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Y. Byoun, S. Kim, T.-I. Kim, E. Kim; Efficacy of Combined Treatment of Cyclosporine 0.05% and 1% Methylprednisolone on Dry Eye Patients of Sjogren Syndrome. Invest. Ophthalmol. Vis. Sci. 2007;48(13):401.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the efficacy of cyclosporine 0.05% (tCSA) and combined treatment with 1% methylprednisolone on treatment of keratoconjunctivitis sicca of Sjogren syndrome.
46 patients with moderate to severe dry eye diseases associated with Sjogren syndrome were treated with tCSA for 3 months. 20 subjects were treated with tCSA only and 26 subjects were treated with 1% methyl prednisolone and tCSA for initial 3 weeks, and treated with tCSA only thereafter. Corneal fluorescein staining, Schirmer score, tear break-up time (TBUT), and frequencies of artificial tear were evaluated before, 1month, and 3 months after treatment. Impression cytology of the bulbar conjunctiva was performed in 5 subjects at 3 months of treatment and compared to those of untreated patients with Sjogren syndrome.
After 1 month, combined treatment with 1% methyl prednisolone significantly improved corneal fluorescein score (p=0.04) and mean schirmer score (p=0.04), whereas solitary use of tCSA resulted in improvement of corneal fluorescein score (p=0.02) only . However, after 3 month, significant improvements were observed in corneal fluorescein staining score (combined, solitary: p<0.01, p=0.03), TBUT (p<0.01, p=0.03), mean schirmer score (p<0.01, p=0.04) and frequencies of artificial tear use (p<0.01, p=0.04) in both groups, and there was no statistical difference between two treatment modalities. In impression cytology, significant increase of periodic acid-Schiff positive cells compared to untreated patients was observed.
Treatment with tCSA appears to be safe and effective in KCS patients with Sjogren syndrome. Combined use of 1% methyl prednisolone improved clinical scores in short periods, however this differences did not persist up to 3 months.
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