Topical Cyclosporine A in the Treatment of Dry Eye

Zhou, Xiao Qing; Wei, Rui

doi:10.1097/ico.0000000000000123

Cited by 79 publications

(48 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It has been shown to inhibit the production and/or release of proinflammatory cytokines and to upregulate the release of anti-inflammatory cytokines [94,96]. Moreover, inhibites the apoptosis and the number of Fas-ligand expression in infiltrating lymphocytes of human conjunctival epithelial cells [96,97]. The U.S. FDA approved on 11 July 2016 the first …”

Section: Topical Immunomodulatorsmentioning

confidence: 99%

Analysis of the Pathogenic Factors and Management of Dry Eye in Ocular Surface Disorders

Nebbioso¹,

Regno²,

Gharbiya³

et al. 2017

Preprint

View full text Add to dashboard Cite

The alteration of the delicate balance that regulates the secretion and distribution of the tear film determines the dry eye (DE) syndrome, because the tear film represents the interface between the eye and the environment. Despite having a multifactorial origin, the main risk factors for the emergence of the ocular disease are female gender and advanced age. Peer-reviewed version available at Int. J. Mol. Sci. 2017, 18, 1764 doi:10.3390/ijms18081764 2 Likewise, morphological changes in several glands and in chemical composition of their secretions such as proteins, mucins, lipidics, aqueous tears, and salinity, are highly relevant factors to maintain a condition of good health of the ocular anterior segment. Another key factor of recurrence and onset of the disease is the presence of local and/or systemic infiammation that reflex on the ocular surface. However, it is one of the most commonly encountered disease in clinical practice and many other causes related to daily life and to lengthen the average life will contribute to the beginning. This review will consider how and what disorders of the ocular surface are responsible for a widespread pathology so. In the end, the most appropriate and new therapies will be briefly exposed according to the specific pathology.

show abstract

Section: Topical Immunomodulatorsmentioning

confidence: 99%

Analysis of the Pathogenic Factors and Management of Dry Eye in Ocular Surface Disorders

Nebbioso¹,

Regno²,

Gharbiya³

et al. 2017

Preprint

View full text Add to dashboard Cite

show abstract

“…6,21–23,33–35 In addition, significant improvement in tear film stability after treatment with tacrolimus 0.05% may relate to enhancement of goblet cells function, an effect that has been previously reported with the use of topical cyclosporine. 36,37 …”

Section: Discussionmentioning

confidence: 99%

A Clinical Trial Comparing the Safety and Efficacy of Topical Tacrolimus versus Methylprednisolone in Ocular Graft-versus-Host Disease

et al. 2016

View full text Add to dashboard Cite

Purpose To evaluate the safety and efficacy of topical tacrolimus 0.05% vs. topical methylprednisolone 0.5% in patients with ocular graft-versus-host disease (GVHD). Design Phase I/II, prospective, randomized, double-masked clinical trial. Subjects Eighty eyes from 40 patients diagnosed with chronic ocular GVHD were enrolled. Methods Forty patients with ocular GVHD were randomized; 24 patients were treated with topical tacrolimus 0.05% and 16 patients with topical methylprednisolone 0.5% twice a day for 10 weeks, in addition to continuing their baseline treatment regimen. Main Outcome Measures Safety was evaluated based on occurrence of adverse events. Tolerability was assessed based on subjects’ reports of discomfort after drop instillation. Intraocular pressure (IOP) was monitored. The main efficacy endpoints were: corneal fluorescein staining (CFS), tear break-up time (TBUT), Schirmer test, and expression of the ocular surface inflammatory markers human leukocyte antigen-DR (HLA-DR) and intercellular adhesion molecule-1 (ICAM-1). Symptoms were evaluated using the Ocular Surface Disease Index (OSDI). Results After 10 weeks of treatment, no major adverse events occurred in either treatment group, and there was no significant difference in the composite tolerability scores between the two groups (P=0.06). However, burning sensation was more pronounced with tacrolimus (P=0.002). Topical tacrolimus was more effective than methylprednisolone in reducing the CFS score at week 10 (55% vs. 23% reduction, respectively; P=0.01), and achieved significant improvement in TBUT when compared to baseline (P<0.001). OSDI score reduction achieved statistical significance with tacrolimus (27% reduction; P=0.02) but was marginal with methylprednisolone (32% reduction; P=0.06). ICAM-1 expression by ocular surface epithelium decreased significantly in both groups (tacrolimus P=0.003; methylprednisolone P=0.008), while HLA-DR expression significantly decreased only in the tacrolimus group (P=0.03). Schirmer test scores did not change significantly in either group during the study; IOP increased significantly with methylprednisolone at week 10 (P=0.04). Conclusions Topical tacrolimus 0.05% is safe, generally well tolerated and effective for the treatment of ocular GVHD, without the hypertensive effects of topical corticosteroids.

