Inflammatory cytokine and osmolarity changes in the tears of dry eye patients treated with topical 1% methylprednisolone.

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)-1β, 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.

• Authors: Ji Hwan Lee, Kyung Min, Se Kyung Kim, Eung Kweon Kim, Tae-im Kim
• Journal: Yonsei medical journal (Yonsei Med J) Vol. 55 Issue 1 Pg. 203-8 (Jan 2014) ISSN: 1976-2437 [Electronic] Korea (South)
• PMID: 24339308 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Cytokines
• Methylprednisolone

Topics

• 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)