Pilot Trial of Cyclosporine 1% Ophthalmic Ointment in the Treatment of Keratoconjunctivitis Sicca

Laibovitz, Robert; Solch, Suzanne; Andriano, Kim; O'Connell, Marianne; Silverman, Michael

doi:10.1097/00003226-199307000-00007

Cited by 98 publications

(48 citation statements)

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“…Topical use of CsA in dry-eye syndrome was first reported by Laibovitz, et al 6 CsA effectively reduced lymphocyte infiltration and apoptosis of lacrimal gland and conjunctiva, and stimulated the apoptosis of lymphocytes in animal models with dry eye. 24 Cs A also significantly reduced IL-6 levels, 25 and HLA-DR and CD11A expression in conjunctival samples and increased goblet cell counts 26 in dry eye patients.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, it has been used for the treatment of dry-eye symptoms in its advanced stages. [6][7][8][9][10][11] In this pilot study, we combined the use of CsA with artificial tear drops in a group of TO patients with documented dry-eye symptoms and compared its use with artificial tear drops alone, in an attempt to reduce dry-eye symptoms more effectively.…”

Section: Introductionmentioning

confidence: 99%

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Topical cyclosporine A for the dry eye findings of thyroid orbitopathy patients

Altiparmak

Acar

Ozer

et al. 2009

Eye

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Purpose To determine the beneficial effect of topically administered Cyclosporine A (CsA) for the dry eye findings of thyroid orbitopathy patients. Patients and methods This prospective pilot study included 73 eyes of 42 patients with thyroid orbitopathy who had documented dry eye findings. Patients were randomly assigned into two groups: in group 1 (48 eyes), patients received topical artificial tear-drop treatment. In group 2 (25 eyes), patients received topical CsA and artificial tear-drop treatment. During a mean follow-up of 6 months, change in Schirmer's test with aneasthesia, tear break-up-time (BUT) and impression cytology results were analyzed and were compared between groups. Results The two groups were age (P ¼ 0.449) and gender (P ¼ 0.942) matched. The Schirmer's test (P ¼ 0.441), tear BUT (P ¼ 0.718) and impression score (P ¼ 0.103) were also similar before the treatment in both groups. In group 1, all three parameters improved significantly with treatment (Po0.001 for all). In group 2, Schirmer's test (P ¼ 0.001) and tear BUT (Po0.001) improved, but the impression score (P ¼ 0.175) did not change significantly after treatment. The percentage of patients with improved tear BUT (P ¼ 0.04) and improved impression score (Po0.001) were higher in group 1. At the end of follow-up, group 1 patients had better Schirmer's test (P ¼ 0.004), tear BUT (P ¼ 0.021) and impression scores (Po0.001), than group 2 patients. Conclusions The combined CsA use with artificial tear drops is not more advantageous than the use of artificial tear drops alone, for the dry eye findings of thyroid orbitopathy patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Topical cyclosporine A for the dry eye findings of thyroid orbitopathy patients

Altiparmak

Acar

Ozer

et al. 2009

Eye

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“…14 There have been several clinical trials investigating the effect of cyclosporine in dry eye patients. [15][16][17] In one, cyclosporine significantly reduced conjunctival Rose Bengal staining, superficial punctuate staining, and ocular irritation symptoms. Cyclosporine has been shown to decrease activated T cells, 15 pro-inflammatory cytokines, 18,19 and epithelial cell apoptosis, 20 and to increase goblet cell density in dry eye with an inflammatory component.…”

Section: Discussionmentioning

confidence: 97%

Short-term effects of topical cyclosporine A 0.05% (Restasis) in long-standing prosthetic eye wearers: a pilot study

