Long-term Resolution of Chronic Dry Eye Symptoms and Signs after Topical Cyclosporine Treatment

Abstract

To report the resolution of symptoms and signs of chronic dry eye for at least 1 year after completion of a minimum 6-month course of topical 0.05% cyclosporine in a subgroup of patients from 2 practices. Retrospective case series. Eight patients who had had chronic dry eye disease for 3 to 20 years were treated with topical cyclosporine for 6 to 72 months, and then remained free of symptoms or signs of disease for at least 1 year (range, 16-29 months; mean, 21 months) after stopping treatment. Treatment with topical 0.05% cyclosporine with or without topical corticosteroids twice a day along with nonpreserved artificial tears. Tests performed were patient history, slit-lamp examination, rose bengal and fluorescein staining of the ocular surface, tear breakup time, and Schirmer's test with anesthesia. Resolution of all symptoms and signs of dry eye disease after a minimum 6-month course of topical 0.05% cyclosporine. Eight patients, including approximately 4% of the total patients with chronic dry eye treated with 0.05% cyclosporine in one author's practice, were free of signs or symptoms of dry eye disease a minimum of 1 year after completing a 6- to 72-month course of therapy. There were no parameters noted that distinguished these patients from others who required maintenance topical cyclosporine or who did not appear to respond to topical cyclosporine. Topical cyclosporine treatment appears to be associated with a cure of symptoms and signs in a subgroup of chronic dry eye patients. In such patients, presumably there is effective elimination of inflammatory processes underlying chronic dry eye disease. Such patients should be monitored long term because a return of disease may be noted. These results suggest that topical cyclosporine treatment halts progression of chronic dry eye in some patients.