A 0,05% cyc­lo­spo­ri­ne tre­at­ment of the ad­van­ced dry eye syn­dro­me

Introduction
The purpose of our study has been to present the results obtained from the treatment with 0.05% cyclosporine solution in drops in patients with severe aggravation of dry eye syndrome manifestations who otherwise did not suffer from any systemic disease (a three-month treatment). Another group in whom we used the same treatment were those who suffered from dry eye syndrome, which developed in the course of Sjogren’s syndrome, and graft versus host disease following bone marrow transplantation (a six-month treatment).

Material and methods
The study comprised 15 dry eye syndrome patients (30 eyes), who were divided into three groups. In Group I were those with severe aggravation of dry eye syndrome manifestations without concomitant systemic diseases (3 women), aged 54 to 59 years (mean 57). Group II comprised the patients with Sjogren’s syndrome (8 women, 1 man), aged 45 to 59 years (mean 55.5) with graft versus host disease. In Group III, there were 3 women, aged 52 to 59 years (mean 55) with graft versus host disease. All the patients were administered 0.05% cyclosporine topically twice daily. The Group I patients were given 0.05% cyclosporine solution for 3 months, those in Groups II and III for 6 months. Subjective complaints were classified according to the protocol of Dr. Mann Pharma/ Bausch&Lomb.

Results
The effectiveness of the therapy with 0.05% cyclosporine solution was evaluated by the mean number of points in a five-point Schirmer II test score, measured before and after the treatment. The Group I patients (dry eye syndrome without systemic diseases) were found to have the highest mean number of points – 4. In the Sjogren’s syndrome Group, the mean number of points was 3.1; and in Group III (graft vs host disease) the mean value was 2 points. Since the number of patients was different in particular groups, the findings have not been compared between themselves.

Conclusions
Using 0.05% cyclosporine solution is effective in treating patients with dry eye syndrome but without systemic diseases. In such cases a short, three-month treatment is sufficient. The 0.05% cyclosporine treatment is just as effective in patients with dry eye syndrome and Sjogren’s syndrome or graft versus host disease. Yet in such cases the treatment has to be longer and take six months. We observed a mean increase points in the five-point Schirmer II test score in all our patients.