RESUMO
Dry eye disease (DED) is pathogenetically based on inflammation of the ocular surface. A step-by-step approach to DED treatment involves early initiation of anti-inflammatory therapy, including instillation of cyclosporine A (CsA). However, recommendations for the use of topical CsA in clinical practice are limited. This article presents an expert consensus on practical recommendations for the management of patients with DED, including indications, time of initiation and duration of CsA therapy, comparison of CsA forms currently registered in the Russian Federation, as well as issues of patient education.
Assuntos
Ciclosporina , Emulsões , Humanos , Administração Oftálmica , Ciclosporina/administração & dosagem , Síndromes do Olho Seco/tratamento farmacológico , Síndromes do Olho Seco/etiologia , Imunossupressores/administração & dosagem , Soluções Oftálmicas/administração & dosagem , Resultado do Tratamento , Xeroftalmia/etiologia , Xeroftalmia/tratamento farmacológico , Xeroftalmia/diagnósticoRESUMO
Purpose - to evaluate clinical effectiveness and safety of anti-inflammatory therapy for the treatment of bacterial corneal ulcers. MATERIAL AND METHODS: The study included 49 patients treated for bacterial corneal ulcers. Main study patients were divided into two subgroups - the 1st group in addition to conventional treatment received parabulbar injections of 0.3 ml Dexamethasone (4 mg/ml) from the first day of treatment and during the entire period. Patients of the 2nd group, in addition to parabulbar injections of 0.3 ml Dexamethasone (4 mg/ml), received instillation of 0.09% bromfenac (Broxinac) once a day from the first day of therapy and for the entire treatment period. The control group consisted of 17 subjects who underwent standard treatment. The study used a scale for assessing the severity of corneal ulcers. Along with standard ophthalmological examination, all patients were assessed for the ulcer defect using optical coherence tomography (OCT) to measure the diameter of the corneal ulcer and the depth coefficient. RESULTS: In the first and second groups, the therapy algorithm has reduced the duration of treatment and hospitalization, promoted rapid epithelization and a reduction in the depth of the ulcer, led to less rough scarring of the cornea reducing corneal neoangiogenesis, and helped achieve higher visual acuity as a result of treatment. CONCLUSION: The use of a corticosteroid drug (Dexamethasone) for bacterial corneal ulcers reduces the duration of treatment and hospitalization and improves functional results of the treatment. Bromfenac 0.09% (Broxinac) was effective in the treatment of pain associated with bacterial corneal ulcer, but did not delay corneal epithelialization nor cause any corneal adverse events.