Abstract
Purpose :
To examine the changes of ocular surface parameters in patients with dry eye disease (DED) instilling hyaluronate/ hydrocortisone 0.001% eye drops versus hyaluronate/ trehalose 3% eye drops.
Methods :
Thirty-eight patients (19 males, 19 females, mean age 51 years) affected by mild-moderate DED associated with meibomian gland disfunction (MGD) were enrolled; inclusion criteria were non-invasive Keratograph breakup time average (NIKBUTa) < 14 sec plus lipid layer thickness (LLT) < 75 nm and/or ocular surface disease index (OSDI) score between 13 and 32. Of these, 19 patients were treated with sodium hyaluronate 2 mg/ml plus hydrocortisone sodium phosphate 10 mcg/ml (group 1, study group) whereas 19 patients were treated with an artificial tear substitute containing sodium hyaluronate and trehalose (group 2, control group). The posology was 1 drop 4 times/ day for 3 months for both groups. Patients were examined at baseline (T0), day 15 (T1), day 45 (T2) and day 90 (T3) by means of Keratograph 5M® for NIKBUTa and LipiView® for LLT. Symptoms of ocular discomfort were scored at the same time points by means OSDI questionnaire.
Results :
A statistically significant difference was found at all follow up visits between the 2 groups in terms of NIKBUTa (median value in group 1 vs group 2 was respectively at T0=7.0 vs 6.0; p= 0.162 ; while at T1=12.8 sec vs 6.5; at T2=15.0 vs 8.0; at T3=19.5 vs 10.0; p<0.001) and in terms of variation of LLT (Delta-LLT group 1 vs group 2 was: ΔT1-T0=15 vs 0 nm; ΔT2-T0=17 vs-3.5; ΔT3-T0=24.5 vs -2.5; p<0.001). Only eyes belonging to group 1 showed a significant increased of the LLT at all visits vs T0 (median T1=78 nm; T2=87; T3=97 vs T0=63; p<0.001). Both groups showed a significant decreased of the OSDI score at all the visits (p<0.001), without significant difference between groups.
Conclusions :
Both treatments determined a significant amelioration of ocular discomfort symptoms. However, hyaluronate/hydrocortisone eye drops showed a statistically significant better performance in terms of increase of NIKBUT and LLT compared to hyaluronate/trehalose eye drops. Probably the low dose of hydrocortisone is useful to improve tear film stability in patient affected by MGD-associated DED, reducing the inflammation of meibomian glands and consequently allowing a higher production of the lipid layer.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.