High-frequency topical cyclosporine 0.05% in the treatment of severe dry eye refractory to twice-daily regimen.
High-frequency topical cyclosporine 0.05% in the treatment of severe dry eye refractory to twice-daily regimen.
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DOI：
10.1097/ico.0b013e3181a16472
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发表时间：
2009-12
期刊：
影响因子：
2.8
通讯作者：
Dana R
中科院分区：
文献类型：
--
作者：
Dastjerdi MH;Hamrah P;Dana R
本研究的目的是报道0.05%环孢素每日3 ~ 4次局部治疗严重干眼病的疗效。我们回顾性地确定了一组患有严重干眼病的患者，他们对每天两次局部使用0.05%环孢素治疗至少4个月的疗程反应不足，但对更频繁的给药有显著改善。纳入22例患者，包括13例眼部移植物抗宿主病患者和9例原发性或继发性Sjögren综合征患者。在至少2个月的疗程后，更频繁地给药0.05%的环孢素（7例患者每天3次，15例患者每天4次），15例（68.2%）患者的总体干眼症状得到改善（9例眼部移植物抗宿主病患者和6例Sjögren综合征患者）。眼移植抗宿主病患者角膜荧光素染色平均评分（国家眼科研究所评分0 - 15）较基线（使用环孢素前）提高（降低）了- 3.5（范围，0至- 7）（P≤0.0008），Sjögren综合征患者的角膜荧光素染色平均评分为- 2.8（范围，0至- 5）（P≤0.001）。在高频率使用0.05%环孢素治疗后，16例（72.7%）患者的干眼状态总体医师评价为良好（改善）。3例（13.6%）患者报告使用高剂量局部环孢素后出现烧灼或刺激的新发症状。没有其他相关不良反应的报道。这些数据表明，严重干眼症患者可能需要更频繁地局部使用0.05%的环孢素，而不是每天两次。
The purpose of this study was to report the efficacy of topical cyclosporine 0.05% at a frequency of 3 to 4 times daily in severe dry eye disease. We retrospectively identified a cohort of patients with severe dry eye disease who had shown inadequate response to at least a 4-month course of treatment with twice-daily use of topical cyclosporine 0.05% but who showed significant improvement to more frequent dosing. Twenty-two patients, including 13 patients with ocular graft versus host disease and 9 patients with primary or secondary Sjögren’s syndrome, were included. After a minimum of a 2-month course of treatment with more frequent dosing of cyclosporine 0.05% (3 times a day in 7 patients and 4 times a day in 15 patients), overall dry eye symptoms were improved in 15 (68.2%) patients (9 patients with ocular graft versus host disease and 6 patients with Sjögren’s syndrome). Mean corneal fluorescein staining scores (National Eye Institute scale of 0–15) improved (decreased) from the baseline (precyclosporine use) by −3.5 (range, 0 to −7) in patients with ocular graft versus host disease (P ≤ 0.0008) and −2.8 (range, 0 to −5) in patients with Sjögren’s syndrome (P ≤ 0.001). After treatment with high-frequency use of cyclosporine 0.05%, the global physician assessment of dry eye status was favorable (improved) in 16 (72.7%) patients. Three (13.6%) patients reported new-onset symptoms of burning or irritation with the use of high-frequency dosing of topical cyclosporine. No other associated adverse effect was reported. These data suggest that patients with severe dry eye may require more frequent dosing of topical cyclosporine 0.05% than twice daily.