Efficacy and safety of topical cyclosporine A 0.05% in vernal keratoconjunctivitis

<p><b>INTRODUCTION</b>While corticosteroids are an effective choice of treatment for severe vernal keratoconjunctivitis (VKC), their long-term use is restricted due to side effects. This study was conducted to evaluate the efficacy and safety of topical cyclosporine A (CsA) 0.05% in the treatment of VKC.</p><p><b>METHODS</b>A total of 30 patients with VKC that was resistant to topical corticosteroids, antihistamines and mast cell stabilisers were treated with topical CsA 0.05%. Patients were evaluated at Weeks 4, 8 and 12 after the initiation of therapy. Symptoms and signs observed before and after treatment were recorded and scores were assigned. Scores for symptoms and signs, the need for topical corticosteroids and ocular side effects were evaluated.</p><p><b>RESULTS</b>At baseline, the median values of the symptom and sign scores were 10.0 (range 5.0-18.0) and 6.0 (range 2.0-13.0), respectively. At Week 4 of treatment with topical CsA 0.05%, the median values of the symptom and sign scores were 3.0 (range 0-14.0) and 3.0 (range 0-8.0), respectively. The reductions in the symptom and sign scores were statistically significant. The reduction in the need for corticosteroid was statistically significant by Week 12 of therapy. No significant side effects were reported.</p><p><b>CONCLUSION</b>Topical CsA 0.05%, which can help to reduce corticosteroid usage, is an effective and safe alternative for the treatment of resistant VKC. Further studies are needed to determine the optimal duration of therapy and possibility of recurrence.</p>

The Effect of Topical Cyclosporine 0.05% on Tear Osmolarity for Dry Eye Syndrome

PURPOSE: To evaluate the effect of topical cyclosporine 0.05% (Restasis; Allergan, Irving, CA, USA) on tear osmolarity in patients with dry eye disease. METHODS: The present study was a single-center, randomized, prospective, and longitudinal trial. Patients who had been using artificial tears to treat dry eye disease were prescribed cyclosporine 0.05% and evaluated using tear osmolarity, tear break-up time, ocular surface staining score, Schirmer test, and the Ocular Surface Disease Index for symptomatic improvement. Clinical measurements of commonly used objective tests were performed at baseline and after 1, 3, and 6 months. RESULTS: At the end of the study, patients demonstrated statistically significant improvement in tear break-up time (6.26 +/- 1.26 sec at 3 months vs. 4.41 +/- 1.63 sec at baseline, p = 0.022) and OSDI (34.98 +/- 20.19 at 3 months vs. 45.02 +/- 22.38 at baseline, p = 0.032) only at 3 months. Other measures such as Schirmer test, ocular surface grade, and tear osmolarity also showed improvement. However, the differences were not significant. CONCLUSIONS: Over a 6-month period, topical cyclosporine 0.05% showed beneficial effects on symptoms and other commonly used signs of dry eye disease for 3 months; however, the tear osmolarity values were not significantly improved.

Effect of Sodium Hyaluronate and Cyclosporine A on Tear Film in Dry Eye Syndrome

PURPOSE: To evaluate the efficacy of topical 0.1% hyaluronate (HA) and 0.05% cyclosporine A on tear film parameters in dry eye syndrome patients. METHODS: Patients who were diagnosed with dry eye syndrome were treated with mbined with cyclosporine A (Group 2, 54 eyes). Ocular surface disease index (OSDI), tear film break-up time (BUT), Schirmer's test, and tear osmolarity were evaluated before treatment and at 1, 2, 3, and 6 months after treatment. RESULTS: OSDI was significantly improved at 2 months after treatment and Schirmer's test results significantly improved at 1 month after treatment in both groups. The BUT was significantly improved 3 months after treatment in Group 1 and at 1 month after treatment in Group 2. Tear osmolarity significantly improved at 1 month after treatment in both groups, but continuously improved up to 6 months after treatment only in Group 2. The BUT and Schirmer's test showed greater improvements in Group 2 than in Group 1. CONCLUSIONS: Combined treatment of topical 0.1% HA and 0.05% cyclosporine A may be more effective for improving dry eye syndrome.

Cinical Effect of Restasis(R) Eye Drops in Mild Dry Eye Syndrome

PURPOSE: To evaluate changes in tear secretion and symptoms in patients with mild dry eye syndrome after using Restasis(R). METHODS: From patients diagnosed with mild dry eye syndrome, Restasis(R) was administered to 46 eyes of 23 patients. The clinical parameters and symptoms were checked over a period of six months. The clinical parameters evaluated were the symptoms of dry eye syndrome using an OSDI scoring scale, the Schirmer test, and tear break-up time. RESULTS: Eight male patients and 15 female patients were included in the study. The mean age was 50.5 years. Before treatment, the values for the OSDI score, BUT, and Schirmer test were 32.3, 5.3 mm, and 8.1 seconds, respectively. After treatment, the OSDI score, BUT, and Schirmer test were 22.9, 8.1 mm, and 12.1 seconds at six months, respectively. The subjective parameter (OSDI score) improved two months after treatment (p=0.003), and the objective parameters (BUT, Schirmer test) improved three months after treatment (p=0.03, p=0.04, respectively). CONCLUSIONS: In the present study, Restasis(R) increased tear secretion and improved clinical symptoms of patients with mild dry eye.

Clinical Effect of Cyclosporine 0.05% Eye Drops in Dry Eye Syndrome Patients

PURPOSE: We conducted a study to evaluate the change of tear secretion and symptoms in the patients with dry eye syndrome after using Restasis(R) (Cyclosporine 0.05% ophthalmic emulsion, Allergan Inc., U.S.A.). METHODS: We randomly selected 39 patients from newly or previously diagnosed dry eye syndrome patients and administered Restasis(R) to them. We checked their clinical parameters and symptoms over a period of 3 months. The clinical parameters evaluated were type I and type II Schirmer tests and tear break-up time, and the symptoms of dry eye syndrome were classified into pain, itching, foreign body sensation, blurred vision, and photophobia using a scoring scale for symptoms of 0 to 5. The results were analyzed with a Mann-Whitney test (P-values <0.05 was considered statistically significant). RESULTS: For 26 of 39 patients (52 eyes) on whom all tests were carried out for 3 months, there was a significant improvement after 3 months in the type I Schirmer test, type II Schirmer test, and tear break-up time (P=0.012, 0.009, 0.001, respectively). Only 14 patients completed the questionnaire for scoring of symptoms. After using Restasis(R), foreign body sensation only improved (P=0.010). CONCLUSIONS: In our study, tear secretion was increased by Restasis(R), and a greater increase in tear secretion was seen in patients with systemic disease than in patients without systemic disease. Additional patients need to be evaluated and longer-term studies need to be performed to confirm our results.