show abstract

“…27,28 The anti-inflammatory effect of topical cyclosporine 0.05% administered twice daily has been proven to be beneficial to reduce the inflammatory effects of mild to moderate dry eye disease. 15,20 Our study evaluated the concurrent effect of topical cyclosporine 0.05% therapy on the ocular surface in patients of long-term ocular hypotensives. Patients enrolled in our study were using combination therapy of topical timolol 0.5% and brimonidine 0.2% and prostaglandins analogs (with BAK preservatives).…”

Section: Discussionmentioning

confidence: 99%

“…5,[7][8][9][10][11][12][13][14] Topical cyclosporine has been proven to have a beneficial effect in cases of dry eye disease (DED). 15 In a recent study in rabbit eyes beneficial effects of topical cyclosporine has been demonstrated on adverse ocular surface changes produced by long-term antiglaucoma medications. 16 The effect of topical cyclosporine therapy in chronic glaucoma patients on changes in the central corneal subbasal nerve fiber layer (SBNFL) density in human eyes has not been evaluated.…”

Section: Introductionmentioning

confidence: 99%

Topical cyclosporine to control ocular surface disease in patients with chronic glaucoma after long-term usage of topical ocular hypotensive medications

Saini

Dhiman

Dada

et al. 2015

Eye

View full text Add to dashboard Cite

Purpose To evaluate changes in ocular surface and central corneal sub-basal nerve fiber layer (SBNFL) after topical cyclosporin therapy in chronic glaucoma patients on long-term topical antiglaucoma therapy. Methods A prospective comparative study of ocular surface evaluation of chronic glaucoma patients on long-term topical therapy treated concurrently with a topical cyclosporine 0.05% twice daily for 6 months and controls was done. The study parameters evaluated at recruitment and at the 6-month follow-up included details of topical antiglaucoma medications, visual acuity, intraocular pressure, ocular surface evaluation parameters (TBUT, Schirmers I, ocular surface staining scores and ocular surface disease (OSD) index score (OSDI)), central corneal sensation (Cochet Bonnett aesthesiometer), and central confocal microscopy to study the SBNFL density (SBNFLD). Results Thirty-two eyes of 16 patients with chronic glaucoma and 30 eyes of 15 normal subjects as controls were studied. Mean TBUT, pre/post CsA treatment was 8.67 ± 3.01/12.24 ± 1.83 s (P = 0.007). Mean conjunctival/corneal staining scores pre/post CsA treatment were 3.38 ± 1.93/1.50 ± 0.718 (P = 0.00) /5.19 ± 1.82/1.81 ± 0.78 (P = 0.098), respectively. Mean OSDI pre/post CsA treatment scores were 30.63 ± 14.61/14.76 ± 6.06 (P = 0.007). Mean corneal sensations scores pre/post CsA treatment were 4.64 ± 0.46/4.94 ± 0.39 (P = 0.002). Central corneal SBNFLD pre and post CsA treatment was 8811.35 ± 2985.29/10335.13 ± 4092.064 μm/mm 2 (P = 0.0001).Conclusions Schirmer's test, ocular surface staining scores, OSDI, corneal sensations, and corneal SBNFLD showed a statistically significant improvement following a 6-month concurrent topical CsA therapy.

show abstract

Topical Cyclosporine A in the Treatment of Dry Eye

Abstract: Topical CsA could be an effective treatment for DES, especially for DES associated with conjunctival injury. Further RCTs with larger sample sizes for different clinical types of DES are warranted to determine the efficacy and limitation for different clinical types of DES.

Cited by 79 publications

References 25 publications

Analysis of the Pathogenic Factors and Management of Dry Eye in Ocular Surface Disorders

Analysis of the Pathogenic Factors and Management of Dry Eye in Ocular Surface Disorders

A Clinical Trial Comparing the Safety and Efficacy of Topical Tacrolimus versus Methylprednisolone in Ocular Graft-versus-Host Disease

Topical cyclosporine to control ocular surface disease in patients with chronic glaucoma after long-term usage of topical ocular hypotensive medications

Contact Info

Product

Resources

About