[0.05% cyclosporine a for treatment of chronic severe ocular surface disease].
OBJECTIVE
To evaluate the effects of topical cyclosporin A on severe and corticodependent chronic ocular surface disorders (OSD), in immune inflammatory disease.


METHODS
Experimental study, Centre hospitalier universitaire (CHU) Bretonneau, Tours, France.


METHODS
Twenty-one patients diagnosed with dry eye syndrome secondary to vernal keratoconjunctivitis (7 cases), atopic keratoconjunctivitis (8 cases), and ocular rosacea (6 cases) were treated twice a day with a 0.05% cyclosporin ophthalmic emulsion.


METHODS
Corneal and conjunctival staining, Oxford score, and symptoms severity assessment (OSDI score) were conducted from the beginning of the cyclosporin treatment up to the end of study. Other collected data included visual acuity, intraocular pressure measurements, an adverse effects questionnaire, and evaluation of the use of adjunctive corticosteroids therapy.


RESULTS
Topical cyclosporin 0.05% gave significant long-term improvement of visual acuity (p = 0.018), symptoms severity (OSDI score, p = 0.001), corneal and conjunctival staining (van Bijesterveld score, p = 0.0003), and Oxford score (p = 0.0002). Topical cyclosporin allowed for less corticosteroid treatment in all cases (p = 0.04), and broke it off with no long-term recurrence in 15 cases (71%). No severe adverse effect occurred, but 3 patients (14%) stopped cyclosporin treatment because of increasing ocular symptoms.


CONCLUSIONS
Given our results, topical cyclosporin represents a new well-tolerated treatment for severe and corticodependent chronic ocular surface disorders. In monotherapy or in association with a corticotherapy, topical cyclosporin could be efficient in any OSD involving immune-based inflammation.
Nochez
Yannick
Y
Service d'Ophtalmologie, CHRU de Tours, 2 boulevard Tonnellé, Tours, France. yannick.nochez@free.fr
Denoyer
Alexandre
A
Pisella
Pierre-Jean
PJ
D000287:Administration, Topical; D000328:Adult; D002908:Chronic Disease; D003233:Conjunctivitis, Allergic / Q000188:drug therapy*; D016572:Cyclosporine / Q000008:administration & dosage* / Q000009:adverse effects; D015352:Dry Eye Syndromes / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007429:Intraocular Pressure; D008297:Male; D012393:Rosacea / Q000188:drug therapy*; D014792:Visual Acuity
D007166:Immunosuppressive Agents; D016572:Cyclosporine