A study to assess the efficacy of topical cyclosporine A 0.05% in the management of dry eye with meibomiam gland dysfunction

2022 ◽  
Vol 7 (4) ◽  
pp. 667-671
Author(s):  
Prajwalli Reddy ◽  
Wajeeha Umam
Keyword(s):  
Dry Eye ◽  
Cyclosporine A ◽  
Ocular Surface ◽  
Tear Film ◽  
Meibomian Gland ◽  
Meibomian Gland Dysfunction ◽  
Control Group ◽  
Dry Eyes ◽  
Group A ◽  
Group B

: Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface. Meibomian Gland Dysfunction (MGD) is an abnormality of the meibomian gland that blocks the secretion of lipids. Without sufficient lipid production, tears evaporate quickly causing Dry Eye.MGD is associated with multiple pathological mechanisms including inflammation, microbial factors and lipid deficiencies. Topical Cyclosporine A (CsA) 0.05% is a calcineurin inhibitor that reduces inflammation by specifically inhibiting T‑cell activity, which reduces ocular surface inflammation and improves tear film dynamics. This was a prospective observational study done on 100 patients at the Department of Ophthalmology Basaveshwar teaching and general hospital, on patients of dry eyes due to meibomian gland dysfunction. Patients who were diagnosed with dry eyes due to meibomian gland dysfunction were invited to take part in the study. Patients were divided randomly into two groups of 50 patients each. This study, was explained in detail to them. An informed consent was obtained. Patients fulfilling the inclusion criteria were listed.All OSDI scores (symptom intensity, frequency and aggravation) revealed decreasing patterns throughout the observation period in both the groups. In single analysis, the cyclosporine A 0.05% group showed a significant improvement for each score at 3 months (p < 0.01, p = 0.01, p = 0.02, respectively). The mean TBUT after treatment in the group A (cyclosporine A group) increased to 12.36± 3.58(p<0.001) seconds, and in the group B (Control group) the TBUT score increased to 11.01±3.06 seconds. After 3 Months, there was statistically significant improvement in the mean Schirmer’s scores in both the treatment groups, however improvement was significantly greater in Cyclosporine A group. Prior to the treatment in group A (Cyclosporine A) mean Lissamine staining score was 2.73±0.15 and post treatment it reduced to 1.32±0.15 which was statistically significant (P<0.001). In group B (Control group) score before treatment was 2.46±0.15 and after treatment it reduced to 2.39±0.27 (p=0.11), not much difference was seen. : Findings from our study showed that there were significant improvements in the dry eye conditions due to defect in meibomian gland by treatment of topical Cyclosporine A 0.05% and sodium hyaluronate 0.1%.

scholarly journals Meibomian Gland Dysfunction

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Sameera Irfan
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Treatment Strategies ◽  
Tear Film ◽  
Meibomian Gland ◽  
Dry Eye Disease ◽  
Meibomian Gland Dysfunction ◽  
Eye Disease ◽  
Treatment Protocols ◽  
Dry Eyes

Dry eyes is a common, chronic condition that has a prevalence of about 5- 50%.1 According to the Dry Eye Workshop II report (DEWS II report), published in 2017, the updated definition of Dry Eye Disease is, “a multifactorial disease of the ocular surface characterised by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyper-osmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.” The Tear Film & Ocular Surface Society (TFOS) released their report on the international work on Meibomian Gland Dysfunction (MGD)2 in 2011, which defined MGD, classified it and considered it as the primary cause of dry eye disease worldwide. Previously dry eye disease was considered as an aqueous deficiency problem, but after this report by TFOS, there is a paradigm shift towards “not producing enough lipids to retain the tears that are being produced”. This has led to a huge impact on the treatment protocols which were previously focused on managing the sequelae and symptoms of dry eyes rather than targeting directly on the underlying cause, the MGD. It has now been accepted worldwide that dry eye occurs when the ocular surface system cannot adequately protect itself from the desiccating stress due to the lack of a healthy meibomian gland secretion. This article is mainly focussed on the Meibomian Gland Dysfunction, discussing the normal anatomy of the glands, how they are affected by disease, its implications on the ocular surface and finally, the various treatment strategies. Key words: Blepharitis, Dry eyes, Meibomian gland dysfunction, blepharospasm.

scholarly journals Topical Cyclosporine (0.05%) for Management of Dry Eyes in Patients Undergoing Cataract Surgery-A Comparative Study

