Consensus Statement on the use of cyclosporin A in patients with severe keratitis in dry eye syndrome in ophthalmology, rheumatology and hematology*

Leszek Borkowski; Dariusz Dobrowolski; Lidia Gil; Piotr Głuszko; Iwona Grabska-Liberek; Marta Misiuk-Hojło; Ewa Mrukwa-Kominek; Agnieszka Piekarska; Joanna Przeździecka-Dołyk; Bożena Romanowska-Dixon; Jacek P. Szaflik; Bożena Targońska-Stępniak; Monika Udziela; Piotr Wiland

doi:10.5114/ko.2020.101648

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Klinika Oczna / Acta Ophthalmologica Polonica

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4/2020
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abstract:

Guidelines/recommendations

Consensus Statement on the use of cyclosporin A in patients with severe keratitis in dry eye syndrome in ophthalmology, rheumatology and hematology*

Leszek Borkowski

¹

,

Dariusz Dobrowolski

²

,

Lidia Gil

³

,

Piotr Głuszko

⁴

,

Iwona Grabska-Liberek

⁵

,

Marta Misiuk-Hojło

⁶

,

Ewa Mrukwa-Kominek

⁷

,

Agnieszka Piekarska

⁸

,

Joanna Przeździecka-Dołyk

^{6, 9}

,

Bożena Romanowska-Dixon

¹⁰

,

Jacek P. Szaflik

¹¹

,

Bożena Targońska-Stępniak

¹²

,

Monika Udziela

¹¹

,

Piotr Wiland

¹³

Director’s plenipontiary for Drug Analysis and Management in Wolski Hospital, President of the foundation ”Razem w Chorobie” Board
Department of Ophthalmology with Pediatric Unit, St Barbara 5th Regional Hospital in Sosnowiec, Poland
Department of Haematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
Department of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
Department of Ophthalmology, Medical Centre for Postgraduate Education, Warsaw, Poland
Department of Ophthalmology, Wroclaw Medical University, Wroclaw, Poland
Department of Ophthalmology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
Department of Hematology and Transplantology, University Clinical Center, Medical University of Gdańsk, Gdańsk, Poland
Department of Optics and Photonics, Faculty of Fundamental Problems of Technology, Wroclaw University of Science and Technology, Wroclaw, Poland
Department of Ophthalmology and Ocular Oncology, University Hospital in Krakow, Poland
Department of Ophthalmology, Medical University of Warsaw, Public Ophthalmic Teaching Hospital, Warsaw, Poland
Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Lublin, Poland
Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Wroclaw, Poland

KLINIKA OCZNA 2020, 122, 4: 135–138

DOI: https://doi.org/10.5114/ko.2020.101648

Online publish date: 2020/12/18

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AMA

Borkowski L, Dobrowolski D, Gil L, et al. Consensus Statement on the use of cyclosporin A in patients with severe keratitis in dry eye syndrome in ophthalmology, rheumatology and hematology*. Klinika Oczna / Acta Ophthalmologica Polonica. 2020;122(4):135-138. doi:10.5114/ko.2020.101648.

APA

Borkowski, L., Dobrowolski, D., Gil, L., Głuszko, P., Grabska-Liberek, I.,  & Misiuk-Hojło, M. et al. (2020). Consensus Statement on the use of cyclosporin A in patients with severe keratitis in dry eye syndrome in ophthalmology, rheumatology and hematology*. Klinika Oczna / Acta Ophthalmologica Polonica, 122(4), 135-138. https://doi.org/10.5114/ko.2020.101648

Chicago

Borkowski, Leszek, Dariusz Dobrowolski, Lidia Gil, Piotr Głuszko, Iwona Grabska-Liberek, Marta Misiuk-Hojło,  and Ewa Mrukwa-Kominek et al. 2020. "Consensus Statement on the use of cyclosporin A in patients with severe keratitis in dry eye syndrome in ophthalmology, rheumatology and hematology*". Klinika Oczna / Acta Ophthalmologica Polonica 122 (4): 135-138. doi:10.5114/ko.2020.101648.

