Update on ocular cicatricial pemphigoid and emerging treatments

Queisi, Munther M.; Zein, Mike; Lamba, Neerav; Meese, Halea; Foster, C. Stephen

doi:10.1016/j.survophthal.2015.12.007

Cited by 35 publications

(14 citation statements)

References 24 publications

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“…It manifests as a chronically progressive conjunctival inflammation causing bilateral blindness. Systemic immunosuppression is required to halt the progressive inflammation and achieve adequate long‐term remission . Topical and sub‐conjunctival corticosteroids are used adjunctively with systemic therapy.…”

Section: Uses Of Locally Administered Steroidsmentioning

confidence: 99%

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Local delivery of corticosteroids in clinical ophthalmology: A review

Fung

Tran

Lim

et al. 2020

Clinical Exper Ophthalmology

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Locally administered steroids have a long history in ophthalmology for the treatment of inflammatory conditions. Anterior segment conditions tend to be treated with topical steroids whilst posterior segment conditions generally require periocular, intravitreal or systemic administration for penetration. Over recent decades, the clinical applications of periocular steroid delivery have expanded to a wide range of conditions including macular oedema from retino-vascular conditions. Formulations have been developed with the aim to provide practical, targeted, longer-term and more efficacious therapy whilst minimizing side effects. Herein, we provide a comprehensive overview of the

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Section: Uses Of Locally Administered Steroidsmentioning

confidence: 99%

“…Due to the infrequency and nature of the condition, there have been no studies assessing their role. Other topical agents shown to give variable results include: calcineurin inhibitors, cyclosporine A, tacrolimus and mitomycin C …”

Section: Uses Of Locally Administered Steroidsmentioning

confidence: 99%

Local delivery of corticosteroids in clinical ophthalmology: A review

Fung

Tran

Lim

et al. 2020

Clinical Exper Ophthalmology

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“…However, the most severe side effects include liver and pulmonary fibrosis during long-term treatment. [ 24 ] Study of McCluskey et al [ 11 ] has demonstrated that the incidence of MTX side effects remained low. Study of Kjellman et al [ 25 ] also found that there are rare patients who have terminated MTX treatment due to side effects, and most of the side effects are mild.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and adverse reactions of methotrexate in the treatment of ocular cicatricial pemphigoid

Shi

Xie

He³

et al. 2018

Medicine

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The application of methotrexate (MTX) in the treatment of autoimmune diseases has been gradually increasing, but reports of MTX treatment for advanced ocular cicatricial pemphigoid (OCP) are extremely rare. This study investigated the efficacy and adverse reactions of low-dose MTX in patients with OCP.This was a retrospective, noncontrolled, case series study. Eleven patients diagnosed with advanced OCP (4 cases in stage III and 7 cases in stage IV) were enrolled. Treatment by oral administration of MTX (7.5 ± 2.5 mg) alone was performed. Visual acuity of the patients, conjunctival inflammation, cicatrization, ocular surface keratinization, and toxic side effects of drugs were evaluated.All patients enrolled in this study were females aged 32 to 83 years. Patients were followed up for 4 to 33 months. Low-dose MTX improved visual acuity of 3 cases (6 eyes, 27.3%). Conjunctival inflammation of 5 patients (10 eyes) rested after treatment, and conjunctival inflammation of 3 cases (6 eyes, 27.3%) was decreased with an effective rate of 72.7%. Cicatrices of 8 cases (15 eyes) showed degeneration after treatment with an effective rate of 71.4% (15/21). Ocular surface keratinization receded in 4 cases with an effective rate of 66.7%. None of the patients discontinued the treatment due to severe toxic side effects. All patients tolerated mild drug-induced gastrointestinal reactions. Three patients terminated the treatment in advance after 4 to 6 months due to no improvement in the disease condition.Observation of clinical efficacy and safety findings demonstrated that low-dose MTX can be used to treat patients with advanced OCP.

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“…There are some problems responsible for impairment of goblet cells function. Mucous membrane pemphigoid and its subtype -ocular cicatricial pemphigoid via recurrent inflammation destroy goblet cells and promote subepithelial fibrosis, resulting in changes ranging from xerophthalmia to conjunctival keratinization and blindness [95][96][97][98][99]. Stevens-Johnson Syndrome, trachoma and severe burns (both thermal and chemical) impair mucin production by decreasing the number of active goblet cells [9,[100][101][102][103].…”

Section: Mucin Layer Deficiencymentioning

confidence: 99%

Tear Film – Physiology and Disturbances in Various Diseases and Disorders

Kopacz¹,

Niezgoda²,

Fudalej³

et al. 2021

Ocular Surface Diseases - Some Current Date on Tear Film Problem and Keratoconic Diagnosis

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The tear film is a thin fluid layer covering the ocular surface. It is responsible for ocular surface comfort, mechanical, environmental and immune protection, epithelial health and it forms smooth refractive surface for vision. The traditional description of the tear film divides it into three layers: lipid, aqueous and mucin. The role of each layer depends on the composition of it. Tear production, evaporation, absorption and drainage concur to dynamic balance of the tear film and leads to its integrity and stability. Nonetheless, this stability can be disturb in tear film layers deficiencies, defective spreading of the tear film, in some general diseases and during application of some general and/or topical medications. Dry eye disease is the result of it. In this review not only physiology of the tear film is presented. Moreover, we would like to discuss the influence of various diseases and conditions on the tear film and contrarily, spotlight tear film disorders as a manifestation of those diseases.

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Update on ocular cicatricial pemphigoid and emerging treatments

Cited by 35 publications

References 24 publications

Local delivery of corticosteroids in clinical ophthalmology: A review

Local delivery of corticosteroids in clinical ophthalmology: A review

Efficacy and adverse reactions of methotrexate in the treatment of ocular cicatricial pemphigoid

Tear Film – Physiology and Disturbances in Various Diseases and Disorders

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