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.