June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Evaluation of Ocular Surface Inflammatory Mediators and Surface Metrology after Topical Application of Corticosteroid in Sjögren’s Dry Eye Subjects
Author Affiliations & Notes
  • Ranjini Kottaiyan
    Flaum Eye Institute, University of Rochester, Rochester, NY
  • Geunyoung Yoon
    Flaum Eye Institute, University of Rochester, Rochester, NY
    Center for Visual Science, Rochester, NY
  • Holly Butler Hindman
    Flaum Eye Institute, University of Rochester, Rochester, NY
  • james zavislan
    Center for Visual Science, Rochester, NY
    The Institute of Optics, Rochester, NY
  • Richard P Phipps
    Flaum Eye Institute, University of Rochester, Rochester, NY
  • James V Aquavella
    Flaum Eye Institute, University of Rochester, Rochester, NY
  • Footnotes
    Commercial Relationships Ranjini Kottaiyan, Bausch & Lomb (F), Research to Prevent Blindness (F); Geunyoung Yoon, Bausch & Lomb (F), Research to Prevent Blindness (F); Holly Hindman, Bausch & Lomb (F), Research to Prevent Blindness (F); james zavislan, Bausch & Lomb (F), Research to Prevent Blindness (F); Richard Phipps, Bausch & Lomb (F), Research to Prevent Blindness (F); James Aquavella, Bausch & Lomb (F), Research to Prevent Blindness (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 4477. doi:
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      Ranjini Kottaiyan, Geunyoung Yoon, Holly Butler Hindman, james zavislan, Richard P Phipps, James V Aquavella, ; Evaluation of Ocular Surface Inflammatory Mediators and Surface Metrology after Topical Application of Corticosteroid in Sjögren’s Dry Eye Subjects. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4477.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To objectively evaluate and compare ocular surface inflammatory mediators to alterations in ocular surface metrology in subjects receiving ophthalmic corticosteroid drop.

Methods: 20 eyes of 10 Sjögren’s syndrome (SS) subjects (9 female, 1 male, age: 56.7± 4.92 years) were imaged using a wavefront sensor and thermal camera to capture visual quality (VQ) changes from root mean square (RMS) of wave front aberrations and ocular surface temperature (OST) changes, respectively. The data was collected before drop instillation (BL), 30 min after instillation of Loteprednol (Lotemax 0.5%) drop, 1 week and 2 weeks of drop use (4 times a day) and at stressed environment (high temperature, 80 F and low humidity 20%). Tear film was collected in 64 mm micro capillary tube and analyzed to measure cytokine levels at BL and weeks 1 and 2 of Lotemax use in both non-stimulated tears and after a 20µL saline wash from 12 eyes of 6 SS subjects.

Results: Both VQ and OST changed with Loteprednol use. At 30 minutes, VQ worsened (BL=0.48 ± 0.04 µm, 30 min=0.54 ± 0.04 µm) with an increase in average OST (BL=33.95 ± 0.13 0C, 30 min=34.3 ± 0.13 0C). VQ returned to base levels in week 1 (0.49 ± 0.08 µm) and week 2 (0.48 ±0.04 µm). OST increased after 2 weeks of Lotemax use (34.6 ± 0.14 0C). At stressed conditions, VQ worsened (0.67 ± 0.09 µm) and OST increased significantly from baseline (0.72 0C, p=0.03). Tear Luminex analysis showed that natural tears had higher cytokine concentrations than washout tears. Although saline wash samples were also collected, those data were highly variable and did not show trends across the sampling time points. MMP-9, IL-1a, IL-1b, IL-6, IL-8, TNFa were elevated in SS subjects before Lotemax use. TNFa, IL-1a, IL-1b, and IL-8 showed decreases after Lotemax treatment for all subjects. One patient showed decrease in all cytokines with noticeable improvement in VQ with Lotemax use as evidenced by significant reduction in RMS from BL (0.76 µm) to week 1 (0.56 µm) and week 2 (0.22 µm). IL-17 concentrations were low and IFNg were in normal range for all subjects, and did not show clear patterns of change after treatment.

Conclusions: A low strength corticosteroid like Lotemax effects ocular surface inflammatory mediators in dry eye patients with Sjögren’s syndrome as evidenced by tear cytokines analysis and concurrent ocular metrology measurements.

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