Evaluation of the effect of topical cyclosporine A with impression cytology in dry eye patients

Eur J Ophthalmol. Jul-Aug 2010;20(4):675-9. doi: 10.1177/112067211002000405.

Abstract

Purpose: This study evaluated the efficacy of topical cyclosporine A 0.05% treatment with impression cytology in dry eye patients.

Methods: Forty eyes of 40 patients with dry eye were included. Schirmer tear break-up time, and Ocular Surface Disease Index (OSDI) scores and goblet cell densities were noted before and after 6 months of topical cyclosporine A treatment. Patients were graded clinically and biomicroscopically as follows: grade 1, 12 patients; grade 2, 18; and grade 3, 10 patients.

Results: Mean age was 57.1 +/- 11.8 (23.0-80.0) years. A total of 36 (90%) of the patients were female and 4 (10%) were male. Mean Schirmer test value was 3.2 +/- 1.6 (0.0-8.0) mm in the beginning and was 8.4 +/- 4.3 (1.0-19.0) mm after 6 months of cyclosporine A topical treatment (p = 0.00). At the first visit, mean tear break-up time was 4.4 +/- 1.8 (2.0-8.0) seconds. It increased to 11.8 +/- 4.8 (2.0-20.0) seconds at the end of the sixth month (p = 0.00). Mean clinical grading was 1.9 +/- 0.8 (1.0-3.0) and this value regressed to 0.8 +/- 1.2 (0.0-3.0) after the treatment (p = 0.00). Mean OSDI score was 30.0 +/- 11.7 (9.0-50.0) before the treatment and 21.3 +/- 11.0 (4.0-47.0) after the treatment (p = 0.00). Mean goblet cell density of all cases was 12.3 +/- 8.7 before the treatment (2.0-28.0). It increased to 33.0 +/- 25.4 (6-70) after the treatment (p = 0.04).

Conclusions: Topical cyclosporine A treatment is effective in grade 1 and grade 2 dry eye patients but results are poor in grade 3 patients.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Topical
  • Adult
  • Aged
  • Conjunctiva / drug effects
  • Conjunctiva / pathology*
  • Cyclosporine / administration & dosage*
  • Cytological Techniques / methods*
  • Dry Eye Syndromes / drug therapy
  • Dry Eye Syndromes / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / administration & dosage*
  • Male
  • Middle Aged
  • Ophthalmic Solutions / administration & dosage
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome
  • Young Adult

Substances

  • Immunosuppressive Agents
  • Ophthalmic Solutions
  • Cyclosporine