Efficiency of 0.01% Dexamethasone Solution in Comprehensive Therapy of Dry Eye Disease

Abstract

Introduction: At present anti-inflammatory therapy of patients with dry eye disease is based mainly on glucocorticoids' instillations. In spite of the fact that dexamethasone in officinal dosage (0.1%) has a marked local anti-inflammatory effect, its wide use is limited by the presence of a destructive process in the cornea. Taking this into account, the authors developed a drug containing 0.01% dexamethasone phosphate in combinations with 6% polyvinylpyrolidone and 1.5-5.5% dextrose solution. Objective: To study the impact of the developed medication on the inflammatory process dynamics in the tissues of the eye surface in patients with dry eye disease of various etiology. Materials and Methods: The material of this study was based on the results of the examination and treatment of 25 volunteers (50 eyes) with corneal-conjunctival xerosis developed on the background of 7 cases of meibomian blepharitis (14 eyes), 8 cases of perimenopause (16 eyes), and 10 cases of Sjögren's syndrome (20 eyes). All patients used the developed medication in the form of eye drops 3-4 times daily on the background of tear replacement therapy. Prior to the therapy and on day 28 of the study the following parameters were assessed, lower tear meniscus index, precorneal tear film production, stability and osmolarity, staining of eye surface epithelium with sodium fluoresce in solution, as well as bengal rose and lissamine green. The quantity of cytokines was determined in the tear fluid and blood plasma with ELISA method: interleukins-1β, 2, 4, 6, 8, 10, 17A, interleukin 1 receptor antagonist, TNF α, interferons α and γ. Besides, all the subjects were asked to fill in a questionnaire to evaluate subjective signs of the ocular surface epithelium xerosis or Ocular Surface Disease Index (OSDI). Results: By day 28 of the study statistically valid increase of the tear meniscus index, precorneal tear film stability, main and total tear production and decrease of tear film osmolarity were observed. Besides, the staining degree of the ocular surface epithelium with bengal rose and lissamine green (van Bijsterv?ld scale) and with sodium fluoresce in (Oxford scale) decreased. Also, the positive dynamics of the objective parameters of the ocular surface epithelium is confirmed by the subjects' patients evaluation of their quality of life. Conclusion: The results of the study performed prove the high clinical efficiency of the developed medication that has a marked local anti-inflammatory effect in the therapy of dry eye disease of various etiology.