Topical Cyclosporine A 0.05% for the Treatment of Dry Eye Disease

Authors

  • Naeima M. Elzlitni Ophthalmology Department, Faculty of medicine, University of Benghazi, Bengahzi, Libya.
  • Samar A. Bukhatwa Ophthalmology Department, Faculty of medicine, University of Benghazi, Bengahzi, Libya.
  • Sabah S. Eldressi Ophthalmology Department, Faculty of medicine, University of Benghazi, Bengahzi, Libya.

DOI:

https://doi.org/10.54172/mjsc.v36i1.8

Keywords:

Cyclosporine A, Dry Eye Disease (DED), Anti-inflammatory

Abstract

Dry eye disease (DED) is a common clinical condition that challenges ophthalmologists. Topical Cyclosporine A is an anti-inflammatory therapy being approved by the Food and Drug Administration (FDA) for the therapy for DED. This study aimed to evaluate the efficacy and pa- tient tolerability of topical Cyclosporine A 0.05% for the treatment of DED. A total of 87 patients diagnosed with DED were included in this study. Dry eye symptoms (foreign body sensation, burn- ing, and pain) were scored. As a baseline measurement, the tear break-up time test (TBUT) and the Schirmer’s test were performed for all the patients. Cyclosporine A 0.05% was given topically twice daily to all the patients for four months. They were followed up every month for a period of four months. The clinical signs (Schirmer’s test, the TBUT), and the symptoms scores, were record- ed for each visit. The mean age of the patients was 57.25±9.70 years (Range 32 - 80 years); 25 males (28.7%) and 62 females (71.3%). Out of them, 23 (26.4%) cases had Sjögren’s syndrome, and 12 (13.7%) cases had previous LASIK (laser in-situ keratomileusis). The symptoms score of the cases improved from (4.95±1.73) pretreatment to (0.40±.70) four months after treatment (P <0.001). The Schirmer’s test results improved from (4.10 ±1.089) pretreatment to (10.80±2.40) four months post-treatment (P <0.0001), and the TBUT test results improved from (5.54±1.77 s) pre- treatment to (12.95±3.12 s) four months post-treatment (P <0.0001). Only seven patients (8%) de- veloped ocular side effects in the form of redness, pain, and systemic side effects in the form of headache. In conclusion, Cyclosporine A 0.05% eye drops is an effective treatment for DED, im- proving both signs and symptoms of DED with few ocular side effects.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Al-Nashar, H. Y. (2015). Efficacy of topical cyclosporine 0.05% eye drops in the treatment of dry eyes. Journal of the Egyptian Ophthalmological Society, 108(4), 233. DOI: https://doi.org/10.4103/2090-0686.174683

Barbarino, J. M., Staatz, C. E., Venkataramanan, R., Klein, T. E., & Altman, R. B. (2013). PharmGKB summary: cyclosporine and tacrolimus pathways. Pharmacogenetics and genomics, 23(10), 563. DOI: https://doi.org/10.1097/FPC.0b013e328364db84

Baudouin, C., Figueiredo, F. C., Messmer, E. M., Ismail, D., Amrane, M., Garrigue, J.-S., Bonini, S., & Leonardi, A. (2017). A randomized study of the efficacy and safety of 0.1% cyclosporine A cationic emulsion in treatment of moderate to severe dry eye. European journal of ophthalmology, 27(5), 520-530. DOI: https://doi.org/10.5301/ejo.5000952

Behrens, A., Doyle, J. J., Stern, L., Chuck, R. S., McDonnell, P. J., Azar, D. T., Dua, H. S., Hom, M., Karpecki, P. M., & Laibson, P. R. (2006). Dysfunctional tear syndrome: a Delphi approach to treatment recommendations. Cornea, 25(8), 900-907. DOI: https://doi.org/10.1097/01.ico.0000214802.40313.fa

Brewitt, H., & Sistani, F. (2001). Dry eye disease: the scale of the problem. Survey of ophthalmology, 45, S199-S202. DOI: https://doi.org/10.1016/S0039-6257(00)00202-2

