Recurrence after topical nonpreserved methylprednisolone therapy for keratoconjunctivitis sicca in Sjögren's syndrome.

Abstract

BACKGROUND:

The aim of this study was to evaluate the prevalence of long-term recurrence after topical nonpreserved methylprednisolone pulse therapy for the treatment of keratoconjunctivitis sicca (KCS) with Sjögren's syndrome.

METHODS:

A total of 106 eyes of 53 Sjögren's syndrome patients were included in the study. All patients were treated with topical nonpreserved 1% methylprednisolone solution. Initial therapy consisted of eyedrops 4 times a day for 2 weeks, and then patients were reevaluated and tapered off the medication every 2 weeks until discontinuation. Tear film breakup time (TBUT), Schirmer test, corneal fluorescein staining, and subjective symptom scores were measured. Additionally, impression cytology of the bulbar conjunctiva was performed. The over-all success rates and success period were determined using the Kaplan-Meier survival curve.

RESULTS:

A reduction in subjective symptoms and fluorescein staining, and an improvement in TBUT and Schirmer test results, was observed after treatment (P<0.001). Impression cytology specimens revealed a significantly increased number of periodic acid-Schiff-positive cells after treatment. After the first pulse therapy, mean survival was 56.6 weeks and 11 (20.8%) patients recurred. After the second pulse therapy, mean survival was 72.4 weeks and only 1 patient recurred. No serious complications, including intraocular pressure elevation and cataract formation, were encountered during the entire follow-up period.

CONCLUSIONS:

Topical nonpreserved methylprednisolone pulse therapy proved to be a safe, effective long-term treatment of improving subjective and objective dry eye factors in KCS patients with Sjögren's syndrome.

• Authors: Samin Hong, Terry Kim, So-Hyang Chung, Eung Kweon Kim, Kyoung Yul Seo
• Journal: Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics (J Ocul Pharmacol Ther) Vol. 23 Issue 1 Pg. 78-82 (Feb 2007) ISSN: 1080-7683 [Print] United States
• PMID: 17341155 (Publication Type: Journal Article)

Chemical References

• Glucocorticoids
• Ophthalmic Solutions
• Preservatives, Pharmaceutical
• Methylprednisolone

Topics

• Administration, Topical
• Female
• Glucocorticoids (administration & dosage)
• Humans
• Keratoconjunctivitis Sicca (drug therapy, etiology)
• Male
• Methylprednisolone (administration & dosage)
• Middle Aged
• Ophthalmic Solutions (administration & dosage)
• Preservatives, Pharmaceutical
• Pulse Therapy, Drug
• Recurrence
• Sjogren's Syndrome (complications, drug therapy)
• Tears (metabolism)
• Treatment Outcome