Efficacy of topical cyclosporine 0.05% in the treatment of dry eye associated with graft versus host disease.
OBJECTIVE
To assess the efficacy of topical cyclosporine 0.05% (Restasis) in patients with dry eye associated with graft versus host disease after stem cell transplantation.


METHODS
After completing a 3-month run-in period of using only artificial tears to control dry eye symptoms in both eyes, patients who failed to achieve adequate relief (n = 8) were instructed to instill topical cyclosporine twice a day. Visual acuity, slit-lamp appearance, and intraocular pressure were evaluated every 2 weeks for a minimum of 3 months. In addition, Schirmer basal secretion tests, noninvasive fluorescein breakup time, and tear lysozyme were also performed. Patients were also given a dry eye questionnaire regarding symptoms of burning, tearing, and blurred vision.


RESULTS
Dry eye signs improved significantly with cyclosporine treatment in 7 of 8 patients. Cyclosporine provided statistically significant improvements in Schirmer basal secretion scores (P = 0.003), tear breakup time (P = 0.002), and tear lysozyme levels (P = 0.033) after 3 months of treatment.


CONCLUSIONS
The findings in this prospective study suggest that dry eye associated with graft versus host disease can be effectively treated with topical cyclosporine, especially in patients unresponsive to other treatment modalities. These findings should be further evaluated in large-scale, controlled clinical trials.
Rao
Sanjay N
SN
Department of Ophthalmology, University of Chicago, Chicago, IL, USA. sanjayrao@pol.net
Rao
Ruta D
RD
D000287:Administration, Topical; D000328:Adult; D016572:Cyclosporine / Q000008:administration & dosage*; D015352:Dry Eye Syndromes / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009113:Muramidase / Q000378:metabolism; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013666:Tears / Q000378:metabolism; D016896:Treatment Outcome; D014792:Visual Acuity
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D009113:Muramidase