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Yukiko Sonomura, Aoi Komuro, Norihiko Yokoi, Mengxi Niu, Hiroaki Kato, Shigeru Kinoshita, Chie Sotozono; Drug-toxicity-induced corneal epitheliopathy in dry-eye patients. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5698.
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© ARVO (1962-2015); The Authors (2016-present)
Various eye drops are used for the treatment of dry eye, and dry-eye patients use a greater number of eye drops, and at a greater frequency, than any other patients suffering from ocular disease. In some patients, epithelial damage becomes worse, despite treatment, and that worsening damage is sometimes related to drug toxicity of the eye drops. However, it is often difficult to distinguish between the worsening of dry eye and the drug toxicity, those prolonging effective treatment. The purpose of this study was to investigate the improvement of corneal epithelial damage, the number and frequency of eye drops used, and the underlying causes in cases of dry eye combined with drug-toxicity-induced epitheliopathy.
This study involved 17 eyes of 10 female dry-eye patients (mean age: 63.1 years) with drug-toxicity-induced corneal epitheliopathy. Corneal epithelial damage was evaluated by NEI score (maximum: 15 points), and those scores and the number and frequency of eye drops and eye drops with preservatives were compared pre and post treatment.
The mean NEI score for corneal epithelial damage significantly improved post treatment (pre treatment:10.4±3.3 points; post treatment: 1.9±3.3 points) (p<0.0001). No significance was found between pre and post treatment in regard to the mean number of eye drops used (2.8±1.2 vs. 2.6±0.6, respectively) (p=0.55), and in the mean frequency of all eye drops used (10.4±3.3 vs. 9.2±1.4, respectively) (p=0.16). A significant difference was found in the mean frequency of eye drops with preservatives used pre and post treatment (5.6±3.9 vs. 0.1±0.5, respectively) (p<0.0001). The underlying causes for epitheliopathy were benzalkonium chloride in 13 eyes, boric acid in 2 eyes, and others in 2 eyes.
Dry-eye patients need to instill eye drops many times per day, yet sometimes the use of those drops results in drug-toxicity-induced corneal epitheliopathy. Our findings suggest that the usage frequency of eye drops with preservatives should be carefully monitored in dry-eye patients.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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