2019 ◽  
Vol 13 (1) ◽  
pp. 34-42 ◽  
Author(s):  
Sri Ganesh ◽  
Sheetal Brar ◽  
Sheetal N. Bagare
Keyword(s):  
Cataract Surgery ◽  
Dry Eye ◽  
Control Group ◽  
Topical Steroids ◽  
Dry Eyes ◽  
Patient Dissatisfaction ◽  
Respective Treatment ◽  
Group A ◽  
Eye Symptoms ◽  
Group B

Purpose: To assess the efficacy of topical cyclosporine 0.05% in the management of cataract surgery induced dry eye. Methods: This prospective, comparative, randomized, interventional study included 67 patients undergoing cataract surgery. The patients were randomized into three categories Group A: patients on topical lubricants and cyclosporine 0.05%, Group B: patients on topical lubricants only and Group C: patients not on any dry eye medication. Patients were given the respective treatment 2 weeks prior and 3 months after cataract surgery, along with an identical perioperative regimen of topical steroids, antibiotics and NSAIDs. Dry eye evaluation done 2 weeks pre-op, 1 week post-op and 3 months post-op consisted of a subjective questionnaire, tear osmolarity, Tear Break Up Time (TBUT) and Schirmer’s 1 without and with anaesthesia. Results: Pre-operatively, all the 3 groups were matched in terms of mean age, tear osmolarity, TBUT and Schirmer’s 1 without and with anaesthesia scores. At 3 months, patients treated with both topical lubricants and cyclosporine (0.05%)(Group A) showed improvement subjective questionnaire, tear osmolarity, TBUT and Schirmer’s 1 tests. Patients treated with lubricants only (Group B) showed a significant worsening in TBUT and tear osmolarity at 1 week, however, the values returned to baseline at 3 months.The control group (Group C) had the worst TBUT scores at the end of 3 months and showed the persistence of raised tear osmolarity, suggestive of a prolonged ocular inflammation resulting in patient dissatisfaction. Conclusion: Topical cyclosporine (0.05%) may be a useful adjuvant to prevent and treat cataract surgery associated with dry eye symptoms, especially in patients with pre-existing dry eye disease.

scholarly journals Multicenter Study of Intense Pulsed Light for Patients with Refractory Aqueous-Deficient Dry Eye Accompanied by Mild Meibomian Gland Dysfunction

2020 ◽  
Vol 9 (11) ◽  
pp. 3467
Author(s):  
Reiko Arita ◽  
Shima Fukuoka ◽  
Takanori Mizoguchi ◽  
Naoyuki Morishige
Keyword(s):  
Dry Eye ◽  
Tear Film ◽  
Meibomian Gland ◽  
Intense Pulsed Light ◽  
Meibomian Gland Dysfunction ◽  
Control Group ◽  
Pulsed Light ◽  
Lipid Layer ◽  
Film Stability ◽  
Schirmer’S Test

Aqueous-deficient dry eye (ADDE) and meibomian gland dysfunction (MGD) can be refractory to therapy. Intense pulsed light (IPL) was recently introduced as an effective treatment for MGD. We here evaluated the efficacy of IPL combined with MG expression (MGX) compared with MGX alone (n = 23 and 20, respectively) for patients with refractory ADDE with mild MGD at three sites. Symptom score, visual acuity (VA), noninvasive breakup time (NIBUT) and lipid layer thickness (LLT) of the tear film, lid margin abnormalities, fluorescein BUT (FBUT), fluorescein staining, tear meniscus height (TMH), meibum grade, meiboscore, and Schirmer’s test value were assessed at baseline and 1 and 3 months after treatment. LLT, plugging, vascularity, FBUT and NIBUT were improved only in the IPL-MGX group at three months compared with baseline. All parameters with the exception of VA, meiboscore, TMH, Schirmer’s test value were also improved in the IPL-MGX group compared with the control group at three months, as was VA in patients with central corneal epitheliopathy. Although IPL-MGX does not affect aqueous layer, the induced improvement in quality and quantity of the lipid layer may increase tear film stability and ameliorate symptoms not only for evaporative dry eye but for ADDE.

