Abstract
Purpose:
Cyclosporine is an immunomodulator with anti-inflammatory effects. Ophthalmic used topically at a concentration of 0.05% and 0.1% during severe droughts eye, primary or secondary, after classical treatment. The aim of the study was to evaluate the efficacy of this treatment. The secondary objective was to identify the best indications.
Methods:
Prospective study of 18 patients treated for pathologies of the ocular surface, in our center, between 2011 and 2014, by Ikervis® (cyclosporine 0.1%) (Santen, SAS) at a dose of one drop a day in the aftermath of treatment with Restasis® (Allergan, Inc.) (0.05% cyclosporine), in combination with a lubricant treatment,. We assessed the patients quality of life before and after treatment with a standardized questionnaire (Ocular Surface Disease Index ©), clinical efficacy was quantified with the extent of Break Up Time (BUT) and Oxford Scale.
Results:
Mean follow-up was 17 months (9-36 months).<br /> 34 eyes of 18 patients (15F / 3H) were included in the study. The average age of patients was 60.1 +/- 6.6 years. The main indications were: Goujerot- Sjögren syndromes (26%), local inflammatory diseases (17%), Lyell syndromes (10%) and neoplastic diseases (10%).<br /> The OSDI was significantly improved after treatment (mean OSDI before Treatment: 72.46 +/- 12.15 after treatment 53, 26 +/- 20.96; p = 0051). Wherever BUT was significantly improved by 2 seconds on average (p = 0.0004), with an increase of the latter in 58% of cases (before purpose treatment: 2.52 +/- 1.1 , after : 4.48 +/- 2.66). The corneal alterations was variable according to the indication with over 80% of patients with a baseline score greater than or equal to 3 in the classification of Oxford. After treatment a significant improvement was found (p = 0.0004), only 42% of patients kept a strict local review (upper stage 3). There was 25% of patients with early stages (stage 1 or 0). The safety profile was good, 80% of the study population had a good compliance with continued treatment at follow-up.
Conclusions:
This study found a clinical improvement after treatment by Ikervis® (Cyclosporine 0.1%) and allows us to consider a prospective protocol study with free treatment patients