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

Soon Il Choi; So Hyang Chung

doi:10.3341/jkos.2015.56.10.1505

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

Original Article

J Korean Ophthalmol Soc 2015;56(10):1505-1510.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.10.1505

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

Soon Il Choi, M.D, So Hyang Chung, M.D, PhD

Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea

Address reprint requests to So Hyang Chung, MD, PhD Department of Ophthalmology, The Catholic University of Korea Seoul St. Mary’s Hospital, #222 Banpo-daero, Seocho-gu, Seoul 06591, Korea Tel: 82-2-2258-1188, Fax: 82-2-599-7405 E-mail: chungsh@catholic.ac.kr

‗ Supported by a grant of Ministry of Science, ICT and Future Planning, Korea and National research foundation of Korea (2014R1A1A3052852).

‗ This study was presented as a narration at the 110th Annual Meeting of the Korean Ophthalmological Society 2013.

Received 15 May 201522 June 2015 Accepted 4 September 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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

Keywords: Cyclosporine, Ocular graft-versus-host disease (GVHD), Tacrolimus

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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.

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.

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