Harvard

Borkowski, L., Dobrowolski, D., Gil, L., Głuszko, P., Grabska-Liberek, I., Misiuk-Hojło, M., Mrukwa-Kominek, E., Piekarska, A., Przeździecka-Dołyk, J., Romanowska-Dixon, B., Szaflik, J., Targońska-Stępniak, B., Udziela, M.,  and Wiland, P. (2020). Consensus Statement on the use of cyclosporin A in patients with severe keratitis in dry eye syndrome in ophthalmology, rheumatology and hematology*. Klinika Oczna / Acta Ophthalmologica Polonica, 122(4), pp.135-138. https://doi.org/10.5114/ko.2020.101648

MLA

Borkowski, Leszek et al. "Consensus Statement on the use of cyclosporin A in patients with severe keratitis in dry eye syndrome in ophthalmology, rheumatology and hematology*." Klinika Oczna / Acta Ophthalmologica Polonica, vol. 122, no. 4, 2020, pp. 135-138. doi:10.5114/ko.2020.101648.

Vancouver

Borkowski L, Dobrowolski D, Gil L, Głuszko P, Grabska-Liberek I, Misiuk-Hojło M et al. Consensus Statement on the use of cyclosporin A in patients with severe keratitis in dry eye syndrome in ophthalmology, rheumatology and hematology*. Klinika Oczna / Acta Ophthalmologica Polonica. 2020;122(4):135-138. doi:10.5114/ko.2020.101648.

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CONTENT OF THE CONSENSUS STATEMENT

In December 2019, clinical experts in the fields of ophthalmology, rheumatology and hematology held a meeting in order to develop guidelines for the prevention and treatment of severe forms of dry eye syndrome (DES). During the meeting, an extremely important therapeutic problem was highlighted; namely the lack of patient access to reimbursed cyclosporin A. In light of above, a Consensus Statement was drawn up regarding the unavailability of sight-saving therapy in the form of reimbursed cyclosporin A to patients with severe DES.
The Consensus Statement was developed with references to the latest guidelines for the treatment of DES, including Polish Ophthalmological Society 2018 [1], TFOS DEWS II [2-5], AAO 2018 [6], EULAR 2020 [7], EBMT 2019 [8], and the publication “Prevention and Treatment of Severe Keratitis in Dry Eye Syndrome” [9]. During the development of the experts’ position, the opinion of dr. n. farm. Leszek Borkowski was taken into account in the section addressing the safety of medicinal products with cyclosporin [10].
Dry eye syndrome is a complex disorder characterized by inflammation, and instability and hyperosmolarity of the tear film. Severe forms of DES can lead to significant damage to the structures of the ocular surface (including severe keratitis), and neurosensory abnormalities.
Even though DES significantly reduces the quality of life of patients, it tends to be trivialized as a public health problem, despite the condition being one of the most common reasons to see an ophthalmologist. When providing their medical history, patients typically report a range of persistent symptoms including burning sensation, discomfort, itching, visual disturbances, irritation, photosensitivity, gritty feeling in the eyes, excessive tearing, and difficulty reading, driving, and working at the computer. The seriousness of the health problem is reflected in the fact that the lack of patient access to reimbursed treatment contributes to progression of the disease, ultimately resulting in ocular damage. The longer the period from the onset of DES symptoms to the diagnosis, the higher the severity of daily discomfort and pain, and the greater the adverse impact of the disease on the overall quality of life and professional activity of patients. The negative effect of moderate to severe DES on the quality of life of affected individuals is comparable to that of conditions requiring dialysis...

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keywords:

Consensus Statement on the use of cyclosporin A in patients with severe keratitis in dry eye syndrome in ophthalmology, rheumatology and hematology*

CONTENT OF THE CONSENSUS STATEMENT

keratitis, dry eye syndrome, cyclosporin A