Abstract
Purpose: :
To evaluate the effects of sequential treatment of dry eye disease with artificial tears and cyclosporin A (CsA) emulsion on conjunctival goblet cell density.
Methods: :
Patients with dry eye disease (n = 6) defined by an Ocular Surface Disease Index (OSDI) symptom score ≥ 25, Schirmer 1 < 10 mm and corneal fluorescein and conjunctival lissamine green staining scores ≥ 3 were treated with artificial tears (Refresh TearsTM, Allergan, Irvine, CA) QID for 4 weeks followed by 0.05% CsA emulsion (Restasis, Allergan) BID for 12 weeks. Impression cytology was performed on the temporal and inferior bulbar conjunctiva of the right eye at baseline, after artificial tear therapy and after 6 and 12 weeks of CsA therapy. Goblet cells were counted in 5 representative microscopic fields per membrane and mean numbers per membrane were statistically compared by ANOVA with post–hoc analysis.
Results: :
Goblet cell density in the temporal bulbar conjunctiva was not significantly different at any time point. There was no change from baseline in inferior bulbar goblet cell density after artificial tear therapy (5.1 ± 5.5 and 4.3 ± 5.8 cells per field, respectively). Inferior bulbar goblet cell density increased following 6 weeks (17.5 ± 18.5; P< 0.01 vs baseline and P< 0.001 vs artificial tears) and 12 weeks (11.9 ± 9.6, P> 0.05 vs baseline and artificial tears) of CsA therapy.
Conclusions: :
CsA emulsion, but not artificial tears, increases the number of conjunctival goblet cells on the inferior bulbar conjunctiva in dry eye patients.
Keywords: cornea: tears/tear film/dry eye • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • cytology