LONDON, April 3, 2018 /PRNewswire/ --
Maurizio Rolando, Christophe Baudouin, José Benitez- Del-Castillo
European Ophthalmic Review, 2017;11(Suppl 1):3-9; http://www.touchophthalmology.com/articles/dry-eye-disease-current-insights-and-future-perspectives
Published recently in a supplement to European Ophthalmic Review, the peer-reviewed journal from touchOPHTHALMOLOGY, Rolando et al, discuss the key factors driving dry eye disease (DED) are tear film instability, tear hyperosmolarity, apoptosis and inflammation, which can lead to corneal damage, keratitis, cytokine release and nerve stimulation, forming a self-sustaining 'vicious circle'. These factors degrade the quality of vision, which worsens with disease severity. The pathophysiology of DED affects the entire ocular surface system involving the innate and adaptive immune systems, and the mechanisms are becoming recognised as more wide-ranging than was previously understood. Many patients show a discrepancy between signs such as corneal fluorescence staining (CFS) and DED symptoms at diagnosis and during treatment, which makes assessment challenging. In response to this, new grading schemes such as those of the ODISSEY European Consensus Group have been developed to aid diagnosis of severe DED. A key treatment for DED is the immunomodulatory agent, topical ciclosporin A (CsA) eye drops (0.1% CsA, Ikervis, Santen). Clinical studies such as the phase III SANSIKA trial (n=246) showed significant reductions in ocular surface inflammation after 6 months of patients receiving 0.1% CsA compared with vehicle (p=0.021). A post hoc analysis of this study in patients with CFS improvement of ≥3 grades revealed a significant treatment effect in which there were more responders to topical CsA treatment than to vehicle (p=0.016). In this trial 0.1% CsA was well tolerated and required only a single daily instillation in contrast with others requiring multiple daily doses. Wider use of topical CsA and better understanding of the inflammatory processes in DED may lead to improved treatments in this debilitating disease.
The full article is available open-access here:
Disclosure: Maurizio Rolando is a consultant or has been sponsored by, or received research grants, from Alcon, Allergan, Bausch & Lomb, Dompé, Farmigea, OFF, Pfizer, Santen, Thea, Novartis and TRB Chemedica. Christophe Baudouin has received consultant fees and research grants from Alcon, Allergan, Dompé, Horus Pharma, Santen and Thea and has received academic financial support and grants from INSERM (Institut National de la Santé et la Recherche Médicale), UMRS968, and University Paris 6 and Labex Lifesenses (reference ANR-10-LABX-65). José Benitez-Del-Castillo has been sponsored by or received research grants from Santen, Bausch & Lomb, AbbVie, Angelini, Horus, Alcon, Allergan, Thea, Esteve and Dompé. This article has not been submitted to external peer reviewers but was reviewed by the advisory board for accuracy before publication. The ECLSO satellite symposium was organised and funded by Santen EMEA. The publication of this article was supported by Santen EMEA. The views and opinions expressed are those of the authors and not necessarily those of Santen EMEA.
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