Byun, Y.-S., Rho, C. R., Cho, K., Choi, J. A., Na, K. S., & Joo, C.-K. (2011). Cyclosporine 0.05% ophthalmic emulsion for dry eye in Korea: a prospective, multicenter, open-label, surveillance study. Korean journal of ophthalmology: KJO, 25(6), 369. DOI: https://doi.org/10.3341/kjo.2011.25.6.369

Craig, J. P., Nichols, K. K., Akpek, E. K., Barbara Caffery, O., Dua, H. S., Joo, C.-K., Liu, Z., Nelson, J. D., Nichols, J. J., & Tsubota, K. (2017). TFOS DEWS II-Relazione su Definizione e Classificazione. Ocular Surface, 30, 276-283. DOI: https://doi.org/10.1016/j.jtos.2017.05.008

De Paiva, C. S., Pflugfelder, S. C., Ng, S. M., & Akpek, E. K. (2019). Topical cyclosporine A therapy for dry eye syndrome. Cochrane Database of Systematic Reviews(9). DOI: https://doi.org/10.1002/14651858.CD010051.pub2

Definition, D. (2007). The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye Workshop. Ocul Surf, 5, 75-92. DOI: https://doi.org/10.1016/S1542-0124(12)70081-2

Isreb, M., Greiner, J., Korb, D., Glonek, T., Mody, S., Finnemore, V., & Reddy, C. (2003). Correlation of lipid layer thickness measurements with fluorescein tear film break-up time and Schirmer's test. Eye, 17(1), 79-83. DOI: https://doi.org/10.1038/sj.eye.6700224

Javadi, M.-A., & Feizi, S. (2011). Dry eye syndrome. Journal of ophthalmic & vision research, 6(3), 192.

Kunert, K. S., Tisdale, A. S., Stern, M. E., Smith, J., & Gipson, I. K. (2000). Analysis of topical cyclosporine treatment of patients with dry eye syndrome: effect on conjunctival lymphocytes. Archives of ophthalmology, 118(11), 1489-1496. DOI: https://doi.org/10.1001/archopht.118.11.1489

Kymionis, G. D., Bouzoukis, D. I., Diakonis, V. F., & Siganos, C. (2008). Treatment of chronic dry eye: focus on cyclosporine. Clinical Ophthalmology (Auckland, NZ), 2(4), 829. DOI: https://doi.org/10.2147/OPTH.S1409

Lemp, M. A., Crews, L. A., Bron, A. J., Foulks, G. N., & Sullivan, B. D. (2012). Distribution of aqueous-deficient and evaporative dry eye in a clinic-based patient cohort: a retrospective study. Cornea, 31(5), 472-478. DOI: https://doi.org/10.1097/ICO.0b013e318225415a

Leonardi, A., Van Setten, G., Amrane, M., Ismail, D., Garrigue, J.-S., Figueiredo, F. C., & Baudouin, C. (2016). Efficacy and safety of 0.1% cyclosporine A cationic emulsion in the treatment of severe dry eye disease: a multicenter randomized trial. European journal of ophthalmology, 26(4), 287-296. DOI: https://doi.org/10.5301/ejo.5000779

Li, N., Deng, X.-G., & He, M.-F. (2012). Comparison of the Schirmer I test with and without topical anesthesia for diagnosing dry eye. International journal of ophthalmology, 5(4), 478.

Mah, F., Milner, M., Yiu, S., Donnenfeld, E., Conway, T. M., & Hollander, D. A. (2012). PERSIST: Physician’s Evaluation of Restasis® Satisfaction in Second Trial of topical cyclosporine ophthalmic emulsion 0.05% for dry eye: a retrospective review. Clinical Ophthalmology (Auckland, NZ), 6, 1971. DOI: https://doi.org/10.2147/OPTH.S30261

Matsuda, S., & Koyasu, S. (2000). Mechanisms of action of cyclosporine. Immunopharmacology, 47(2-3), 119-125. DOI: https://doi.org/10.1016/S0162-3109(00)00192-2

Othman, T. M., Mousa, A., Gikandi, P. W., AbdelMabod, M., & Abdelrahman, A. M. (2018). Efficacy and safety of using topical cyclosporine A for treatment of moderate to severe dry eye disease. Saudi Journal of Ophthalmology, 32(3), 217-221. DOI: https://doi.org/10.1016/j.sjopt.2018.06.001

