局部使用环孢素A(0˙05%)滴眼液治疗轻至重度干眼病的疗效

Md Emdad Hussain, Md Kamrul Hasan Khan, Zulfikar Hasan, Shamima Shammi, M. Quader
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摘要

干眼症是一种多因素的泪液和眼表疾病,发病率高,对生活质量有显著影响。长期使用环孢素已经证明,这种药物可以阻止慢性干眼病的进展,并与干眼病的症状和体征的治愈有关。本研究的目的是评价外用环孢素A(0˙05%)治疗轻、中、重度干眼病的疗效。方法:本前瞻性研究于2019年1月至2019年12月在山东陆军联合医院眼科进行,选取20例年龄20-26岁,确诊为常规治疗难治性干眼综合征的患者。所有患者均给予每日2次环孢素A治疗,并于第1、2、3、4、5和6个月评估泪膜破裂时间、schirmer试验、荧光素染色、泪膜半月板高度、眼部不适症状和视力从基线的变化。结果:20例患者平均年龄48.7岁,其中女性14例(70%),男性6例(30%)。治疗6个月后,平均TBUT由4.4秒改善至8.7秒(p=0.001)。在治疗开始前进行SCHIRMER ' S纸试验,6个月后润湿从平均3.5mm改善到8.2mm (p=0.001)。治疗6个月后,撕裂下半月板平均高度由0.2 mm提高到0.63 mm (p=0.002)。治疗6个月后,荧光素染色从平均2.8显著降低到1.8 (p=0.001),眼部症状明显减轻,视力明显改善。结论:外用环孢素A(0˙05%)已被证明对所有类型的干眼病有效。它可以减轻干眼病的症状和体征,对严重干眼病患者的症状改善最大。中华医学杂志2021年1月第10卷第10期[00:98 . 104
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Efficacy of Using Topical Cyclosporine A (0˙05%) Eye Drops for the Treatment of Mild to Severe Dry Eye Disease
Introduction: Dry eye is a multifactorial disease of the tears and ocular surface, is highly prevalent and has a significant impact on quality of life. Long term use of Cyclosporine has demonstrated that this drug halt progression of chronic dry eye disease and is associated with a cure of signs and symptoms of Dry Eye disease. The aim of our study is to evaluate the efficacy of topical Cyclosporine A (0˙05%) for the treatment of mild, moderate and severe dry eye disease. Methods: This prospective study was conducted in the ophthalmology department of Combined Military Hospital, Jashore from January 2019 to December 2019 among selected 20 patients aged 20-26 years with a confirmed diagnosis of dry eye syndrome refractory to conventional management. All the patients were treated with Cyclosporine A twice daily and were evaluated at month 1,2,3,4,5 and 6 for changes from base line in tear film break up time, schirmer test, fluorescein staining, tear meniscus height, symptoms of ocular discomfort and visual acuity. Result: Mean age of 20 cases was 48.7 years among them 14(70%) female and 6(30%) male. Mean TBUT improved from 4.4 second to 8.7 second (p=0.001) after 6 months of treatment. SCHIRMERʼS paper test was performed before the beginning of the treatment and showed improvement of wetting from mean 3.5mm to 8.2mm (p=0.001) after 6 month. Mean lower tear meniscus height improved from 0.2 mm to 0.63 mm (p=0.002) after 6 months of treatment. Fluorescein staining was significantly lowered from mean 2.8 to 1.8 (p=0.001) with significant reduction of ocular symptoms and improvement of visual acuity after 6 months of treatment. Conclusion: Topical Cyclosporine A (0˙05%) has been demonstrated to be effective in all categories of dry eye disease. It reduces symptoms and signs of dry eye disease with the greatest improvement of signs in patients with severe dry eye disease. CBMJ 2021 January: vol. 10 no. 02 P: 98-104
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