Topical cyclosporine A for the dry eye findings of thyroid orbitopathy patients

Abstract

Purpose: To determine the beneficial effect of topically administered Cyclosporine A (CsA) for the dry eye findings of thyroid orbitopathy patients.

Patients and methods: This prospective pilot study included 73 eyes of 42 patients with thyroid orbitopathy who had documented dry eye findings. Patients were randomly assigned into two groups: in group 1 (48 eyes), patients received topical artificial tear-drop treatment. In group 2 (25 eyes), patients received topical CsA and artificial tear-drop treatment. During a mean follow-up of 6 months, change in Schirmer's test with aneasthesia, tear break-up-time (BUT) and impression cytology results were analyzed and were compared between groups.

Results: The two groups were age (P=0.449) and gender (P=0.942) matched. The Schirmer's test (P=0.441), tear BUT (P=0.718) and impression score (P=0.103) were also similar before the treatment in both groups. In group 1, all three parameters improved significantly with treatment (P<0.001 for all). In group 2, Schirmer's test (P=0.001) and tear BUT (P<0.001) improved, but the impression score (P=0.175) did not change significantly after treatment. The percentage of patients with improved tear BUT (P=0.04) and improved impression score (P<0.001) were higher in group 1. At the end of follow-up, group 1 patients had better Schirmer's test (P=0.004), tear BUT (P=0.021) and impression scores (P<0.001), than group 2 patients.

Conclusions: The combined CsA use with artificial tear drops is not more advantageous than the use of artificial tear drops alone, for the dry eye findings of thyroid orbitopathy patients.