Dry eye and Meibomian gland dysfunction evaluation in sarcoidosis patients

2021 ◽  
pp. 112067212110065
Author(s):  
Pelin Kiyat ◽  
Melis Palamar ◽  
Bengu Gerceker Turk
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Surface Damage ◽  
Meibomian Gland ◽  
Drop Out ◽  
Meibomian Gland Dysfunction ◽  
Ocular Surface Disease Index ◽  
Group 2 ◽  
Group 1

Purpose: To analyze the relation between Meibomian gland dysfunction, dry eye, and sarcoidosis. Materials and Methods: Twenty eyes of 10 sarcoidosis patients (Group 1) and 20 left eyes of 20 age-sex matched healthy volunteers (Group 2) were included. Presence of dry eye was evaluated with Schirmer 1 test, tear film break-up time (T-BUT), Oxford scale scoring, Ocular Surface Disease Index (OSDI) score assessments. A slit-lamp biomicroscope infrared filter (Topcon, SL-D701, IJssel, The Netherlands) was used to evaluate Meibomian glands. The drop-out ratio according to meibography was scored for each eyelid from grade 0 (no loss) through grade 3 (lost area >2/3 of the total Meibomian gland area). Results: Among dry eye tests mean Schirmer 1 and T-BUT values were lower and OSDI score was higher in Group 1 compared to Group 2 and the differences were statistically significant ( p = 0.017, p = 0.039, p = 0.003, respectively). In addition, the upper, lower and total meiboscores were statistically significantly higher in Group 1 ( p = 0.047, p = 0.003, p = 0.005, respectively). Conclusion: A significantly higher presence of dry eye and Meibomian gland drop out ratios was detected in sarcoidosis patients. It is important to monitor sarcoidosis patients for dry eye and Meibomian gland dysfunction and when detected, to treat adequately to prevent ocular surface damage.

scholarly journals Meibom-mirigy-diszfunkció és a száraz szem

2021 ◽  
Vol 162 (2) ◽  
pp. 43-51
Author(s):  
Balázs Kovács ◽  
Boglárka Láng ◽  
Anna Takácsi-Nagy ◽  
Györgyi Horváth ◽  
Cecília Czakó ◽  
...  
Keyword(s):  
Effective Treatment ◽  
Dry Eye ◽  
Ocular Surface ◽  
Clinical Signs ◽  
Tear Film ◽  
Meibomian Gland ◽  
Diagnosis And Treatment ◽  
Meibomian Gland Dysfunction ◽  
Pharmacologic Treatment ◽  
Inflammatory Processes

Összefoglaló. A szárazszem-panaszok hátterében gyakran áll Meibom-mirigy-diszfunkció, melynek felismerése kiemelten fontos a hatékony kezelés érdekében. A Meibom-mirigyek kóros működése miatt a termelt lipid nem oszlik el megfelelően a szemfelszínen, így a könnyfilm párolgása fokozódik. A könnytermelési zavar következtében szárazszem-panaszok alakulnak ki, melyek a hagyományos könnypótló kezelésre rendszerint csak átmenetileg javulnak. A Meibom-mirigy-diszfunkciót gyakran kíséri a szemhéjszél Demodex-atka-fertőzése – az atka eradikálása szükséges a mirigyek működésének helyreállításához és ezáltal a panaszok megszüntetéséhez. A Meibom-mirigy-diszfunkció a leggyakrabban enyhe formában jelentkezik; a terápia ilyenkor a beteg által is elvégezhető szemhéjtisztításból áll, míg a gyógyszeres kezelés csak az előrehaladottabb, kifejezett gyulladással járó formákban szükséges. Az összefoglaló áttekinti a Meibom-mirigy-diszfunkció klinikai jeleivel és kezelésével kapcsolatos legfontosabb tudnivalókat, különös tekintettel a Demodex-fertőzés felismerésére és kezelésére vonatkozóan. Orv Hetil. 2021; 162(2): 43–51. Summary. The onset of dry eye complaints is often a result of Meibomian gland dysfunction and its diagnosis is essential for effective treatment. In the case of Meibomian gland dysfunction, there is an increased evaporation of the tear film due to the abnormal secretion of lipids that cannot spread on the ocular surface. The treatment of dry eye complaints associated with Meibomian gland dysfunction with tear supplementation is usually ineffective and only results in an intermittent relief of complaints. Meibomian gland dysfunction is often associated with Demodex infestation of the eyelids, and eradicating the mites is essential to re-establish normal meibum production and thus, decreasing ocular complaints. In most cases, Meibomian gland dysfunction is mild, and the treatment of these forms is based on ocular hygiene performed by the patient, while only more advanced forms with inflammatory processes require pharmacologic treatment. This review summarizes the most important knowledge on the clinical signs and treatment of Meibomian gland dysfunction with particular attention to the diagnosis and treatment of ocular Demodex infection. Orv Hetil. 2021; 162(2): 43–51.

