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Effects of topical loteprednol etabonate on tear cytokines and clinical outcomes in advanced stages of meibomian gland dysfunction

Poster Details

First Author: H.LEE SOUTH KOREA

Co Author(s):    H. Lee   K. Seo   E. Kim   T. Kim     

Abstract Details



Purpose:

To assess inflammatory tear cytokine levels and clinical outcomes in patients with advanced stages of meibomian gland dysfunction (MGD) after two months' treatment with topical loteprednol etabonateand eyelid scrubs with warm compresses versus eyelid scrubs with warm compresses alone.

Setting:

Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea

Methods:

Patients with stage 3 or 4 MGD were randomized into 2 groups: topical loteprednol etabonate and eyelid scrubs with warm compresses (group I, 35 eyes) or eyelid scrubs with warm compresses alone (group II, 35 eyes). Before and 1 month, and 2 months after treatment, inflammatory tear cytokine levels, tear film break-up time (TBUT), corneal and conjunctival fluorescein stain, intraocular pressure (IOP), biomicroscopic examination of lid margins and meibomian glands, and Ocular Surface Disease Index were evaluated. Tear samples were collected and analyzed using a BD Cytometric Bead Array (BD Bioscience, San Jose, CA, USA) for detection of interleukin (IL)-6, IL-7, IL-8, IL-1β, IL-17α, monocyte chemotactic protein-1, tumor necrosis factor-α, IL-12p70, and interferon-γ. Linear mixed model analysis was performed to detect any possible differences between the two groups and three time courses.

Results:

There was significant decrease in the level of IL-6, IL-8, and IL-1β in group I, and IL-6 and IL-8 in group II. Moreover, observed decreases of IL-6 and IL-8 in group I were more prominent compared with those in group II, which are attributed to significant decrease in each cytokine level between before and 1 month after treatment. In group I, there were significant improvements in all clinical outcomes, demonstrating remarkable improvement in TBUT, corneal and conjunctival fluorescein stain, and meibum quality after 1 month of treatment. Although lower efficacy was reported in group II compared with group I, eyelid management alone improved all clinical outcomes except corneal fluorescein stain. Meibomian gland expressibility improvement and MGD stage reduction were more remarkable in group I. No clinically significant increase (10 mmHg or more) of IOP was observed in both groups.

Conclusions:

The topical loteprednol etabonate for the treatment of stage 3 or 4 MGD was tolerated and efficacious during the treatment period, with significant effects on inflammatory tear cytokine levels and clinical outcomes. We suggested that it was possible that such effects could be manifested after 1 month of treatment. FINANCIAL INTEREST: NONE

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