions: While both CS-HA and 0.05% CsA eyedrops improve ocular surfaces, topical CsA may have a better effect on enhancing tear film stability and goblet cell density.
Abstract
Purpose: To compare the short term effects of topical 0.05% cyclosporine (CsA) and a mixture of 0.08% chondroitin sulfate and 0.06% sodium hyaluronate (CS-HA) on dry eye ocular surfaces. Methods: 36 patients with moderate to severe dry eye (5 mm/5 min or less with Schirmer's test or tear break up time (BUT) less than 6 seconds), were treated with topical application of CS-HA on one eye and CsA on the other 4 times a day for 6-8 weeks. BUT, Schirmer's test without anesthesia, and conjunctival impression cytology (CIC; goblet cell density, nucleus to cytoplasmic ratio, and epithelial cell morphology) were evaluated and compared between eyes before and after treatment (repeated measurement of ANOVA). Results: After treatment, BUT and tear wettings were significantly prolonged in each group. Topical CsA treated eyes had greater increase in BUT (p=0.026); there was no significant difference in tear wetting (p=0.132). While the 3 parameters of CIC improved in both groups, goblet cell density was significantly higher in eyes treated with CsA (p=0.033). Conclusions: While both CS-HA and 0.05% CsA eyedrops improve ocular surfaces, topical CsA may have a better effect on enhancing tear film stability and goblet cell density.
참고문헌 (36)
- Baudouin C, "The pathology of dry eye", 45, pp.S211~S220 (2001)
- Lemp MA, "Report of the National Eye Institute", Industry workshop on Clinical Trials in Dry Eyes, 1995, pp.21, 221~232
- Yeh S, "Apoptosis of ocular surface cells in experimentally induced dry eye", 44, pp.124~129 (2003)
- Kunert KS, "Goblet cell numbers and epithelial proliferation in the conjunctiva of patients with dry eye syndrome treated with cyclosporine", 120, pp.330~337 (2002)
- Turner K, "Interleukin-6 levels in the conjunctival epithelium of patients with dry eye disease treated with cyclosporine ophthalmic emulsion", 19, pp.492~496 (2000)
- Pflugfelder SC, "Correlation of goblet cell density and mucosal epithelial membrane mucin expression with rose bengal staining in patients with ocular irritation", 104, pp.223~235 (1997)
- Baudouin C, "Flow cytometry in impression cytology specimens: a new method for evaluation of conjunctival inflammation", 8, pp.1458~1464 (1997)
- Brignole F, "Efficacy and safety of 0.18% sodium hyaluronate in patients with moderate dry eye syndrome and superficial keratitis", 243, pp.531~538 (2005)
- Sall K, "Two multicenter, randomized studies of the efficacy and safety of cyclosporine ophthalmic emulsion in moderate to severe dry eye disease", 107, pp.631~639 (2000)
- Tatlipinar S, "Topical ciclosporin in the treatment of ocular surface disorders", 89, pp.1363~1367 (2005)
- Papa V, "Comparison of hypotonic and isotonic solutions containing sodium hyaluronate on the symptomatic treatment of dry eye patients", 215, pp.124~127 (2001)
- Nepp J, "The clinical use of viscoelastic artificial tears and sodium chloride in dry-eye syndrome", 22, pp.3305~3310 (2001)
- Campo GM, "Efficacy of treatment with glycosaminoglycans on experimental collagen-induced arthritis in rats", 5, pp.122~131 (2003)
- Hamano H, "et al. A new method for measuring tears. CLAO J 1983", pp.281~9
- Toda I, "Tsubota K. Practical double vital staining for ocular surface evaluation. Cornea 1993", pp.366~7
- Saini JS, "Dhar S. Clinicopathological correlation of hard contact lens related changes in tarsal conjunctiva by impression cytology. Acta Ophthalmol", pp.65~70 (1990)
- Kinoshita S, "Thoft RA. Goblet cell density in ocular surface disease. A better indicator than tear mucin. Arch Ophthalmol 1983", pp.1284~7
- Barber LD, "Phase III safety evaluation of cyclosporine 0.1% ophthalmic emulsion administered twice daily to dry eye disease patients for up to 3 years", 112, pp.1790~1794 (2005)
- Strong B, "Topical cyclosporine inhibits conjunctival epithelial apoptosis in experimental murine keratoconjunctivitis sicca", 24, pp.80~85 (2005)
- Moore CP, "Effect of cyclosporine on conjunctival mucin in a canine keratoconjunctivitis sicca model", 42, pp.653~659 (2001)
- el Tayar N, "et al. Solvent-dependent conformation and hydrogen-bonding capacity of cyclosporin A evidence from partition coefficients and molecular dynamics simulations. J Med Chem 1993", pp.3757~64
- Mithani SD, "Estimation of the increase in solubility of drugs as a function of bile salt concentration", 13, pp.163~167 (1996)
- Kuwano M, "Cyclosporine A formulation affects its ocular distribution in rabbits", 19, pp.108~111 (2002)
- Limberg MB, "Kaufman HE. Topical application of hyaluronic acid and chondroitin sulfate in the treatment of dry eyes. Am J Ophthalmol 1987", McCaa C
- Shimmura S, "Sodium hyaluronate eyedrops in the treatment of dry eyes", 79, pp.1007~1011 (1995)
- Fukuda K, "Hyaluronic acid in tear fluid and its synthesis by corneal epithelial cells", 40, pp.62~65 (1998)
- Inoue M, "Katakami C. The effect of hyaluronic acid on corneal epithelial cell proliferation. Invest Ophthalmol Vis Sci 1993", pp.2313~5
- Lerner LE, "Hyaluronan and CD44 in the human cornea and limbal conjunctiva", 67, pp.481~484 (1998)
- Entwistle J, "HA receptors: signalling to the cytoskeleton", 61, pp.569~577 (1996)
- Rosales C, "Signal transduction by cell adhesion receptors", 1242, pp.77~98 (1995)
- Miyazaki T, "The effect of sodium hyaluronate on the growth of rabbit corneal epithelial cells in vitro", 12, pp.409~415 (1996)
- Nakamura M, "et al. Characterization of water retentive properties of hyaluronan. Cornea 1993", pp.433~6
- Nelson JD, "Farris RL. Sodium hyaluronate and polyvinyl alcohol artificial tear preparations. A comparison in patients with keratoconjunctivitis sicca. Arch Ophthalmol 1988", pp.484~7
- Stadler J, "et al. Articular chondrocytes synthesize nitric oxide in response to cytokines and lipopolysaccharide. J Immunol 1991", stefa(vic-racic m), pp.3915~20
- Solomon A, "Pro- and anti-inflammatory forms of interleukin-1 in the tear fluid and conjunctiva of patients with dry-eye disease", 42, pp.2283~2292 (2001)
- Luo L, "Experimental dry eye stimulates production of inflammatory cytokines and MMP-9 and activates MAPK signaling pathways on the ocular surface", 45, pp.4293~4301 (2004)
