Effects of the topical treatment with NSAIDs on corneal sensitivity and ocular surface of Sjögren's syndrome patients.
OBJECTIVE
To evaluate the effects of two NSAIDs on corneal sensitivity and ocular surface in Sjögren's syndrome (SS) patients.


METHODS
In all, 20 SS patients with epithelial corneal defects, were randomly divided into two groups: group 1 (10 females, age 35-63 years), treated with 0.1% indomethacin, one drop three times a day; group 2 (nine females, one male, age 38-65 years) treated with 0.1% diclofenac, at the same regimen. No systemic NSAIDs were allowed. Use of tear substitute was allowed. Corneal sensitivity, corneal staining, BUT, and ocular discomfort, were evaluated before and after 15, 30 days of treatment and 7 days after NSAID discontinuation. For statistical analysis, the Student's t-test and Mann-Whitney U test were used.


RESULTS
Both groups showed at day 30 a statistically significant reduction of corneal sensitivity (P<0.05), although the diclofenac-treated group showed a statistically significant lower sensitivity if compared to the indomethacin-treated group (P<0.05). Corneal fluorescein score showed a statistically significantly worst alteration in group 2, 7 days after the discontinuation of the therapy (P=0.02). The ocular discomfort score was statistically significantly reduced in both groups starting from day 15 (P<0.05).


CONCLUSIONS
The results indicate that NSAIDs can be useful in resolving symptoms of ocular discomfort in SS patients. However, they should be used with caution and under close monitoring, and the treatment should be promptly discontinued if corneal epithelial defects develop or worsen during treatment.
Aragona
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P
Department of Surgical Science, Section of Ophthalmology, University of Messina, Messina, Italy. paragona@unime.it
Stilo
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A
Ferreri
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Mobrici
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D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003315:Cornea / Q000187:drug effects*; D004008:Diclofenac / Q000627:therapeutic use*; D015352:Dry Eye Syndromes / Q000188:drug therapy; D019573:Epithelium, Corneal / Q000187:drug effects; D005128:Eye Diseases / Q000188:drug therapy*; D005260:Female; D019793:Fluorescein; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D012677:Sensation / Q000187:drug effects; D016037:Single-Blind Method; D012859:Sjogren's Syndrome / Q000188:drug therapy*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D009883:Ophthalmic Solutions; D004008:Diclofenac; D019793:Fluorescein; D007213:Indomethacin