gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Cyclosporine A eye drops in chronic inflammatory eye conditions

Meeting Abstract

  • corresponding author D. Böhringer - Augenklinik, Universitätsklinikum, Freiburg
  • M. Braun - Augenklinik, Heinrich-Heine-Universität, Düsseldorf
  • G. Schilgen - Augenklinik, Heinrich-Heine-Universität, Düsseldorf
  • B. Wojanowski - Augenklinik, Heinrich-Heine-Universität, Düsseldorf
  • R. Sundmacher - Augenklinik, Heinrich-Heine-Universität, Düsseldorf
  • T. Reinhard - Augenklinik, Universitätsklinikum, Freiburg

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogDO.16.03

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dog2004/04dog139.shtml

Veröffentlicht: 22. September 2004

© 2004 Böhringer et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

From immunosuppressive potential and excellent safety profile so far, cyclosporine A eye drops (CsA ED) might turn out an important option in treatment of chronic inflammatory eye conditions. They might thus be able to help avoiding long term dependence on topical steroids and help in avoiding respective side effects such as cataract, glaucoma and tear film destabilisation. Whether long-term application of CsA ED exerts conjunctival carcinogenicity has not yet been investigated formally. Purpose of this report is to investigate acceptance, safety and efficacy of long-term application of CsA ED.

Methods

85 eyes suffering from nummular subepithelial infiltrates following adenovirus keratoconjunctivitis (group A) and 53 eyes affected from Thygeson keratitis (group B) had been treated with CsA over in mean 1.9±1.9 years. After follow-up of 4.3±2.6 years, patients were asked whether they would in retrospective again opt for treatment with CsA ED. Influencing factors on this decision were assessed by means of logistic regression analysis. Additionally, 57 patients gave consent for conjunctival brush biopsy and DNA-image-cytometry analysis. Objective criteria of therapeutic success were visual acuity (group A) and Kaplan Meier estimation of recurrence-free interval (group B).

Results

In total 85% of all patients would retrospectively again opt for treatment with CsA. The only influencing factors on this decision reaching statistical significance were intensity of the short lasting burning sensation after CsA instillation and subjective imprevement of visual acuity. DNA-image-cytometry readings as well as cytologic pathology findings were normal in all patients. 66% of patients from group A experienced improvement of visual acuity. Delay to improvement in these patients was significantly correlated with treatment time (R2=0.54; p<0.001). 87% of eyes in group B were recurrence-free at end of follow-up.

Conclusions

From this uncontrolled observation CsA seems to be safe and effective at least for indications from this observation. However, controlled clinical trials are mandatory for confirmation as well as further follow-up to rule out late side effects of CsA ED.