Abstract
Purpose :
To profile conjunctival T cell populations in Allogeneic Haematopoietic Stem Cell Transplant patients after instillation of daily Topical Cyclosporine-A (CsA) 0.1% cationic emulsion (Ikervis), and to evaluate patients’ tolerance to these eyedrops.
Methods :
In this prospective interventional single-arm study, nineteen participants were prescribed Ikervis prophylaxis once daily to both eyes from 3-5 weeks pre-HSCT to 12 months post-HSCT. The outcome measure was conjunctival T cell proportions from flow cytometry after impression cytology. Covariates included visual acuity, intraocular pressure, slit lamp and fundal examination, dry eye (SPEED) and quality of life questionnaires, non-invasive keratograph tear break up time (NIKBUT), conjunctival redness, meibography, lipid thickness, Schirmer test, tear cytokines, fluorescein staining, tear osmolarity and meibomian gland expressibility.
Results :
The conjunctival T cell analysis showed either stable or decreased proportions of conjunctival CD4 T cells at the last visit from baseline in compliant patients. CD4 proportions were increased in non-compliant patients and in the single patient who developed ocular-GVHD. All patients were tolerant to Ikervis but 6/19 were not compliant to Ikervis. In the majority of patients, vision did not affect activities of daily living. Pre and post-HSCT up to the last study visit, there was no statistically significant change in the clinical covariates. Only 1 participant developed ocular-GVHD at 9 months post-HSCT.
Conclusions :
In conclusion, superficial conjunctival T cell profile reflects compliance to daily topical Ikervis eyedrops and clinical ocular surface parameters in allo-HSCT patients. Tolerance is comparable to other formulations of topical CsA in the first 12 months.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.