Keratitis in Dry Eye Disease and Topical Ciclosporin A.
Tear film alterations in dry eye disease (DED) include reduced tear volume and an increase in inflammatory cytokines. Instability and reduced tear production initiate a vicious cycle where hyperosmolarity, ocular inflammation, and apoptosis may induce damage of the ocular surface including keratitis. Topical cyclosporine (CsA) has been used for the treatment of moderate-to-severe DED; however, previous studies failed to demonstrate its benefits by the European Agency standards. A new formulation of CsA 0.1% has been recently approved in the EU to treat severe keratitis in DED patients. Patients with severe keratitis showed a better improvement after 6 months of treatment with CsA compared with vehicle. HLA-DR expression was significantly reduced by CsA treatment. The clinically significant improvement in keratitis associated with the inflammatory biomarker HLA-DR confirms the efficacy of CsA to improve inflammation and its damaging effect on the ocular surface in DED patients.
a Department of Neurosciences, Ophthalmology Unit , University of Padua , Padua , Italy.
Andrea
A
Leonardi
b Molecular Physiology Research Unit, Namur Research Institute for Life Sciences , University of Namur , Namur , Belgium.
Bruno
B
Flamion
c Quinze-Vingts National Ophthalmology Hospital , INSERM-DHOS CIC 1423 , Paris , France.
Christophe
C
Baudouin
D060433:Administration, Ophthalmic; D016572:Cyclosporine / Q000008:administration & dosage*; D017277:Drug Approval; D015352:Dry Eye Syndromes / Q000150:complications / Q000188:drug therapy*; D004655:Emulsions; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007634:Keratitis / Q000188:drug therapy* / Q000209:etiology; D009883:Ophthalmic Solutions; D004364:Pharmaceutical Preparations
D004655:Emulsions; D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions; D004364:Pharmaceutical Preparations; D016572:Cyclosporine
Ciclosporin; HLA-DR; dry eye disease; keratitis; osmolarity