There were no significant differences in signs and symptoms of DED between the groups at baseline. Clinical data, including Ocular Surface Disease Index (OSDI) questionnaire, corneal fluorescein staining (CFS), conjunctival lissamine green staining, tear break-up time (TBUT), and Schirmer's test, were evaluated before and after treatment. In each group, patients received either loteprednol etabonate 0.5% ophthalmic suspension or artificial tears twice daily for 4 weeks. This single-center study included 42 patients with moderate to severe DED associated with (N=21) or without (N=21) chronic GVHD. Post-hoc analysis of a double-masked, randomized clinical trial. To compare the response of dry eye disease (DED) to treatment with topical steroid in patients with and without graft-versus-host disease (GVHD). Loteprednol etabonate 0.5% may have a lower risk for IOP elevation than fluorometholone 0.1%. Long-term application of low-dose topical corticosteroids is effective for controlling signs and symptoms of chronic, severe dry eye associated with SS. The mean IOP in these patients was lower in group A than in group B (15.00☐.82 mmHg versus 16.50☑.12 mmHg p=0.04). At 24 months, the number of patients with IOP elevation of more than 2 mmHg compared with baseline was 4 in group A (6.1%) and 9 in group B (13.4%). No significant differences between the groups were found in any parameter during follow-up. Schirmer test results, keratoepitheliopathy, and symptom scores at 6, 12, 18, and 24 months (p<0.05) and tear film BUT at 12, 18, and 24 months (p<0.05) significantly improved after treatment compared with baseline in both groups. VA and IOP were not changed significantly during follow-up in either group. Visual acuity (VA), intraocular pressure (IOP), Schirmer test, tear film breakup time (BUT), keratoepitheliopathy, and symptom scores were measured at baseline and 6, 12, 18, and 24 months after treatment. Patients who had severe dry eye associated with SS were topically treated with loteprednol etabonate 0.5% (group A, n=66) or fluorometholone 0.1% (group B, n=67) twice daily and were followed up for 2 years. This retrospective study was performed to analyze the long-term outcome of topical corticosteroid treatment for severe dry eye associated with Sjögren's syndrome (SS).
Topical steroids have proven beneficial in conjunction with other anti-inflammatory medications such as topical calcineurin inhibitors.Īs inflammation plays an important role in pathogenesis of DED, topical steroids may be considered for patients with refractory disease. For this, low-potency steroids, such as loteprednol or fluorometholone, would be reasonable due to their reduced risk for increasing intraocular pressure. Although topical steroids are often used for a short period of time, patients with chronic ocular surface inflammation can benefit from long-term treatment. These medications are useful for patients with both aqueous-deficient and evaporative subtypes of DED. Recent studies have shown that topical steroids are effective for the treatment of patients with moderate or severe DED who have failed to respond to more conservative measures. To review current literature on the use of topical steroids for treatment of both aqueous-deficient and evaporative subtypes of dry eye disease (DED).
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