Han

Yoon

Jang

2014

Eye

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Purpose Long-standing prosthetic eye wearing induces ocular surface inflammation. We investigated the short-term effects of topical cyclosporine A 0.05% (Restasis) in patients with ocular discomfort resulting from long-standing prosthetic eye wearing. Methods This was a prospective, interventional case series. Patients who were unilateral prosthetic eye wearers over a period of 5 years were enrolled at a single institution from March to July 2013. The subjects were instructed to instill topical cyclosporine A 0.05% twice per day. Measurements were made pre-treatment and after 1 and 3 months of treatment. Outcome measures were the ocular symptom score, the lid margin abnormality score, the Schirmer test, and the tear meniscus amount, using Fourier-domain optical coherence tomography. Results In total, 20 consecutive patients (mean age: 60.1 years, 8 males, 12 females) were included. Ocular symptoms were improved after treatment for 1 month in all patients (ocular symptom score pre-treatment 76.83 vs 46.75 after treatment; Po0.001). There was no statistically significant difference in lid margin abnormality score or tear meniscus amount. The Schirmer test results were improved after treatment for 3 months (pre-and after treatment, 6.70 vs 11.40; Po0.001). Conclusions Topical cyclosporine A 0.05% showed a satisfactory effect in long-standing prosthetic eye wearers. Ocular symptoms were markedly relieved in all subjects after treatment for 1 month.

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“…[24][25][26][27][28][29] Considerable evidence exists that topical cyclosporin A reduces the lacrimal gland infiltrate and improves tear production in keratoconjunctivitis sicca dogs, [30][31][32][33] and a few clinical studies indicate that systemic or topical cyclosporine improves some objective or subjective signs of keratoconjunctivitis sicca in patients with or without Sjogren's syndrome. [34][35][36] Therefore, it appears that cyclosporin A may target the tear deficient aspect of dry eye by modulating the immune reactivity and inflammatory processes of both senescence-related dry eye as well as the dry eye condition associated with Sjogren's syndrome.…”

Section: Discussionmentioning

confidence: 99%

The use of topical cyclosporin A in ocular graft-versus-host-disease

Kiang

Tesavibul

Yee

et al. 1998

Bone Marrow Transplant

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Summary:Ocular manifestations of GVHD include keratoconjunctivitis sicca, cicatricial lagophthalmos, sterile conjunctivitis, persistent corneal epithelial defects, corneal ulcers and corneal melting. Conventional initial therapy such as lubrication and topical steroids is directed to treat decreased tear production and ocular surface abnormalities. The purpose of this study was to illustrate the possible benefit of topical cyclosporin A 1% (CsA) as an adjunct in managing ocular surface abnormalities in five cases of GVHD refractory to conventional therapy. Five clinical case reports of chronic GVHD patients in whom conventional therapy was inadequate to stop the progression from its initial presentation are described. Patient presentation varied in severity on a spectrum of mild to moderate diffuse punctate epithelial erosions to sterile necrotizing corneal melts. Although systemic therapy for GVHD consisting of systemic immunosuppressants (ie cyclosporin A and corticosteroids) was given to these patients, this therapy was insufficient in managing the ocular manifestations of the disease. Topical CsA was added to the treatment regimen and the progression of the ocular disease was recorded. The addition of topical CsA 1% probably helped in controlling the epithelial keratitis and melting process in our reported cases and we conclude that topical CsA may be an appropriate modality in managing ocular surface abnormalities in patients with ocular GVHD after conventional treatments have been tried. However, a further randomized clinical prospective study is needed to evaluate the efficacy of topical CsA in managing these problems in GVHD patients.

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Pilot Trial of Cyclosporine 1% Ophthalmic Ointment in the Treatment of Keratoconjunctivitis Sicca

Cited by 98 publications

References 0 publications

Topical cyclosporine A for the dry eye findings of thyroid orbitopathy patients

Topical cyclosporine A for the dry eye findings of thyroid orbitopathy patients

Short-term effects of topical cyclosporine A 0.05% (Restasis) in long-standing prosthetic eye wearers: a pilot study

The use of topical cyclosporin A in ocular graft-versus-host-disease

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