Journal List > J Korean Ophthalmol Soc > v.56(10) > 1010102

Choi and Chung: Therapeutic Effects of 0.03% Tacrolimus Eye Drops for Chronic Ocular Graft-Versus-Host Disease

Abstract

Purpose

To evaluate the therapeutic effects of 0.03% tacrolimus eye drops on dry eye associated with chronic ocular graft-ver-sus-host disease (GVHD).

Methods

This study included 24 eyes of 12 patients with refractory dry eye associated with chronic ocular GVHD who were un-responsive to topical steroid and 0.05% topical cyclosporine. The topical steroid and cyclosporine were discontinued for 2 weeks before treatment and 0.03% tacrolimus eye drops were applied twice a day for 1 month. Artificial tears, ointment, and lid cleanser were used in the same manner before initiating tacrolimus treatment. Ocular staining score, tear break-up time, ocular surface disease index (OSDI), and Schirmer I test score were evaluated.

Results

Ocular staining score, tear break-up time, and OSDI improved with statistical significance ( p < 0.05) after 28 days of treatment. Schirmer I test did not show statistical improvement after treatment.

Conclusions

The use of 0.03% tacrolimus eye drops were effective for refractory dry eye associated with chronic ocular GVHD. J Korean Ophthalmol Soc 2015;56(10):1505-1510

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Figure 1.
Slit lamp photographs with fluorescein staining in chronic ocular graft-versus-host disease patient with severe dry eye syndrome. (A) Prior to treatment, definite corneal lesions were noted (OSDI: 42 points, TBUT: 0 sec, staining score: 5 points, Schirmer I test: 0 mm). (B) After 28 days of treatment with topical 0.03% tacrolimus eye drops, the previous lesions showed im-provements (OSDI: 32 points, TBUT: 2 sec, staining score: 2 points, Schirmer I test: 2 mm). OSDI = ocular surface disease index; TBUT = tear film break up time.
jkos-56-1505f1.tif
Figure 2.
Changes before (D0) and after 14 (D14), 28 (D28) days of treatment with 0.03% tacrolimus eye drops in refractory dry eye associated with graft-versus-host disease. (A) OSDI. (B) TBUT. (C) Ocular surface staining score, and (D) Schirmer I test. The bars represent the mean of each value. The error bars indicate the standard deviation of the mean. OSDI = ocular surface disease index; TBUT = tear film break up time. * p= 0.024; p=0.015; p=0.031.
jkos-56-1505f2.tif
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