title: Inflammatory cytokine and osmolarity changes in the tears of dry eye patients treated with topical 1% methylprednisolone.
abstract: OBJECTIVE
  To evaluate changes in clinical outcomes, inflammatory cytokine levels, and tear osmolarity in the tears of patients with moderate to severe dry eye syndrome before and after the application of topical 1% methylprednisolone.
  
  
  METHODS
  Thirty-two patients with moderate to severe dry eye unresponsive to previous aqueous enhancement therapy were enrolled. Five patients were lost to follow up, and twenty-seven patients were eligible for analysis. Patients were instructed to apply topical 1% methylprednisolone four times per day, as well as to continue applying their current therapy of preservative-free 0.1% sodium hyaluronate four times per day. Corneal and conjunctival staining scores, tear film breakup time (TFBUT), Schirmer test, and tear osmolarity were assessed at baseline, 4 weeks, and 8 weeks. Tear samples were collected at every visit for cytokine analysis.
  
  
  RESULTS
  Corneal and conjunctival staining scores and TFBUT showed significant improvement at 4 (p<0.001, <0.001, <0.001 respectively) and 8 (p<0.001, <0.001, <0.001 respectively) weeks. Tear osmolarity decreased significantly at 8 weeks (p=0.008). Interleukin (IL)-1β, IL-8, and monocyte chemoattractant protein-1 were significantly decreased at 8 weeks compared with those at baseline (p=0.041, 0.001, 0.008 respectively).
  
  
  CONCLUSIONS
  Short-term treatment with topical 1% methylprednisolone not only improved clinical outcomes, but also decreased tear osmolarity and cytokine levels. By measuring the changes in cytokine levels and tear osmolarity, we could objectively evaluate the anti-inflammatory effects of topical methylprednisolone applied in the treatment of patients with moderate to severe dry eye syndrome.
authors: Vision Research Institute, Department of Ophthalmology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. tikim@yuhs.ac.
authors: Ji Hwan
authors: JH
authors: Lee
authors: Kyung
authors: K
authors: Min
authors: Se Kyung
authors: SK
authors: Kim
authors: Eung Kweon
authors: EK
authors: Kim
authors: Tae-im
authors: TI
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D016207:Cytokines / Q000378:metabolism*; D015352:Dry Eye Syndromes / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D009994:Osmolar Concentration; D011446:Prospective Studies; D013666:Tears / Q000737:chemistry* / Q000378:metabolism*
chemical_list: D016207:Cytokines; D008775:Methylprednisolone
keywords: Dry eye syndrome; cytokines; methylprednisolone; osmolar concentration