Evaluation of the effect of topical cyclosporine A with impression cytology in dry eye patients.
OBJECTIVE
This study evaluated the efficacy of topical cyclosporine A 0.05% treatment with impression cytology in dry eye patients.


METHODS
Forty eyes of 40 patients with dry eye were included. Schirmer tear break-up time, and Ocular Surface Disease Index (OSDI) scores and goblet cell densities were noted before and after 6 months of topical cyclosporine A treatment. Patients were graded clinically and biomicroscopically as follows: grade 1, 12 patients; grade 2, 18; and grade 3, 10 patients.


RESULTS
Mean age was 57.1 +/- 11.8 (23.0-80.0) years. A total of 36 (90%) of the patients were female and 4 (10%) were male. Mean Schirmer test value was 3.2 +/- 1.6 (0.0-8.0) mm in the beginning and was 8.4 +/- 4.3 (1.0-19.0) mm after 6 months of cyclosporine A topical treatment (p = 0.00). At the first visit, mean tear break-up time was 4.4 +/- 1.8 (2.0-8.0) seconds. It increased to 11.8 +/- 4.8 (2.0-20.0) seconds at the end of the sixth month (p = 0.00). Mean clinical grading was 1.9 +/- 0.8 (1.0-3.0) and this value regressed to 0.8 +/- 1.2 (0.0-3.0) after the treatment (p = 0.00). Mean OSDI score was 30.0 +/- 11.7 (9.0-50.0) before the treatment and 21.3 +/- 11.0 (4.0-47.0) after the treatment (p = 0.00). Mean goblet cell density of all cases was 12.3 +/- 8.7 before the treatment (2.0-28.0). It increased to 33.0 +/- 25.4 (6-70) after the treatment (p = 0.04).


CONCLUSIONS
Topical cyclosporine A treatment is effective in grade 1 and grade 2 dry eye patients but results are poor in grade 3 patients.
Eye Bank and Cornea Section, Izmir Bozyaka Teaching and Research Hospital, Bozyaka-Izmir, Turkey. drborayuksel@gmail.com
Bora
B
Yüksel
Berkant
B
Bozdağ
Memed
M
Acar
Engin
E
Topaloğlu
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D003228:Conjunctiva / Q000187:drug effects / Q000473:pathology*; D016572:Cyclosporine / Q000008:administration & dosage*; D003584:Cytological Techniques / Q000379:methods*; D015352:Dry Eye Syndromes / Q000188:drug therapy / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions; D016572:Cyclosporine