Effect of Oral Choline Alfoscerate on Patients with Keratoconjunctivitis Sicca

Abstract

Keratoconjunctivitis sicca (KCS) or dry eye is a disease characterized by ocular surface symptoms. This study aimed to investigate the effectiveness of oral choline alfoscerate (CA) administration as a treatment for KCS. The medical records of dry eye patients who were refractory to topical eyedrops and then took oral CA were reviewed. Results of tear break-up time (TBUT), fluorescein ocular surface staining score (FSS), and tear secretion by the Schirmer test (STT) were analyzed. The results of the ocular surface disease index (OSDI), visual analog pain score (VAS), reporting of the severity and frequency of symptoms, and the modified Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire were also analyzed. The records of 47 patients were analyzed for this study. The mean age was 62.8 ± 9.3 years, and the patients included 9 males and 38 females. TBUT, OSDI, and VAS significantly improved after CA administration compared to before (p < 0.05, paired t-test). After CA administration, symptom frequency and impact on life improved (p < 0.05, paired t-test). No significant change in photophobia or FSS was identified. In conclusion, oral CA administration was effective in improving tear stability and alleviating symptoms of KCS.

Changes in Plasma Phospholipid Metabolism Are Associated with Clinical Manifestations of Systemic Sclerosis

“…This is in line with previously published data showing low levels of PE and SM in the ocular fluid, which was associated with ocular surface abnormalities in sicca patients [45]. Recently, a study was published describing the positive effects of oral uptake of choline alfoscerate (precursor of acetylcholine) in patients with sicca symptoms, and PC was shown to stimulate the synthesis of acetylcholine [46,47]. Thus, PC, PE, and SM play an important role in pathophysiology, and PC possibly also in the therapy of sicca symptoms, which could be true also for SSc patients with sicca problems and should be further evaluated.…”

Supplementary Effect of Choline Alfoscerate on Speech Recognition in Patients With Age-Related Hearing Loss: A Prospective Study in 34 Patients (57 Ears)

“…The severity of the disease or the effect of other medication they were taking could have affected their hearing progression. Fifth, the side effect of CA has not yet been revealed in the clinical study dealing with patients without cognitive disorders (Choi et al, 2020). Even though all patients in this study have not complained unexpected symptoms or signs, there is a possibility for unintended efficacy on the cholinergic system for better or worse; the long-term use of CA should be monitored with precaution.…”

Cholinergic system and the role it plays in the visual system

“…Similarly, studies in mouse models have confirmed the importance of mAchR M1 in RGC survival and suggest the impact of this receptor signaling as the possible therapeutic target in the management of glaucoma 136 . On the other hand, the benefits derived from the use of parasympathomimetic Ach precursors 137 such as choline alphoscerate to treat dry eye 138 -a disorder that has become prevalent across the -has already been established. This shows that cholinergic activity could be a matter of great interest regarding visual and eye research.…”