Inflammatory Cytokine and Osmolarity Changes in the Tears of Dry Eye Patients Treated with Topical 1% Methylprednisolone.
10.3349/ymj.2014.55.1.203
- Author:
Ji Hwan LEE
1
;
Kyung MIN
;
Se Kyung KIM
;
Eung Kweon KIM
;
Tae Im KIM
Author Information
1. Vision Research Institute, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. tikim@yuhs.ac
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Dry eye syndrome;
cytokines;
osmolar concentration;
methylprednisolone
- MeSH:
Adult;
Aged;
Cytokines/*metabolism;
Dry Eye Syndromes/*drug therapy/metabolism;
Female;
Humans;
Male;
Methylprednisolone/administration & dosage/*therapeutic use;
Middle Aged;
Osmolar Concentration;
Prospective Studies;
Tears/*chemistry/*metabolism
- From:Yonsei Medical Journal
2014;55(1):203-208
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To evaluate changes in clinical outcomes, inflammatory cytokine levels, and tear osmolarity in the tears of patients with moderate to severe dry eye syndrome before and after the application of topical 1% methylprednisolone. MATERIALS AND METHODS: Thirty-two patients with moderate to severe dry eye unresponsive to previous aqueous enhancement therapy were enrolled. Five patients were lost to follow up, and twenty-seven patients were eligible for analysis. Patients were instructed to apply topical 1% methylprednisolone four times per day, as well as to continue applying their current therapy of preservative-free 0.1% sodium hyaluronate four times per day. Corneal and conjunctival staining scores, tear film breakup time (TFBUT), Schirmer test, and tear osmolarity were assessed at baseline, 4 weeks, and 8 weeks. Tear samples were collected at every visit for cytokine analysis. RESULTS: Corneal and conjunctival staining scores and TFBUT showed significant improvement at 4 (p<0.001, <0.001, <0.001 respectively) and 8 (p<0.001, <0.001, <0.001 respectively) weeks. Tear osmolarity decreased significantly at 8 weeks (p=0.008). Interleukin (IL)-1beta, IL-8, and monocyte chemoattractant protein-1 were significantly decreased at 8 weeks compared with those at baseline (p=0.041, 0.001, 0.008 respectively). CONCLUSION: Short-term treatment with topical 1% methylprednisolone not only improved clinical outcomes, but also decreased tear osmolarity and cytokine levels. By measuring the changes in cytokine levels and tear osmolarity, we could objectively evaluate the anti-inflammatory effects of topical methylprednisolone applied in the treatment of patients with moderate to severe dry eye syndrome.
