Chonnam Med J.  2015 Apr;51(1):26-32. 10.4068/cmj.2015.51.1.26.

Long-Term Outcome of Treatment with Topical Corticosteroids for Severe Dry Eye Associated with Sjogren's Syndrome

• Jung HH
• Ji YS
• Sung MS
• Kim KK
• Yoon KC

• KMID: 2172144
• DOI: http://doi.org/10.4068/cmj.2015.51.1.26

Abstract

This retrospective study was performed to analyze the long-term outcome of topical corticosteroid treatment for severe dry eye associated with Sjogren's syndrome (SS). Patients who had severe dry eye associated with SS were topically treated with loteprednol etabonate 0.5% (group A, n=66) or fluorometholone 0.1% (group B, n=67) twice daily and were followed up for 2 years. Visual acuity (VA), intraocular pressure (IOP), Schirmer test, tear film breakup time (BUT), keratoepitheliopathy, and symptom scores were measured at baseline and 6, 12, 18, and 24 months after treatment. VA and IOP were not changed significantly during follow-up in either group. Schirmer test results, keratoepitheliopathy, and symptom scores at 6, 12, 18, and 24 months (p<0.05) and tear film BUT at 12, 18, and 24 months (p<0.05) significantly improved after treatment compared with baseline in both groups. No significant differences between the groups were found in any parameter during follow-up. At 24 months, the number of patients with IOP elevation of more than 2 mmHg compared with baseline was 4 in group A (6.1%) and 9 in group B (13.4%). The mean IOP in these patients was lower in group A than in group B (15.00+/-0.82 mmHg versus 16.50+/-1.12 mmHg; p=0.04). Long-term application of low-dose topical corticosteroids is effective for controlling signs and symptoms of chronic, severe dry eye associated with SS. Loteprednol etabonate 0.5% may have a lower risk for IOP elevation than fluorometholone 0.1%.

Keyword

Dry eye syndromes; Sjogren's syndrome; Fluorometholone; Loteprednol etabonate

MeSH Terms

Adrenal Cortex Hormones*
Dry Eye Syndromes
Fluorometholone
Follow-Up Studies
Humans
Intraocular Pressure
Retrospective Studies
Sjogren's Syndrome*
Tears
Visual Acuity
Loteprednol Etabonate
Adrenal Cortex Hormones
Fluorometholone

Figure

• 

  FIG. 1 Changes of Schirmer test (A), Tear film break-up time (BUT), (B) Keratoepitheliopathy, (C) and symptom score (D) in the loteprednol etabonate 0.5% and fluorometholone 0.1% groups. Group A: loteprednol etabonate group, Group B: fluorometholone group, Tear film-BUT: tear film break-up time, *p<0.05 compared to the baseline.

• 

  FIG. 2 Changes of intraocular pressure (IOP) in the loteprednol etabonate 0.5% and fluorometholone 0.1% groups. IOP: intraocular pressure, Group A: loteprednol etabonate group, Group B: fluorometholone group.

• 

  FIG. 3 (A) Proportion of patients with intraocular pressure (IOP) elevation by more than 2 mmHg compared to the baseline at 6, 12, 18 and 24 months in the loteprednol etabonate 0.5% and fluorometholone 0.1% groups. (B) Mean IOP value in patients with IOP elevation by more than 2 mmHg compared to the baseline at 24 months. IOP: intraocular pressure, Group A: loteprednol etabonate group, Group B: fluorometholone group, *p values (comparison between group A and group B)<0.05.

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