1. ¹Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
2. ²Department of Ophthalmology, Eye and ENT Hospital of Fudan University School of Medicine, Shanghai, China
3. ³J & J Ocular Surface and Visual Optics Department, Keio University School of Medicine, Tokyo, Japan
4. ⁴Department of Ophthalmology, Tokyo Dental College, Chiba, Japan
5. ⁵Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan

Correspondence: Dr Y Ogawa, Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. E-mail: yoko@sc.itc.keio.ac.jp

Received 30 April 2007; Revised 21 August 2007; Accepted 20 September 2007; Published online 5 November 2007.

Abstract

We investigated the effect of 0.05% topical cyclosporine (Cys) on the ocular surface and tear functions in dry eye patients with chronic GVHD (cGVHD) in a prospective comparative study. Thirty eyes of 15 patients refractory to baseline treatment were recruited and the patients assigned for topical Cys treatment group (14 eyes of 7 patients) and control group (12 eyes of 6 patients) respectively. Two patients dropped out because of intolerable irritation while using topical Cys eye drops. Visual analog scale symptom scores, corneal sensitivity, Schirmer I test value, tear film break-up time (TBUT), tear evaporation rate and ocular surface vital staining scores were recorded at baseline and at the end of the following one month. Conjunctival impression and brush cytology were performed before and after the treatment. After topical Cys treatment, significant improvements were found in symptom scores, corneal sensitivity, tear evaporation rate, TBUT, vital staining scores, goblet cells density, conjunctival squamous metaplasia grade, inflammatory cell numbers and the MUC5AC expression. Our study suggests that 0.05% topical Cys may be an effective treatment for dry eye patients with cGVHD. The improvements in the ocular surface and tear functions resulted presumably from the decreased inflammation, increased goblet cell density and MUC5AC mRNA expression.