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

Saini, Manu; Dhiman, Rebika; Dada, Tanuj; Tandon, Radhika; Vanathi, Murugesan

doi:10.1038/eye.2015.40

Cited by 31 publications

(16 citation statements)

References 34 publications

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“…Topical cyclosporine 0.05% has been found to be beneficial for ocular surface symptoms following a trabeculectomy 16 . In glaucoma patients on chronic topical glaucoma therapy, taking topical cyclosporine for 6 months was found to significantly improve their sub-basal nerve fiber layer density and corneal sensitivity, helping to reverse the adverse surface toxicity from preserved anti-glaucoma medications 29,85 .…”

Section: Management Of Ocular Surface Disease In Conjunction With Glamentioning

confidence: 99%

Ocular Surface Disease and Glaucoma Medications: A Clinical Approach

Zhang

Vadoothker

Munir

et al. 2019

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

118

100

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Section: Management Of Ocular Surface Disease In Conjunction With Glamentioning

confidence: 99%

Ocular Surface Disease and Glaucoma Medications: A Clinical Approach

Zhang

Vadoothker

Munir

et al. 2019

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

118

100

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“…This group found a lower density of subbasal nerve fibers in the treatment group as compared with normal controls. Interestingly, the density of subbasal nerve fibers increased significantly after 6 months of topical CsA 0.05% twice daily, supporting the fact that ocular surface inflammation causes nerve degeneration, which could be reversed using anti-inflammatory topical medication such as CsA 0.05% [38]. The authors did not investigate DC density or keratocyte activation grade as possible markers of inflammation in the cornea.…”

mentioning

confidence: 91%

“…Topical cyclosporine (CsA) use has been found to be beneficial in eyes on long-term ocular hypotensive medications [38]. Saini et al [38] evaluated the central corneal subbasal nerve fiber layer by Confoscan 4 (Nidek Technologies) after topical CsA 0.05% therapy in glaucomatous eyes under chronic topical therapy.…”

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confidence: 99%

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Assessment of Corneal Changes Associated with Topical Antiglaucoma Therapy Using in vivo Confocal Microscopy

et al. 2018

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Purpose: Ocular surface disease (OSD) is highly prevalent in eyes treated with chronic, topical antiglaucoma (A/G) therapy. The purpose of this study was to utilize in vivo confocal microscopy (IVCM) to evaluate the corneal morphology, including characteristics of corneal epithelial cells, presence of epithelial dendritic cells (DCs), and characteristics of subbasal nerve plexus, of eyes under topical A/G therapy versus normal eyes. Methods: Central corneal images were prospectively captured from 30 eyes of 16 patients under topical A/G therapy (>6 months) and 20 normal control eyes, using IVCM (HRT 3 RCM, Heidelberg, Germany). Demographic data were collected, as well as information on the types and duration of A/G therapy. In addition, OSD index (OSDI) score, tear film breakup time, Schirmer 1 test results, density of epithelial wing cells (WCs) and basal cells (BCs), subbasal nerve features (density, tortuosity, and reflectivity), and presence of DCs were all assessed and recorded by trained Doheny Image Reading Center graders. Results: IVCM findings of 30 glaucomatous eyes and 20 normal control eyes were analyzed. The mean OSDI score was 8.72 in controls and 32.06 in patients under A/G therapy (p = 0.002). Nerve fiber density, nerve fiber reflectivity, and BC density were all decreased in the A/G group (1,789.07 ± 785.70 μm/frame, 2.79 ± 0.83, 6,457.67 ± 692.55 cells/mm², respectively) as compared to controls (2,815.981 ± 563.77 μm/frame, 3.52 ± 0.50, 7,854.13 ± 1,073.69 cells/mm², respectively) (p < 0.05), whereas the decrease in WC density was statistically nonsignificant (p = 0.5). Nerve tortuosity and DC density were both significantly greater in the A/G eyes (3.00 ± 0.57, 71.24 ± 61.74 cells/mm², respectively) compared to controls (2.10 ± 0.42, 34.08 ± 11.70 cells/mm², respectively) (p < 0.05). Tear film breakup time and Schirmer 1 test results were significantly lower in the A/G group as compared to controls (p < 0.001). Conclusions: Using IVCM, our study identified significant microstructural alterations in the corneas of eyes treated with topical A/G therapy. In addition, our study also revealed that glaucoma patients treated with topical A/G therapy report significantly higher OSDI scores compared to controls. Thus, IVCM may be a useful tool in providing structural parameters to correlate with the functional OSDI assessments in the evaluation of ocular surface toxicity associated with topical A/G therapy.

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“…The corneal sensation threshold recorded was the measured lament length (cm) that provides a 50% positive response from four stimuli presentations. 14 Confocal microscopy was carried out in all recruited eyes using Heidelberg Retinal Tomograph with Rostock corneal module (HRT3-RCM, Dossenhein Germany). Central corneal images were obtained, in a manual gain mode using the standard setting of 63X objective lens, utilizing 670 nm red wavelength Helium-Neon diode laser as an illumination source.…”

Section: Methodsmentioning

confidence: 99%

Clinical Outcomes of Corneal Neurotization Using Sural Nerve Graft in Neurotrophic Keratopathy

Saini

Kalia²,

Jain³

et al. 2022

Preprint

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Objective To evaluate the efficacy of corneal neurotization using sural nerve graft coaptation to the contralateral supratrochlear nerve in unilateral neurotrophic keratopathy and corneal anaesthesia Methods A Prospective interventional study involving unilateral neurotrophic keratopathy, not responding to the medical measures was conducted. A few variations in corneal neurotization were attempted to expedient the surgical procedure. The study parameters evaluated were best corrected visual acuity improvement, ocular surface evaluation parameters [Tear break-up time (TBUT), Schirmer’s 1, and ocular surface staining scores (corneal and conjunctival staining)], central corneal sensation (Cochet Bonnet aesthesiometer), sub-basal nerve fibre length (SBNFL) and sub-basal nerve fibre density (SBNFD) determined by central confocal microscopy at recruitment and during follow-up at 1-month, 3-month, 6-month, 9-month and 12-month respectively following corneal neurotization procedure. Results Eleven eyes of 11 patients with unilateral neurotrophic keratopathy (NK) who underwent corneal neurotization were studied. Mean follow-up was 10.09 ± 2.31months (range, 6–12). Mean best corrected visual acuity at baseline, 1.35 ± 0.52 improved significantly to 1.06 ± 0.76 (P = 0.012) at 3 months and continued to 0.55 ± 0.60 (P = 0.027) at 12 months. There was a significant reduction in NK grade severity and improvement in ocular surface, as early as 1 month, and central corneal sensations (P = 0.024) as soon as 3 months. Mean corneal SBNF improved from 3.12 ± 1.84mm/mm2 to 4.49 ± 1.88 at 1-month (P = 0.008), 13.31 ± 3.61mm/mm2 (P = 0.028) at 12 months. Mean central corneal SBNFD evident at 6-months 1.83 ± 2.54no/mm2 (P = 0.018) and 4.90 ± 3.12no/mm2 (P = 0.028) at 12-month. Conclusion The study substantiates the routine practice of corneal neurotization, by simplifying the intricacies observed during the procedure.

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

Cited by 31 publications

References 34 publications

Ocular Surface Disease and Glaucoma Medications: A Clinical Approach

Ocular Surface Disease and Glaucoma Medications: A Clinical Approach

Assessment of Corneal Changes Associated with Topical Antiglaucoma Therapy Using in vivo Confocal Microscopy

Clinical Outcomes of Corneal Neurotization Using Sural Nerve Graft in Neurotrophic Keratopathy

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