Recurrence after Topical Nonpreserved Methylprednisolone Therapy for Keratoconjunctivitis Sicca in Sjögren's Syndrome

Hong, Samin; Kim, Terry; Chung, Sung Kun; Kim, Eung Kweon; Seo, Kyoung Yul

doi:10.1089/jop.2006.0091

Cited by 62 publications

(30 citation statements)

References 8 publications

(10 reference statements)

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“…The treatment led to significantly improved tear break-up time (BUT) and Schirmer test results at the end of the treatment period and drug-free remission for a mean duration of 56.6 weeks and 20.8% recurrences. The clinical improvement was associated with an increased number of conjunctival goblet cells as assessed by impression cytology (23).…”

Section: Topical Treatmentsmentioning

confidence: 94%

Advances in the treatment of ocular dryness associated with Sjögren׳s syndrome

Ciurtin

Ostas

Cojocaru³

et al. 2015

Seminars in Arthritis and Rheumatism

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Section: Topical Treatmentsmentioning

confidence: 94%

Advances in the treatment of ocular dryness associated with Sjögren׳s syndrome

Ciurtin

Ostas

Cojocaru³

et al. 2015

Seminars in Arthritis and Rheumatism

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Section: Corticosteroidsmentioning

confidence: 99%

“…In the setting of dry eye disease, topical corticosteroids have been shown to decrease corneal fluorescein staining, improve tear break up time, and improve Schirmer 1 testing [18,19]. A recurrence of signs of keratoconjunctivitis sicca may recur after stopping topical corticosteroids [19]. Lowpotency topical corticosteroid treatment with fluoromethalone (FML) in conjunction with artificial tears when compared to artificial tears alone and combination artificial tears and flurbiprofen (a topical nonsteroidal) has been shown to not only improve fluorescein and rose bengal staining but also demonstrate higher numbers of goblet cells on impression cytology in a randomized trial (involving Sjögren's syndrome and non-Sjögren's participants) [20].…”

Section: Corticosteroidsmentioning

confidence: 99%

Ocular Involvement in Sjögren’s Syndrome: Advances in Therapy

Gonzales

Lietman

2018

Curr Treat Options in Rheum

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“…Numerous studies have concluded topical or systemic corticosteroid therapy may have several benefi ts in the treatment of moderate to severe dry eyes. 59,87,88 For instance, in one study reviewing the effi cacy and side effects of topical nonpreserved corticosteroid therapy for treatment of severe KCS with SS, topical nonpreserved methylprednisolone was found to be effective for severe KCS. However, it has been also emphasized that careful monitoring is mandatory in these cases because of steroid-related complications.…”

Section: Corticosteroid Therapymentioning

confidence: 99%

“…87 Similar results were obtained from another study that evaluated the prevalence of long-term recurrence after topical nonpreserved methylprednisolone pulse therapy for the treatment of KCS with SS. 88 In an experimental dry eye model, the mechanisms of topical methylprednisolone and doxycycline in the treatment of infl ammation were described. 59 According to that study, both agents reduced expression and activity of MMP-9, decreased levels of infl ammatory cytokines transcripts and reduced activation of MAPKs in the corneal epithelium.…”

Section: Corticosteroid Therapymentioning

confidence: 99%

The role of inflammation and antiinflammation therapies in keratoconjunctivitis sicca

Gümüş

Cavanagh

2008

OPTH

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Purpose: To review and integrate recent advances in identifying the role of infl ammation in the pathogenesis of dry eye conditions and the biological rationale and practical clinical aspects of newer, antiinfl ammatory theories. Methods: A comprehensive literature survey. Results and conclusion: Keratoconjunctivitis Sicca (KCS) is a multifactorial and complex disorder in which ocular surface infl ammations play a central role. Identifi cation of specifi c CD4-T-Cell pathways and the recent recognition of targeting of alpha-fodrin suggest a case for novel new therapeutic aspects such as anti-CD4 monoclonal antibodies, systemic linoleic and gamma-linolenic acids, and omega-6 essential fatty acids. Replacement of tear volume with nonpreserved wetting agents and standard typical antiinfl ammatory corticosteroid and/or cyclosporine A continues to be central current conventional therapy for KCS. Keywords: dry eye, keratoconjunctivitis sicca, antiinfl ammatory therapy Dry eye disease or keratoconjunctivitis sicca (KCS) is a common disorder which refers to a spectrum of ocular surface diseases with multiple etiologies.1 KCS is associated with symptoms of ocular discomfort such as burning, sense of dryness, foreign body sensation, ocular pain, and is sometimes associated with photophobia, blurred vision, visual fatigue, and sight-threatening corneal complications in severe cases. 2,3Epidemiologic studies have stated that more than 6% of the population complains of dry eye symptoms, and this ratio increases to 15% over the age of 65. [4][5][6] Most of the studies have also found an increasing prevalence with aging and greater prevalence among women due to the hormonal status. 4,6,7 Pathogenesis of KCS has not been completely clarified. Even though KCS has been thought of classically and basically as a condition of tear deficiency, whether caused by decreased lacrimation or excessive evaporation, it is a complex disorder. Many clinicopathological entities involving tear film, lacrimal glands, eyelids, and a wide spectrum of ocular surface cells, including epithelial, inflammatory, immune, and goblet cells may play a role in its pathogenesis. 2,8Over the past years, as a result of numerous studies, new concepts of pathogenesis have shown that KCS seems to be caused by infl ammation mediated by T-cell lymphocytes. [9][10][11] This fi nding has also been augmented by the studies investigating the role of antiinfl ammatory therapies. For instance, the treatment of KCS gained a new dimension with the approval of topical 0.05% cyclosporine A (Restasis) (Allergan, Inc., package insert for Restasis) by the US Food and Drug Administration. Consequently, because of the increasing importance of the role of infl ammation and the use of cyclosporine eye drops, the goal of this review article is to provide the readers with an overview of Clinical Ophthalmology downloaded from https://www.dovepress.com/ by 35.167.132.9 on 10-May-2018 For personal use only.Powered by TCPDF (www.tcpdf.org)

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Recurrence after Topical Nonpreserved Methylprednisolone Therapy for Keratoconjunctivitis Sicca in Sjögren's Syndrome

Abstract: Topical nonpreserved methylprednisolone pulse therapy proved to be a safe, effective long-term treatment of improving subjective and objective dry eye factors in KCS patients with Sjögren's syndrome.

Cited by 62 publications

References 8 publications

Advances in the treatment of ocular dryness associated with Sjögren׳s syndrome

Advances in the treatment of ocular dryness associated with Sjögren׳s syndrome

Ocular Involvement in Sjögren’s Syndrome: Advances in Therapy

The role of inflammation and antiinflammation therapies in keratoconjunctivitis sicca

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