July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018

Is significant reduction of ocular surface inflammation while applying CSA 0,1% eyedrops in patients with ocular Graft versus Host Disease (GVHD) accompanied by improvement of the Ocular Surface disease Index (OSDI)?
Author Affiliations & Notes
  • Stephanie Weissleder
    Department of Ophthalmology, University of Hamburg, Hamburg, Germany
  • Alexander Steinhorst
    Department of Ophthalmology, University of Hamburg, Hamburg, Germany
  • Francis Ayuk Ayuketang
    Bone Marrow Transplantation, University of Hamburg, Hamburg, Germany
  • Stefan Linke
    Department of Ophthalmology, University of Hamburg, Hamburg, Germany
  • Nicole Stuebiger
    Department of Ophthalmology, University of Hamburg, Hamburg, Germany
  • Footnotes
    Commercial Relationships   Stephanie Weissleder, None; Alexander Steinhorst, None; Francis Ayuk Ayuketang, None; Stefan Linke, None; Nicole Stuebiger, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 930. doi:
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      Stephanie Weissleder, Alexander Steinhorst, Francis Ayuk Ayuketang, Stefan Linke, Nicole Stuebiger;
      Is significant reduction of ocular surface inflammation while applying CSA 0,1% eyedrops in patients with ocular Graft versus Host Disease (GVHD) accompanied by improvement of the Ocular Surface disease Index (OSDI)?. Invest. Ophthalmol. Vis. Sci. 2018;59(9):930.

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

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Abstract

Purpose : Dry eye disease (DED) and ocular surface inflammation (OSI) are common manifestations of ocular Graft versus Host Disease (GVHD) in patients after bone marrow transplantation (BMT). We compared the effect of CSA 0,1% eye drops (Ikervis®,1mg/ml cyclosporine in a cationic oil-water emulsion) and artificial tears versus artificial tears monotherapy. An additional use of CSA 0,1% eye drops is known to reduce ocular surface inflammation and should therefore lead to subjective improvement of OSI in these patients.

Methods : We performed Schirmer’s test I and analyzed the corneal staining (using GVHD Consensus Group Criteria, CFS), the conjunctival injection (using GVHD Consensus Group Criteria) and the Ocular Surface Disease Index (OSDI, 0-100 points) in patients (n= 20, m=12 f= 8) after bone marrow transplantation (7-70 months) before and 3 months after treatment with artificial tears in addition with CSA 0,1% eye drops (n= 20 eyes, meanage 52,5) or artificial tears alone representing the control group (n= 20 eyes, meanage 58,5). Independent two sample t-test was used for statistical analysis (Excel was used for Analysis).

Results : The corneal staining significantly decreased in the group receiving CSA eye drops (-1 +/- 0,22) compared to patients receiving artificial tears monotherapy (-0,11 +/- 0,1; p=0,04). Both groups showed a non significant reduction in conjunctival injection (CSA= 0.00 +/- 0,3; control group= 0,01 +/- 0,21) and no effect to Schirmer’s test (CSA= -0,5 +/- 2,5; Control group= -0,6 +/- 3,0). The OSDI showed significant improvement in both groups (CSA = -18 +/- 20,5) with a slight but not significant benefit for patients in the control group (-19,5 +/- 17; p=0,263).

Conclusions : Our results are consistent with other findings that using CSA 0,1% eye drops in addition leads to significant reduction in ocular surface inflammation. Regarding the subjective benefit, represented by the OSDI, both patient groups demonstrated significant improvement but no significant difference between the CSA and the control group could be achieved. So in our study significant improvement of ocular surface inflammation was not accompanied by significant differences in OSDI. Larger trials are required to derive more definitive data.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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