scholarly journals The prevalence of meibomian gland dysfunction, tear film and ocular surface parameters in an Austrian dry eye clinic population

2018 ◽  
Vol 96 (6) ◽  
Author(s):  
Dieter Franz Rabensteiner ◽  
Haleh Aminfar ◽  
Ingrid Boldin ◽  
Gerold Schwantzer ◽  
Jutta Horwath‐Winter
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Meibomian Gland ◽  
Meibomian Gland Dysfunction ◽  
Surface Parameters ◽  
Clinic Population ◽  
Eye Clinic

scholarly journals Meibomian gland dysfunction and keratopathy are associated with dry eye disease in aniridia

2018 ◽  
Vol 103 (1) ◽  
pp. 119-124 ◽  
Author(s):  
Erlend Christoffer Sommer Landsend ◽  
Hilde Røgeberg Pedersen ◽  
Øygunn Aass Utheim ◽  
Jiaxin Xiao ◽  
Muhammed Yasin Adil ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Vital Staining ◽  
Meibomian Gland ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Control Group ◽  
Healthy Controls ◽  
Congenital Aniridia

AimsTo investigate the aetiology and characteristics of dry eye disease (DED) in a Nordic cohort of patients with congenital aniridia.MethodsThirty-four Norwegian and one Danish subject with congenital aniridia and 21 healthy controls were examined. All subjects underwent an extensive dry eye examination, including evaluation of meibomian glands (MGs) by meibography, measurement of tear production and tear film osmolarity and grading of vital staining of the ocular surface. Moreover, slit-lamp biomicroscopy was undertaken, including grading of aniridia-associated keratopathy (AAK).ResultsMean tear film osmolarity was significantly higher (314±11 mOsmol/L) in patients with aniridia compared with the healthy control group (303±11 mOsmol/L, p=0.002). Vital staining score was higher in the aniridia group (4.3±3.0) compared with healthy controls (2.4±1.6, p=0.02). The degree of staining correlated positively with the stage of AAK (r=0.44, p=0.008) and negatively with corneal sensitivity (r=−0.45, p=0.012). Number of expressible MGs was lower in aniridia subjects (2.9±1.6) than in controls (4.0±1.3, p=0.007). MG loss, staged from 0 to 3, was higher in the aniridia group than in the control group, both in upper eyelid (0.86±0.89 vs 0.10±0.31, p=0.001) and lower eyelid (0.94±0.73 vs 0.30±0.47, p=0.003). Computerised analyses showed thinning (p=0.004) and lower density (p<0.001) of the MGs compared with the healthy population.ConclusionsPatients with congenital aniridia demonstrate increased tear film osmolarity, ocular surface staining, loss of MGs and lower MG expressibility. We conclude that meibomian gland dysfunction and keratopathy are related to development of DED in aniridia.

scholarly journals Characterization of Meibomian Gland Dysfunction in Patients with Rosacea

2020 ◽  
Author(s):  
Eduardo Buzolin Barbosa ◽  
Carla Melo Tavares ◽  
Dimitri Felipe Luz da Silva ◽  
Lorraine Souza Santos ◽  
Andrea Fernandes Eloy da Costa França ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Meibomian Gland ◽  
Rupture Time ◽  
Meibomian Gland Dysfunction ◽  
Ocular Involvement ◽  
Conjunctival Hyperemia ◽  
Film Rupture ◽  
Glandular Secretion

Abstract Background: Rosacea frequently evolve the eyes with impact on life and vision quality. There are gaps in the understanding of ocular involvement, specially related to eyelid glands, which share common features to sebaceous glands.Purpose: Describe ocular surface disease related to Rosacea and its associations.Methods: Ninety-three individuals were selected to this cross-sectional, observational, non-interventionist study, divided into groups: rosacea (n=40) and controls (n=53). We investigated objective parameters of the ocular surface (conjunctival hyperemia, tear film stability and volume, meibomian gland dysfunction, dry eye disease, ocular surface staining) comparing healthy individuals with rosacea patients.Results: 69.23% of rosacea group were women, mean age of 47.34 ± 12.62 years old. Compared to matched controls there was no statistically significant differences regarding to visual acuity (p=0.987) and tear film parameters (tear meniscus height (p=0.338), non-invasive tear film rupture time (NIBUT) (p= 0.228), invasive rupture time (TBUT) (p=0.471) and Schirmer's test (p=0.244)) as well as conjunctival hyperemia (p = 0.106), and fluorescein staining (p = 0.489). Significant association was found in meibography evaluation (p = 0.026), mucous layer integrity (p = 0.015) and ocular surface symptoms (p <0.0001). Rosacea patients also showed important eyelid changes: glandular expressibility (p <0.001), glandular secretion pattern (p <0.001) and telangiectasia (p <0.001) compared to controls.Conclusion: Meibomian gland dysfunction is frequently associated to dermatologic conditions and is characterized by morphological findings in the meibography as well as lipid secretion impairment that lead to evaporative dry eye and ocular surface dysfunction and inflammation.

