Topical cyclosporine A for mustard gas induced ocular surface disorders

Purpose: To evaluate the effectiveness of topical cyclosporine A 0.05% for treatment of mustard gas-induced ocular surface disorders with special attention to conjunctival goblet cell density in patients with severe dry eye. Methods: This prospective clinical study included 20 eyes of 20 patients p...

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Main Authors: Khosrow Jadidi, Ali Ebrahimi, Yunes Panahi, Ali Alishiri, Bagher Hosseini, Sepideh Heydarzadeh, Sona Akbarikia, Mostafa Mafi
Format: Article
Language:English
Published: Knowledge E 2015-01-01
Series:Journal of Ophthalmic & Vision Research
Subjects:
Online Access:http://www.jovr.org/article.asp?issn=2008-322X;year=2015;volume=10;issue=1;spage=21;epage=25;aulast=Jadidi
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author Khosrow Jadidi
Ali Ebrahimi
Yunes Panahi
Ali Alishiri
Bagher Hosseini
Sepideh Heydarzadeh
Sona Akbarikia
Mostafa Mafi
author_facet Khosrow Jadidi
Ali Ebrahimi
Yunes Panahi
Ali Alishiri
Bagher Hosseini
Sepideh Heydarzadeh
Sona Akbarikia
Mostafa Mafi
author_sort Khosrow Jadidi
collection DOAJ
description Purpose: To evaluate the effectiveness of topical cyclosporine A 0.05% for treatment of mustard gas-induced ocular surface disorders with special attention to conjunctival goblet cell density in patients with severe dry eye. Methods: This prospective clinical study included 20 eyes of 20 patients previously exposed to mustard gas with dry eye syndrome unresponsive to artificial tears. Before and after treatment with topical cyclosporine A 0.05% twice daily for 3 months, subjects were evaluated for improvement in symptoms using the ocular surface disease index (OSDI) and signs by tear breakup time (TBUT), Schirmer test and measurement of superior bulbar conjunctival goblet cell density. Limbal stem cell deficiency (LSCD) and the degree of corneal squamous cell metaplasia were also assessed before and after treatment. Results: Before treatment, mean OSDI score, Schirmer test I value and mean TBUT were 42.8 ± 6.1, 4.2 ± 1.2 mm and 2.5 ± 1.3 s, respectively. After 3 months of treatment with topical cyclosporine A, these scores reached 36.4 ± 5.2, 5.8 ± 1.6 mm and 4.9 ± 2.1 s, respectively showing a statistically significant improvement (P < 0.001) in all parameters. Mean goblet cell density was 23.3 ± 17.1/high power field (hpf) at baseline which was significantly increased to 47.7 ± 16.1/hpf at the end of the study (P < 0.001). There was no improvement, however, in corneal conjunctivalization, LSCD and the degree of corneal squamous cell metaplasia based on impression cytology reports (P > 0.05). Conclusion: Treatment with topical cyclosporine A 0.05% in patients with severe dry eye due to mustard gas injury increases goblet cell density in the bulbar conjunctiva and improves symptoms of the disease.
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spelling doaj.art-ab4911f3089d4958bfdada9b58b8cc082022-12-22T02:38:54ZengKnowledge EJournal of Ophthalmic & Vision Research2008-322X2015-01-01101212510.4103/2008-322X.156089Topical cyclosporine A for mustard gas induced ocular surface disordersKhosrow JadidiAli EbrahimiYunes PanahiAli AlishiriBagher HosseiniSepideh HeydarzadehSona AkbarikiaMostafa MafiPurpose: To evaluate the effectiveness of topical cyclosporine A 0.05% for treatment of mustard gas-induced ocular surface disorders with special attention to conjunctival goblet cell density in patients with severe dry eye. Methods: This prospective clinical study included 20 eyes of 20 patients previously exposed to mustard gas with dry eye syndrome unresponsive to artificial tears. Before and after treatment with topical cyclosporine A 0.05% twice daily for 3 months, subjects were evaluated for improvement in symptoms using the ocular surface disease index (OSDI) and signs by tear breakup time (TBUT), Schirmer test and measurement of superior bulbar conjunctival goblet cell density. Limbal stem cell deficiency (LSCD) and the degree of corneal squamous cell metaplasia were also assessed before and after treatment. Results: Before treatment, mean OSDI score, Schirmer test I value and mean TBUT were 42.8 ± 6.1, 4.2 ± 1.2 mm and 2.5 ± 1.3 s, respectively. After 3 months of treatment with topical cyclosporine A, these scores reached 36.4 ± 5.2, 5.8 ± 1.6 mm and 4.9 ± 2.1 s, respectively showing a statistically significant improvement (P < 0.001) in all parameters. Mean goblet cell density was 23.3 ± 17.1/high power field (hpf) at baseline which was significantly increased to 47.7 ± 16.1/hpf at the end of the study (P < 0.001). There was no improvement, however, in corneal conjunctivalization, LSCD and the degree of corneal squamous cell metaplasia based on impression cytology reports (P > 0.05). Conclusion: Treatment with topical cyclosporine A 0.05% in patients with severe dry eye due to mustard gas injury increases goblet cell density in the bulbar conjunctiva and improves symptoms of the disease.http://www.jovr.org/article.asp?issn=2008-322X;year=2015;volume=10;issue=1;spage=21;epage=25;aulast=JadidiCyclosporine A; Dry Eye Disease; Goblet Cell Density; Impression Cytology; Mustard Gas
spellingShingle Khosrow Jadidi
Ali Ebrahimi
Yunes Panahi
Ali Alishiri
Bagher Hosseini
Sepideh Heydarzadeh
Sona Akbarikia
Mostafa Mafi
Topical cyclosporine A for mustard gas induced ocular surface disorders
Journal of Ophthalmic & Vision Research
Cyclosporine A; Dry Eye Disease; Goblet Cell Density; Impression Cytology; Mustard Gas
title Topical cyclosporine A for mustard gas induced ocular surface disorders
title_full Topical cyclosporine A for mustard gas induced ocular surface disorders
title_fullStr Topical cyclosporine A for mustard gas induced ocular surface disorders
title_full_unstemmed Topical cyclosporine A for mustard gas induced ocular surface disorders
title_short Topical cyclosporine A for mustard gas induced ocular surface disorders
title_sort topical cyclosporine a for mustard gas induced ocular surface disorders
topic Cyclosporine A; Dry Eye Disease; Goblet Cell Density; Impression Cytology; Mustard Gas
url http://www.jovr.org/article.asp?issn=2008-322X;year=2015;volume=10;issue=1;spage=21;epage=25;aulast=Jadidi
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AT yunespanahi topicalcyclosporineaformustardgasinducedocularsurfacedisorders
AT alialishiri topicalcyclosporineaformustardgasinducedocularsurfacedisorders
AT bagherhosseini topicalcyclosporineaformustardgasinducedocularsurfacedisorders
AT sepidehheydarzadeh topicalcyclosporineaformustardgasinducedocularsurfacedisorders
AT sonaakbarikia topicalcyclosporineaformustardgasinducedocularsurfacedisorders
AT mostafamafi topicalcyclosporineaformustardgasinducedocularsurfacedisorders