Effects of Topical Loteprednol Etabonate on Tear Cytokines and Clinical Outcomes in Moderate and Severe Meibomian Gland Dysfunction: Randomized Clinical Trial
Effects of Topical Loteprednol Etabonate on Tear Cytokines and Clinical Outcomes in Moderate and Severe Meibomian Gland Dysfunction: Randomized Clinical Trial
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DOI：
10.1016/j.ajo.2014.08.015
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发表时间：
2014-12-01
影响因子：
4.2
通讯作者：
Kim, Tae-Im
中科院分区：
文献类型：
--
作者：
Lee, Hun;Chung, Byunghoon;Kim, Tae-Im
目的：评估中度和重度睑板腺功能障碍 (MGD) 患者使用局部依碳酸氯替泼诺和热敷眼睑擦洗与仅热敷眼睑擦洗治疗 2 个月后的泪细胞因子水平和临床结果。设计：随机对照试验。方法：中度和重度睑板腺功能障碍 (MGD) 患者被随机分为 2 组：局部依碳酸氯替泼诺和热敷眼睑擦洗（第一组，34 只眼睛）或用温热敷布擦洗眼睑（第二组，36 只眼睛）。我们在开始治疗前以及治疗后1个月和2个月评估了细胞因子水平、泪膜破裂时间（TBUT）、角膜和结膜荧光素染色、眼睑边缘和睑板腺的生物显微镜检查以及眼表面疾病指数。 结果：I组中白细胞介素（IL）-6、IL-8和IL-1β水平显着下降，II组中IL-6和IL-8水平显着下降。此外，在第一组中观察到的这些细胞因子的减少归因于治疗期间和治疗后1个月的显着减少。与II组相比，I组的所有临床结果均有所改善，治疗1个月后TBUT、角膜和结膜荧光素染色以及睑脂质量显着改善。 I 组睑板腺表达性的改善和 MGD 阶段的降低更为显着。结论：局部依碳氯替泼诺和热敷眼睑磨砂对于治疗中度和重度 MGD 具有耐受性和有效性。我们建议这种有益效果可以在 1 个月后显现出来。 （(C) 2014 年，Elsevier Inc. 保留所有权利。）
PURPOSE: To assess tear cytokine levels and clinical outcomes in moderate and severe meibomian gland dysfunction (MGD) after 2 months of treatment with topical loteprednol etabonate and eyelid scrubs with warm compresses vs eyelid scrubs with warm compresses alone.DESIGN: Randomized controlled trial.METHODS: Patients with moderate and severe MGD were randomized into 2 groups: topical loteprednol etabonate and eyelid scrubs with warm compresses (Group I, 34 eyes) or eyelid scrubs with warm compresses (Group II, 36 eyes). We evaluated cytokine levels, tear film break-up time (TBUT), corneal and conjunctival fluorescein staining, biomicroscopic examination of lid margins and meibomian glands, and the Ocular Surface Disease Index before initiating treatment and 1 month and 2 months after treatment.RESULTS: There were significant decreases in the levels of interleukin (IL)-6, IL-8, and IL-1 beta in Group I, and IL-6 and IL-8 in Group II. Moreover, the observed decreases of these cytokines in Group I were attributed to a remarkable decrease between treatment and 1 month after treatment. In Group I, there were improvements in all of the clinical outcomes, with prominent improvement in TBUT, corneal and conjunctival fluorescein staining, and meibum quality after 1 month of treatment, compared with Group II. An improvement in meibomian gland expressibility and MGD stage reduction were more remarkable in Group I.CONCLUSIONS: Topical loteprednol etabonate and eyelid scrubs with warm compresses were tolerated and efficacious for the treatment of moderate and severe MGD. We suggest that such beneficial effects could manifest after 1 month. ((C) 2014 by Elsevier Inc. All rights reserved.)