Kashima Tomoyuki, Akiyama Hideo, Miura Fumihide, Kishi Shoji
Department of Ophthalmology, Gunma University School of Medicine, Maebashi, Japan.
Clin Ophthalmol. 2012;6:1403-6. doi: 10.2147/OPTH.S35122. Epub 2012 Aug 29.
Rebamipide is an antiulcer agent used to treat gastric ulcer and gastritis. Biological effects of rebamipide include cytoprotection, wound healing, and anti-inflammatory properties that are known to be universal for a variety of tissues in addition to gastrointestinal mucosa. The therapeutic effects of rebamipide eye drops are due to its ability to increase corneal and conjunctival mucin-like substances and improve corneal and conjunctival injury in vivo. In this paper, we report a case of Sjögren's syndrome with complete disappearance of corneal erosion after administration of rebamipide eye drops. This was observed even though corneal erosion had not improved for 6 months after punctal occlusion surgery. The patient was a 33-year-old female, diagnosed with Sjögren's syndrome by a salivary gland biopsy. The corneal and conjunctival surfaces were filled with dense erosions, which did not improve with topical drugs. Punctal plugs were applied several times; however, the plugs were repeatedly shed. All four puncta of both eyelids were surgically occluded, and both corneal and conjunctival erosion was clearly improved. However, the erosion in the inferior cornea of both eyes had not improved for 6 months after surgery. We used the newly approved topical rebamipide for treatment of this patient. The corneal erosion gradually improved and completely disappeared 4 weeks after administration of the drug. Dry eye sensation disappeared at the same time. Both membrane-associated mucin and secreted mucin in the ocular surface are thought to be essential for maintenance of the tear film. Induction of mucin from ocular surface epithelium could be an effective treatment in cases of dry eye caused by mucin deficiency. Through its various mechanisms, rebamipide improves ocular surface conditions. To our knowledge, this is the first clinical case report using rebamipide ophthalmic solution. This drug may provide a novel approach to treat drying diseases of the eye.
瑞巴派特是一种用于治疗胃溃疡和胃炎的抗溃疡药物。瑞巴派特的生物学效应包括细胞保护、伤口愈合和抗炎特性，除了胃肠道黏膜外，这些效应在多种组织中都是普遍存在的。瑞巴派特滴眼液的治疗效果归因于其能够增加角膜和结膜的黏蛋白样物质，并在体内改善角膜和结膜损伤。在本文中，我们报告了一例干燥综合征患者，使用瑞巴派特滴眼液后角膜糜烂完全消失。即使在泪点闭塞手术后6个月角膜糜烂仍未改善的情况下，这种情况仍被观察到。该患者为一名33岁女性，经唾液腺活检诊断为干燥综合征。角膜和结膜表面布满密集的糜烂，局部用药后没有改善。多次应用泪点塞；然而，塞子反复脱落。双眼的所有四个泪点均通过手术闭塞，角膜和结膜糜烂均明显改善。然而，手术后6个月双眼下角膜的糜烂仍未改善。我们使用新批准的局部用瑞巴派特对该患者进行治疗。用药4周后角膜糜烂逐渐改善并完全消失。同时干眼症状消失。眼表的膜相关黏蛋白和分泌性黏蛋白都被认为对维持泪膜至关重要。从眼表上皮诱导黏蛋白可能是治疗黏蛋白缺乏引起的干眼病例的有效方法。通过其多种机制，瑞巴派特改善眼表状况。据我们所知，这是第一例使用瑞巴派特眼药水的临床病例报告。这种药物可能为治疗眼部干燥疾病提供一种新方法。