scholarly journals Evaluation of Dry Eye after Implantable Collamer Lens Surgery

2020 ◽  
Author(s):  
Haiting Chen ◽  
Xueyan Feng ◽  
Guangzeng Niu ◽  
Yuxiang Fan
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Case Series ◽  
Meibomian Gland ◽  
Quality Score ◽  
Control Group ◽  
Ocular Surface Disease Index ◽  
Implantable Collamer Lens ◽  
Lens Surgery ◽  
Breakup Time

<b><i>Objectives:</i></b> To evaluate dry eye (DE) and associated meibomian gland dysfunction parameters after Implantable Collamer Lens (ICL) surgery. <b><i>Methods:</i></b> This is a prospective observational case series. Patients who underwent ICL implantation without previous ocular diseases or ophthalmic treatments were enrolled. Their Ocular Surface Disease Index (OSDI), noninvasive breakup time (NIBUT), meibography, slit-lamp examination of the lid margin, corneal fluorescein staining (CFS), and Schirmer test I were examined preoperatively and at 1 and 3 months postoperatively. <b><i>Results:</i></b> A total of 117 eyes of 60 patients were enrolled, and 107 eyes completed 3-month follow-up period. OSDI, lid marginal abnormality, and meibomian gland (MG) secretion, and meibum quality score were significantly higher at 1 month postoperatively and recovered partially at 3 months after surgeries, while NIBUT was significantly decreased all the time. Patients with previous DE symptoms (OSDI score ≥12) showed not only lower Schirmer and TBUT values but also higher CFS, lid margin score, MG loss, MG secretion, and meibum quality scores compared with those in the control group after operations. Low Schirmer, NIBUT values, and high meibum quality score were determined as risk factors for DE symptoms after ICL surgery. <b><i>Conclusions:</i></b> ICL implantation has a bad influence on the ocular surface and MG functions. The influence may be more obvious in patients with existing DE.

scholarly journals Effects of a New Eyelid Shampoo on Lid Hygiene and Eyelash Length in Patients with Meibomian Gland Dysfunction: A Comparative Open Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Asuka Kobayashi ◽  
Takeshi Ide ◽  
Teruki Fukumoto ◽  
Emiko Miki ◽  
Kazuo Tsubota ◽  
...  
Keyword(s):  
Dry Eye ◽  
Tear Film ◽  
Meibomian Gland ◽  
Meibomian Gland Dysfunction ◽  
Controlled Study ◽  
Subjective Symptoms ◽  
Eyelid Margin ◽  
Before And After ◽  
And Function ◽  
Lid Hygiene

Purpose. Meibomian gland dysfunction (MGD) can lead to abnormalities in the composition and function of tear film, resulting in dry eye. Eyelid hygiene is a key to management of MGD. We tested a novel eyelid shampoo (Eye Shampoo Long, ESL) for its ability to maintain lid hygiene. This shampoo is nonirritating and can potentially lengthen eyelashes. This study was aimed to evaluate the efficacy of ESL in the treatment of MGD and its effects on eyelash length. Methods. Ten patients with MGD and 10 healthy subjects without MGD applied ESL twice daily for 8 weeks. Patients were examined for lid margin and dry eye before and after the trial. Subjective symptoms were evaluated. Eyelash length was measured at baseline and at the end of the trial. Results. In the MGD group, significant improvements were observed in subjective symptoms obstruction of the meibomian orifice, secretion of meibum, eyelashes contamination, eyelid margin foam, and SPK. Eyelash length became significantly longer. Conclusions. Maintaining eyelid hygiene using ESL improved the eyelid margins and symptoms of dry eye in MGD patients and increased eyelash length. These findings are promising and warrant confirmation in a larger randomized controlled study.

Sign in / Sign up

Export Citation Format

Share Document