Efficacy of Rebamipide Instillation for Contact Lens Discomfort With Dry Eye.

Tsutomu Igarashi,Chiaki Fujimoto,Maika Kobayashi,Hisaharu Suzuki,Chiemi Yaguchi,Hiroshi Takahashi

doi:10.1097/icl.0000000000000438

Tsutomu Igarashi, Chiaki Fujimoto + Show 4 more

Open Access

https://doi.org/10.1097/icl.0000000000000438

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Abstract

Objective:To examine the effects of rebamipide ophthalmic solution on the symptoms, signs, and cytokine concentrations in tear fluid among soft contact lens (SCL) wearers with Dry eye disease (DED).Methods:From November 2015 to June 2017, this open-label, single-arm study examined 40 eyes of 20 SCL wearers with DED who had been using daily disposable SCLs for >3 months (mean age, 30.0±8.33 years; range, 20–47 years). Signs, symptoms, and cytokine concentrations were assessed before and 4 weeks after starting 2% rebamipide ophthalmic solution 4 times/day. Dry eye disease was diagnosed according to: compromised tear dynamics (Schirmer test ≤5 mm or tear break-up time (TBUT) ≤5 sec); ocular surface abnormalities (positive vital staining with fluorescein or lissamine green); and presence of symptoms. Touch thresholds using a Cochet-Bonnet anesthesiometer were also determined for the cornea and conjunctivae. Symptoms were assessed using the 12-item Ocular Surface Disease Index questionnaire. Concentrations of cytokines in tear fluid were measured.Results:Significant improvements in signs were seen for TBUT, surface abnormalities, and touch thresholds. Ocular Surface Disease Index scores likewise improved significantly in all the 12 items. Of the cytokines measured, only interleukin-1β, interleukin-8, and monocyte chemotactic protein-1 were found in ≥60% of tear samples, with no significant differences in concentrations before and after rebamipide use.Conclusions:Rebamipide significantly improved all signs and symptoms in patients with DED who wore daily disposable SCLs. Rebamipide is effective for DED treatment with SCL wear.

Highlights

This study examined the effects of rebamipide ophthalmic solution on symptoms, signs, and cytokine concentrations in the tears of soft contact lens (SCL) wearers
Clinical Evaluation of Dry Eye Dry eye was diagnosed according to the 2006 Japanese criteria for DED21 which contains three categories: compromised tear dynamics; ocular surface abnormalities; and existence of subjective symptoms
Rebamipide has been marketed for instillation, and many recent studies, including our own,[11] have reported the efficacy of this agent in the treatment of Dry eye disease (DED).[9,29,30]

Summary

Objective

Parameters Objective parameters before and at 4 weeks after starting rebamipide administration were compared (Figs. 1 and 2). Parameters Objective parameters before and at 4 weeks after starting rebamipide administration were compared Schirmer test decreased significantly from 15.98610.57 mm to 11.0868.5 mm (Fig. 1E; P,0.01). The change in total average CS was significant (Fig. 2F; 0.6560.51 mm to 0.7860.69 mm, P,0.01). Ocular Surface Disease Index Score Ocular Surface Disease Index score after 4 weeks of rebamipide use significantly improved compared with pretreatment (Fig. 3; 37.58610.9 to 17.08611.33, P,0.01). Significant improvements were observed in all the 12 items (Table 1 and Fig. 4). Tear Cytokine Concentrations Of the 10 cytokines measured (IL-1b, IL-4, IL-6, IL-8, IL-10, IL-12 (p70), IL-17A, IFN-g, MCP-1, and TNF-a), only three cytokines (IL-1b, IL-8, and MCP-1) were found in $60% of tear samples (Table 2). Comparisons of the concentrations of these three cytokines before and after rebamipide instillation showed no significant differences Score–corrected cytokine concentrations showed no significant differences Score–corrected cytokine concentrations showed no significant differences (Figs. 5B,D,F)

MATERIALS AND METHODS

RESULTS

DISCUSSION

15. The definition and classification of dry eye disease