Efficacy of Topical Cyclosporine 0.05% in the Treatment of Dry Eye Associated With Graft Versus Host Disease

Abstract

The findings in this prospective study suggest that dry eye associated with graft versus host disease can be effectively treated with topical cyclosporine, especially in patients unresponsive to other treatment modalities. These findings should be further evaluated in large-scale, controlled clinical trials.

Ocular surface and tear functions after topical cyclosporine treatment in dry eye patients with chronic graft-versus-host disease

“…28,29 A previous noncontrolled trial in 8 patients with cGVHD dry eyes showed significant improvement of Schirmer basal secretion scores, TBUT and tear lysozyme levels after 3 months of treatment with 0.05% topical Cys. 30 Another retrospective noncontrolled study in 16 patients with cGVHD dry eye disease treated with 0.05% topical Cys showed significant improvements of symptom scores and vital staining after a mean follow up of 90 days. 31 The two studies showed increased Schirmer values, but the baseline Schirmer value in these two studies were much higher (from 7.274.0 mm to 11.372.2 mm after 3 months of treatment, from 8.0 mm to 8.5 mm after a mean follow up of 90 days) than the values reported in our study (from 3.473.1 mm to 4.774.5 mm after 1 month of treatment), suggesting a much more severe disease in our case compared to these two previous reports.…”

The Effect of Topical Cyclosporine A on Clinical Findings and Cytological Grade of the Disease in Patients With Dry Eye

“…This study suggested that topical cyclosporine 0.05% treatment provided improvements in Schirmer test results, BUT scores, and tear lysozyme levels in patients with GVHD. 28 Wang et al 29 also investigated the effect of topical cyclosporine in patients with dry eye with chronic GVHD and suggested that improvements in the ocular surface and tear functions after 1 month of topical cyclosporine A emulsion therapy resulted from the decreased inflammation, increased goblet cell density, and MUC5AC messenger RNA expression.…”

Diagnosis and Treatment of Ocular Chronic Graft-Versus-Host Disease: Report From the German–Austrian–Swiss Consensus Conference on Clinical Practice in Chronic GVHD

“…8 Anti-inflammatory drugs such as topical steroids and cyclosporine eye drops have been shown to be effective in the therapy of cGVHD-related and non-cGVHD-related KCS. [8][9][10][11][12][13][14][15][16][17] The main therapeutic aim in the management of ocular cGVHD is therefore the treatment of both inflammation and dryness to relieve patients' symptoms and to maintain ocular integrity and function.…”