Pei-Yu, L., Su-Ying, T., Ching-Yu, C., Jorn-Hon, L., Pesus, C., & Wen-Ming, H. (2003). Prevalence of dry eye among an elderly Chinese population in Taiwan. Ophthalmology, 110(6), 1096-1101. DOI: https://doi.org/10.1016/S0161-6420(03)00262-8

Pflugfelder, S. C., De Paiva, C. S., Villarreal, A. L., & Stern, M. E. (2008). Effects of sequential artificial tear and cyclosporine emulsion therapy on conjunctival goblet cell density and transforming growth factor-β2 production. Cornea, 27(1), 64-69. DOI: https://doi.org/10.1097/ICO.0b013e318158f6dc

Phogat, J., Verma, R., Rathi, M., Sachdeva, S., & Pandey, L. (2019). Efficacy of cyclosporine 0.05% in patients with dry eye syndrome. International Journal of Community Medicine and Public Health, 6(8), 3339. DOI: https://doi.org/10.18203/2394-6040.ijcmph20193451

Prabhasawat, P., Tesavibul, N., Karnchanachetanee, C., & Kasemson, S. (2013). Efficacy of cyclosporine 0.05% eye drops in Stevens Johnson syndrome with chronic dry eye. Journal of ocular pharmacology and therapeutics, 29(3), 372-377. DOI: https://doi.org/10.1089/jop.2012.0009

Schaumberg, D. A., Sullivan, D. A., Buring, J. E., & Dana, M. R. (2003). Prevalence of dry eye syndrome among US women. American journal of ophthalmology, 136(2), 318-326. DOI: https://doi.org/10.1016/S0002-9394(03)00218-6

Schein, O. D., MUÑO, B., Tielsch, J. M., Bandeen-Roche, K., & West, S. (1997). Prevalence of dry eye among the elderly. American journal of ophthalmology, 124(6), 723-728. DOI: https://doi.org/10.1016/S0002-9394(14)71688-5

Stern, M. E., Beuerman, R. W., Fox, R. I., Gao, J., Mircheff, A. K., & Pflugfelder, S. C. (1998). The pathology of dry eye: the interaction between the ocular surface and lacrimal glands. Cornea, 17(6), 584-589. DOI: https://doi.org/10.1097/00003226-199811000-00002

Strong, B., Farley, W., Stern, M. E., & Pflugfelder, S. C. (2005). Topical cyclosporine inhibits conjunctival epithelial apoptosis in experimental murine keratoconjunctivitis sicca. Cornea, 24(1), 80-85. DOI: https://doi.org/10.1097/01.ico.0000133994.22392.47

Sullivan, B. D., Crews, L. A., Sönmez, B., Maria, F., Comert, E., Charoenrook, V., de Araujo, A. L., Pepose, J. S., Berg, M. S., & Kosheleff, V. P. (2012). Clinical utility of objective tests for dry eye disease: variability over time and implications for clinical trials and disease management. Cornea, 31(9), 1000-1008. DOI: https://doi.org/10.1097/ICO.0b013e318242fd60

Tuan, H.-I., Chi, S.-C., & Kang, Y.-N. (2020). An updated systematic review with meta-analysis of randomized trials on topical cyclosporin A for dry-eye disease. Drug design, development and therapy, 14, 265. DOI: https://doi.org/10.2147/DDDT.S207743

Yavuz, B., Bozdağ Pehlivan, S., & Ünlü, N. (2012). An overview on dry eye treatment: approaches for cyclosporin a delivery. The Scientific World Journal, 2012. DOI: https://doi.org/10.1100/2012/194848

Downloads

Published

2021-03-31

How to Cite

Elzlitni, N. M. ., Bukhatwa , S. A. ., & Eldressi, S. S. . (2021). Topical Cyclosporine A 0.05% for the Treatment of Dry Eye Disease. Al-Mukhtar Journal of Sciences, 36(1), 34–41. https://doi.org/10.54172/mjsc.v36i1.8

Issue

Section

Research Articles

Categories

Most read articles by the same author(s)

Obs.: This plugin requires at least one statistics/report plugin to be enabled. If your statistics plugins provide more than one metric then please also select a main metric on the admin's site settings page and/or on the journal manager's settings pages.