gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Pharmacological prevention of radiation-induced dry eye: an experimental study

Meeting Abstract

  • corresponding author C. Schröder - Klinik für Augenheilkunde, Universitätsklinikum Lübeck
  • S. G. Hakim - Klinik für Kiefer-Gesichtschirurgie, Universitätsklinikum Lübeck
  • L. Liu - Klinik für Augenheilkunde, Universitätsklinikum Lübeck
  • P. Sieg - Klinik für Kiefer-Gesichtschirurgie, Universitätsklinikum Lübeck
  • G. Geerling - Klinik für Augenheilkunde, Universitätsklinikum Lübeck

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogDO.12.05

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dog2004/04dog105.shtml

Veröffentlicht: 22. September 2004

© 2004 Schröder et al.
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Gliederung

Text

Objective

Radiotherapy in the head and neck region may induce a damage of lacrimal gland and consequently alteration of secretion. Patients suffer from severe ocular symptoms and showed damage of the ocular surface. The use of pilocarpine, lidocaine and amifostine to avoid xerostomie is known, however, there is no study concerning their effects in preventing radiation-induced dry eye.

Methods

Twenty-five rabbits were used for the study; all were irradiated with 15 Gy (single dose). They were randomised into 5 groups (n=5). One group was pre-treated with pilocarpine (0.6 mg/kg i.p.), another group with lidocaine (0.01 mg/kg i.v.). The rabbits of the third group received amifostine (250 mg/m2). Further 5 animals were irradiated but received no treatment. The remaining 5 animals were not irradiated; they served as control and provided normal lacrimal gland tissue. Prior to irradiation, 3 days and one month afterwards, lacrimal secretion and the ocular surface were evaluated by Schirmer-test (5 minutes, without local anaesthesia), conjunctival impression cytology and fluorescein-staining of the epithelium. Hyperaemia of the conjunctiva was also assessed. One month after irradiation lacrimal glands were removed and investigated histologically.

Results

Irradiation with 15 Gy induced no significant change in the conjunctival impression cytology or conjunctival vascularity. In control group, Schirmer-Test displayed 12±8 mm/5min prior to irradiation and revealed a significant reduction 3 days and 30 days following irradiation (6±6 mm/5min and 7±3 mm/5min, respectively). In animal pretreated with pilocarpine this reduction was lower than in the control group after 3 days no more significant after 1 month (9±4 mm/5min; 15±8 mm/5min respectively). Lidocaine showed a lower grade of protection after one month (8±2 mm/5min, 10±3 mm/5min), whereas amifostine had no protective effects at any time (8±3 mm/5min; 7±3 mm/5min). Compared to the control group, irradiated lacrimal glands showed after 3 days a transient up-regulation of tenascin-C and a significant loss of alpha smooth muscle actin. 1 month later these changes were declining.

Conclusions

As a prophylactic agent against radiation-induced dry eye, pre-medication with pilocarpine seems to represent a useful therapeutic procedure. Further investigations are necessary.