used for pre-and post-treatment comparisons. Bivariate affecting at leastone-third of the limbus in 11 (30.1%)associations between baseline and post-treatment values cases, and cornealvascularization in 10 (27.7%) cases.of the evaluated parameters as well as their changes Figure 1 shows the outcome measures before andduring the course of the study were assessed using after treatment. Best corrected visual acuity improvedPearson’s (in case of normally distributed data) or from 0.5 ± 0.2 LogMAR at baseline to 0.4 ± 0.2 LogMARSpearman’s (in case of non-normally distributed data) at the end of the study (P = 0.001). Mean OSDI scorecorrelation coefficients. P < 0.05 were considered as was 47.5 ± 7.2 at baseline and 42.7 ± 7.1 at the end ofstatistically significant. study (P < 0.001). There was a significant increase inSchirmer test scores from baseline (4.6 ± 1.3 mm) tothe end of the study (5.0 ± 1.3 mm) (P < 0.001). tCsARESULTS therapy was associated with a significant decrease in tearA total of 36 eyes from 36 patients with mean age osmolarity (from 301.7 ± 11.5–286.3 ± 7.9 mOsmol/L,of 47.1 ± 6.5 years were included in this study. Two P < 0.001), and a significant increase in TBUT (frompatients (5.6%) failed to complete the treatment period 1.9 ± 1.4–2.7 ± 1.5 s, P < 0.001).with tCsA. Reasons for drop-out were respiratory Overall, the majority of patients experiencedcomplications due to MG exposure which made it improved symptoms associated with each evaluatedimpossible to continue the study in one case and severe efficacy measure. The proportion of patients with anburning sensation and blurred vision after instillation of improved score in Schirmer’s test, visual acuity andtCsA in another patient. These two cases were excluded TBUT at the end ofthe study were 61.8%, 35.3% andfrom statistical analysis. Mean time from exposure to MG 50%, respectively.The proportion of patients with anwas 26.5 ± 0.7 years. All subjects were previously using increased score inSchirmer’s test, visual acuity andpreservative-free artificial tears for treatment of dry eye TBUT at the end ofthe study were 61.8%, 35.3% and 50%,and 23 (63.9%) of them had undergone punctal plugging. respectively. Also, the majority of patients (85.3%) had
Figure 1. Dry eye parameters before and after treatment with topical cyclosporine A. Values are mean±standard deviation. OSDI,ocular surface disease index; TBUT, tear break-up time; LogMAR, logarithm of the minimum angle of resolution.Journal of Ophthalmic and Vision Research 2014; Vol. 9, No. 4 419
Topical CsA for Dry Eye in Mustard Gas Injury; Jadidi et aldecreased tear osmolarity and OSDI score at the end of punctuate keratitis, and symptoms of ocular discomfortstudy as compared to baseline [Figure 2]. in patients with moderate to severe keratoconjunctivitissicca. They reported that the 0.05% concentrationDISCUSSION is associated withthe highest rate of improvement.Sall et al compared treatment with tCsA 0.05%, 0.1%,The morbidity associated with chronic complications of or vehicle twice daily in 877 patients with moderate toMG injury in different organs of the body necessitates severe dry eye.