June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Combinatorial Therapy with Immunosuppressive, Immunomodulatory and Tear Substitute Eyedrops (‘Triple Play’) in Recalcitrant Immunological Ocular Surface Diseases
Author Affiliations & Notes
  • Sarah Sunshine
    Ophthalmology, University of Maryland School of Medicine, Baltimore, Maryland, United States
  • Eitan Katz
    Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Christine Mun
    Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Jessica Mun
    Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Caitlin Berek
    Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Anubhav Pradeep
    Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Bayasgalan Surenkhuu
    Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Sandeep Jain
    Illinois Eye and Ear Infirmary, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Sarah Sunshine, None; Eitan Katz, None; Christine Mun, None; Jessica Mun, None; Caitlin Berek, None; Anubhav Pradeep, None; Bayasgalan Surenkhuu, None; Sandeep Jain, ADVAITE Inc, SELAGINE Inc (I), Ocugen Inc (C), University of Illinois at Chicago College of Medicine (P)
  • Footnotes
    Support  P30 EY001792 (Deepak Shukla), Research to Prevent Blindness, R01 EY024966 (Sandeep Jain)
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1306. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Sarah Sunshine, Eitan Katz, Christine Mun, Jessica Mun, Caitlin Berek, Anubhav Pradeep, Bayasgalan Surenkhuu, Sandeep Jain; Combinatorial Therapy with Immunosuppressive, Immunomodulatory and Tear Substitute Eyedrops (‘Triple Play’) in Recalcitrant Immunological Ocular Surface Diseases. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1306.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose : Current paradigm for therapy of immune mediated ocular surface diseases (iOSD) consists of targeting innate or adaptive immune system pathways in a sequential, step-up treatment approach. A combinatorial topical therapy (anti-inflammatory/immunosuppressive pharmaceutical [steroid] with immunomodulatory [pooled human immune globulin] and tear substitute [serum] biologics) that simultaneously targets several immunological pathways may be more efficacious. This combinatorial therapy targets distinct albeit overlapping pathways of the immune system to affect several inflammatory mediators (eicosanoids, autoantibodies, complement system and cytokines/chemokines).

Methods : We performed a retrospective, case study of patients receiving topical formulations of methylprednisolone, pooled human immune globulin, and serum tears to evaluate if the ‘triple play’ therapy resulted in clinical benefit in recalcitrant OSD cases (n=10). Patients included one male and nine females ranging in age from 27 to 87 years old. Patients were included if they suffered from recalcitrant OSD, received the three therapies, and had slit lamp photographs prior to starting the ‘Triple Play’ therapy and a subsequent photograph following at least a month of treatment. Outcome measures were individualized by case and included visual acuity, ocular surface disease index (OSDI), ocular discomfort score, subjective global assessment (SGA), and slit lamp photographs.

Results : Pathologies included ocular graft-versus-host disease, Sjögren’s syndrome, ocular cicatricial pemphigoid, neurotrophic keratitis, pemphigus vulgaris, peripheral ulcerative keratitis, Stevens-Johnson syndrome, and giant papillary conjunctivitis. All patients were ‘much improved’ on SGA after ‘Triple Play’ therapy. Additionally, three patients had improvement in their visual acuity (one from 20/400 to 20/20). All patients had clinically meaningful improvement in signs (reduction in bulbar redness and corneal staining).

Conclusions : Combinatorial ‘Triple Play’ therapy provides a clinical benefit by reducing the symptoms and signs in recalcitrant iOSD. Our study provides the rationale for performing prospective clinical trials to evaluate the efficacy of combinatorial ‘Triple Play’ therapy for treating iOSD.

This is a 2021 ARVO Annual Meeting abstract.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×