Sodium hyaluronate eye drops of different osmolarity for the treatment of dry eye in Sjogren's syndrome patients

Abstract

Aim: To study the effect of the treatment of dry eye in Sjögren's syndrome patients with hypotonic or isotonic hyaluronate eye drops. Methods: 40 Sjögren's syndrome patients were divided in two groups and treated as follows: group 1 with hypotonic (150 mOsm/l) 0.4% hyaluronate eye drops; group 2 with isotonic 0.4% hyaluronate eye drops. The eye drops were instilled six times a day for 90 days. Grading of subjective symptoms, break up time (BUT), corneal fluorescein staining, conjunctival rose bengal staining, Schirmer's I test, and conjunctival impression cytology were carried out at 0 and 15, 30, 90 days from the beginning of the study. Patients were examined in a blind fashion. For the statistical analysis the Student's t test, Mann-Whitney U test, and χ 2 test were performed. Results: Symptoms were statistically significantly improved at day 15 in both groups but group 1 patients had a global score statistically significantly better group 2 (p=0.02). At day 15 group 1 patients had an improvement from baseline values of BUT (p=0.003), fluorescein, and rose bengal score (p=0.000001 and p=0.0004 respectively). Group 2 patients had, at day 15, an improvement of BUT and fluorescein score compared to baseline values (p=0.05 and p=0.0001 respectively). A comparison between the two groups showed better results for group 1 patients at day 15 for rose bengal stain (p=0.01) and for BUT (p=0.05) and fluorescein score (p=0.0003) at day 90. The conjunctival impression cytology showed that group 1 had a statistically significant better total score than group 2 starting from day 15 and lasting throughout the study (p<0.02). Also group 2 patients showed an improvement from baseline values starting from day 30 (p=0.000005). Conclusion: Hyaluronate eye drops are useful for treating severe dry eye in Sjögren's syndrome patients. The use of a formulation with pronounced hypotonicity showed better effects on corneoconjunctival epithelium than the isotonic solution.S odium hyaluronate eye drops have been used in several trials for the treatment of dry eye.

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

“…Instillations with 0.4% sodium hyaluronate were effective in achieving improvement in the rose bengal conjunctival stain starting from day 15 (p = 0.01) and for BUT and fluorescein corneal stain at day 90, but showed no improvement in the Schirmer's test, according to another RCT involving patients with primary (pSS) and secondary SS (26).…”

Aplicações oftalmológicas do ácido hialurônico

“…Utilizaram como parâmetros de comparação os sintomas apresentados, BUT, escore de fluoresceína, escore de rosa bengala e citologia de impressão da conjuntiva. A solução hipotô-nica foi superior em todos os parâmetros, exceto no escore de fluoresceína (16) . O uso de AH foi testado em usuários de lentes de contato rígidas com síndrome de 3h e 9h.…”

High molecular weight hyaluronan decreases oxidative DNA damage induced by EDTA in human corneal epithelial cells

“…21,22 HA is used as a tear substitute for dry eyes to increase tear film stability and reduce subjective symptoms, such as ocular irritation and burning. [23][24][25] Thus, HA is a remarkable biopolymer that appears to have an impressive array of biological functions.…”