J Korean Ophthalmol Soc.  2010 Oct;51(10):1319-1326.

Effect of Topical 0.05% Cyclosporine A in Dry Eye Associated With Thyroid Ophthalmopathy

• Choi W
• Park YG
• Cho JK
• Yoon KC

Abstract

PURPOSE
The present study was performed to evaluate the changes in tear film and ocular surface parameters after using sodium hyaluronate (SH) 0.1% alone or in combination with cyclosporine A (CsA) 0.05% in patients with thyroid-associated ophthalmopathy accompanied by dry eye.
METHODS
A total of 72 eyes from 36 patients were divided into two groups; 36 eyes of 18 patients were treated with 0.1% SH alone (group 1), and 36 eyes of 18 patients were treated with SH 0.1% and CsA 0.05% (group 2). Tear break-up time (BUT), basal tear secretion test (BST), tear clearance rate (TCR), fluorescein staining (FS) and corneal sensitivity test (CST) were evaluated at pre-treatment and one, three and six months post-treatment. Conjunctival impression cytology was performed and tear CXCL11 (Chemokine (C-X-C motif) ligand) levels were measured pre-treatment and three months post-treatment.
RESULTS
BUT, BST, TCR, KEP and CST were significantly improved at six months in group 1 (p < 0.05) and at three months in group 2 (p < 0.05). The degree of conjunctival squamous cell metaplasia, goblet cell density and tear CXCL11 levels were significantly changed at three months in group 2 (p < 0.05). However, there were no significant changes in group 1 after 3 months.
CONCLUSIONS
Combined use of topical 0.1% SH and 0.05% CsA can result in early improvement in tear films and ocular surface parameters in patients with thyroid-associated ophthalmopathy accompanied by dry eye.

Keyword

Cyclosporine; Dry eye syndrome; Sodium hyaluronate; Thyroid associated ophthalmopathy

MeSH Terms

Cyclosporine
Dry Eye Syndromes
Eye
Fluorescein
Goblet Cells
Graves Ophthalmopathy
Humans
Hyaluronic Acid
Metaplasia
Tears
Thyroid Gland
Cyclosporine
Fluorescein
Hyaluronic Acid

Figure

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  Figure 1. Impression cytologic findings (PAS, ×400) (A,B). Specimen before (A) and 3 months after (B) treatment of topical 0.1% sodium hyaluronate. (A) Loss of goblet cell and large, polygonal epithelial cells with a nucleocytoplasmic ratio of 1:4 or 1:5 (squamous metaplasia grade 2) is visible. (B) Goblet cell density and microscopic findings did not changed after 3 months of treatment. (C, D) Specimen before (C) and 3 months after (D) treatment of topical 0.1% sodium hyaluronate and 0.05% cyclosporine A. (C) Loss of goblet cell and large, polygonal epithelial cells with a nucleocytoplasmic ratio of 1:4 or 1:5 (squamous metaplasia grade 2) were visible. (D) Increased periodic acid-Schiff positive goblet cells and round epithelial cells with a nucleocytoplasmic ratio of 1:3 (squamous metaplasia grade 1) are shown after 3 months of treatment.

• 

  Figure 2. Comparison of tear CXCL11 levels between before and 3 months after treatment with topical 0.1% sodium hyaluronate alone (Group 1) or topical 0.1% sodium hyaluronate and 0.05% cyclosporine A (Group 2).

Reference

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