Analysis of Topical Cyclosporine Treatment of Patients With Dry Eye Syndrome<subtitle>Effect on Conjunctival Lymphocytes</subtitle>

Abstract

To study the effect of topical cyclosporine on lymphocyte activation within the conjunctiva of patients with moderate to severe dry eye syndrome (Sjö gren and non-Sjö gren).Methods: Biopsy specimens were obtained at baseline and after 6 months of cyclosporine treatment from eyes of 32 patients with moderate to severe dry eye syndrome; 19 were cyclosporine treated (0.05% cyclosporine, n = 13; 0.1% cyclosporine, n = 6) and 13 were vehicle treated. Within this group there were 12 with Sjö gren syndrome and 20 with non-Sjö gren syndrome. Biopsy tissue was analyzed using immunohistochemical localization of binding of monoclonal antibodies to lymphocytic markers CD3, CD4, and CD8 as well as lymphocyte activation markers CD11a and HLA-DR.Results: In cyclosporine-treated eyes, biopsy results of conjunctivae showed decreases in the number of cells posi-tive for CD3, CD4, and CD8, while in vehicle-treated eyes, results showed increases in these markers, although these differences were not statistically significant. Following treatment with 0.05% cyclosporine, there was a significant decrease in the number of cells expressing the lymphocyte activation markers CD11a (PϽ.05) and HLA-DR (PϽ.05), indicating less activation of lymphocytes as compared with vehicle treatment. Within the Sjö gren patient subgroup, those treated with 0.05% cyclosporine also showed a significant decrease in the number of cells positive for CD11a (PϽ.001) as well as CD3 (PϽ.03), indicating a reduction in number of activated lymphocytes. Conclusion:Treatment of dry eye syndrome with topical cyclosporine significantly reduced the numbers of activated lymphocytes within the conjunctiva.

The effect of preservative-free HP-Guar on dry eye after phacoemulsification: a flow cytometric study

“…Elevated levels of this marker have been found in dry eye patients. 25 Treating dry eyes with artificial tears has proven to reduce the expression of these inflammatory markers, 26 which could be a consequence of the increased stability of the tear film upon increasing the TBUT and of the subsequent reduction in hyperosmolarity that the lubricant treatment produces. Our study indicates an increase in HLA-DR and CD3 after cataract surgery, which is insignificant in the case of HLA-DR.…”

Autologous serum eye drops for the treatment of severe dry eye in patients with chronic graft-versus-host disease

“…To avoid systemic side effects, topical treatment with cyclosporin A eye drops has been investigated for dry eye, but its efficacy for dry eye associated with cGVHD remains to be clarified. 5,19 It is possible that autologous serum eye drops may have functioned as a topical treatment with immunosuppressants in patients who received systemic immunosuppressants. However, this possibility is difficult to confirm, because patients on systemic immunosuppressants tend to have more severe dry eye.…”

Effects of the topical treatment with NSAIDs on corneal sensitivity and ocular surface of Sjögren's syndrome patients

“…4,5 It was shown that the topical antiinflammatory treatment of dry eye patients brought to a significant reduction of the numbers of activated lymphocytes within the conjunctiva, so demonstrating the potential usefulness of an anti-inflammatory treatment for dry eye. 6 The treatment of ocular surface inflammation can be helpful to improve symptoms of ocular discomfort in patients with SS. Nonsteriodal anti-inflammatory drugs (NSAIDs) could be considered a good alternative to steroids in order to avoid all the complications of steroidal therapy in the treatment of patients with chronic diseases such as SS.…”