Efficacy and Safety of Topical Atorvastatin for the Treatment of Dry Eye Associated with Blepharitis: A Pilot Study

Abstract

Aims: To elucidate if topically applied atorvastatin safely decreases corneal fluorescein staining in dry eyes associated with blepharitis. Methods: Ten dry eye and blepharitis (DEB) patients were enroled in a prospective pilot study. All patients were treated with topical atorvastatin (50 μ<smlcap>M</smlcap>) 8 times a day for 4 weeks and allowed to continue with their existing dry eye treatment. The patients were examined weekly for 4 weeks. The primary outcome measure was corneal fluorescein staining. Secondary outcome measures were tear film break-up time (BUT), Schirmer I testing, blepharitis score and bulbar conjunctival injection. The subjective efficacy was evaluated with global symptom and facial analogue scores. Results: An improvement in corneal fluorescein staining in the treated eye by >1 point from baseline to completion of the trial at week 4 was found in 9 of 10 patients (p < 0.01). Topical atorvastatin significantly improved the tear film BUT (p < 0.01), blepharitis score (p < 0.05) and bulbar conjunctival injection (p < 0.05). The global symptom score and facial analogue score also improved (p < 0.05). There were no side effects. Conclusion: Topical atorvastatin is a potential therapy for DEB patients. Larger comparative clinical studies are required to establish the efficacy and safety of topical atorvastatin.

Ocular manifestations of rosacea: A clinical review

“…This has led to the postulation that the use of topical statins may be beneficial in meibomian gland disease. In a pilot study, treatment with topical atorvastatin (50 μM, 8 times a day for 4 weeks) has been shown to improve symptoms of dry eyes and blepharitis 107 . Conversely, oral statins have not been shown to modify meibomian gland atrophy and meibum quality 108 …”

Association of dyslipidaemia and oral statin use, and dry eye disease symptoms in the Blue Mountains Eye Study

“…The authors ascribe this effect to be due to potentially a local, more potent HMG-CoA reductase inhibition as well as through their known anti-inflammatory properties. 18 Different mechanisms underlying the DED symptoms may have confounded our study findings. DED symptoms due to MGD and aqueous deficiency or mixed aetiology were not differentiated in the study.…”

“…Furthermore, a topical statin applied to the ocular surface has been shown to be efficacious for the treatment of dry eye associated with blepharitis. The authors ascribe this effect to be due to potentially a local, more potent HMG‐CoA reductase inhibition as well as through their known anti‐inflammatory properties …”

“…Establishing an association may allow “at‐risk” patients for dry eye to be identified. It could also inform the development of new oral as well topical statin‐based therapeutic strategies for dry eye, with the latter now reported in the literature …”

“…It could also inform the development of new oral as well topical statin-based therapeutic strategies for dry eye, with the latter now reported in the literature. 18…”