High-frequency topical cyclosporine 0.05% in the treatment of severe dry eye refractory to twice-daily regimen.

Abstract

PURPOSE:

The purpose of this study was to report the efficacy of topical cyclosporine 0.05% at a frequency of 3 to 4 times daily in severe dry eye disease.

METHODS:

We retrospectively identified a cohort of patients with severe dry eye disease who had shown inadequate response to at least a 4-month course of treatment with twice-daily use of topical cyclosporine 0.05% but who showed significant improvement to more frequent dosing.

RESULTS:

Twenty-two patients, including 13 patients with ocular graft-versus-host disease and 9 patients with primary or secondary Sjögren's syndrome, were included. After a minimum of a 2-month course of treatment with more frequent dosing of cyclosporine 0.05% (3 times a day in 7 patients and 4 times a day in 15 patients), overall dry eye symptoms were improved in 15 (68.2%) patients (9 patients with ocular graft-versus-host disease and 6 patients with Sjögren's syndrome). Mean corneal fluorescein staining scores (National Eye Institute scale of 0-15) improved (decreased) from the baseline (precyclosporine use) by -3.5 (range, 0 to -7) in patients with ocular graft-versus-host disease (P < or = 0.0008) and -2.8 (range, 0 to -5) in patients with Sjögren's syndrome (P < or = 0.001). After treatment with high-frequency use of cyclosporine 0.05%, the global physician assessment of dry eye status was favorable (improved) in 16 (72.7%) patients. Three (13.6%) patients reported new-onset symptoms of burning or irritation with the use of high-frequency dosing of topical cyclosporine. No other associated adverse effect was reported.

CONCLUSION:

These data suggest that patients with severe dry eye may require more frequent dosing of topical cyclosporine 0.05% than twice daily.

• Authors: Mohammad H Dastjerdi, Pedram Hamrah, Reza Dana
• Journal: Cornea (Cornea) Vol. 28 Issue 10 Pg. 1091-6 (Dec 2009) ISSN: 1536-4798 [Electronic] United States
• PMID: 19770713 (Publication Type: Journal Article)

Chemical References

• Fluorescent Dyes
• Immunosuppressive Agents
• Cyclosporine
• Fluorescein

Topics

• Administration, Topical
• Adult
• Aged
• Cohort Studies
• Cyclosporine (administration & dosage, adverse effects)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Female
• Fluorescein
• Fluorescent Dyes
• Graft vs Host Disease (complications)
• Humans
• Immunosuppressive Agents (administration & dosage, adverse effects)
• Male
• Middle Aged
• Retreatment
• Retrospective Studies
• Severity of Illness Index
• Sjogren's Syndrome (complications)
• Staining and Labeling
• Xerophthalmia (diagnosis, drug therapy, etiology, physiopathology)