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壳聚糖-N-乙酰半胱氨酸(Lacrimera)用于治疗多种病因所致干眼症的早期结果。

Early results on the use of chitosan-N-acetylcysteine (Lacrimera) in the management of dry eye disease of varied etiology.

作者信息

Messina Marco, Dua Harminder S

机构信息

Section of Academic Ophthalmology, Division of Clinical Neuroscience, Department of Ophthalmology, Queens Medical Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Derby Road, Nottingham, NG7 2UH, UK.

出版信息

Int Ophthalmol. 2019 Mar;39(3):693-696. doi: 10.1007/s10792-018-0843-0. Epub 2018 Mar 16.

Abstract

PURPOSE

To evaluate the effect of once daily administration of chitosan-N-acetylcysteine (Lacrimera) in the management of dry eye disease (DED).

METHODS

Eighteen patients (3 male, 15 female) aged 25-86 years (mean 61.1) and suffering from moderate to severe DED with superficial punctate keratitis (SPK) were retrospectively evaluated after a trial of Lacrimera drops (1 drop in the morning for 5 days only). All the patients were using other artificial tears before the treatment. All lubricants were stopped, and Lacrimera was started instead. Slit-lamp examination and images were taken before and at 1 and 3 weeks follow-up after the treatment. The subjective (Ocular Surface Disease Index, OSDI) and objective (Oxford Grading System, OGS) evaluation was recorded. A paired student's t test was performed to analyse the data.

RESULTS

At baseline, the SPK grade was I to IV (OGS) and the OSDI ranged from 25 to 71.4. Fifteen patients showed a statistically significant (p < 0.0001) improvement in OGS and the OSDI at 3 weeks post-treatment. Three patients showed no improvement.

CONCLUSIONS

A single-dose instillation of chitosan-N-acetylcysteine for five consecutive days improved signs and symptoms in patients affected from DED from a variety of causes, who were refractory to standard treatment with lubricants. Given its posology, the absence of side effects and the results obtained Lacrimera should be taken into consideration as a viable option in patients with moderate to severe DED.

摘要

目的

评估每日一次给予壳聚糖 - N - 乙酰半胱氨酸(Lacrimera)治疗干眼病(DED)的效果。

方法

对18例年龄在25 - 86岁(平均61.1岁)、患有中度至重度DED并伴有浅层点状角膜炎(SPK)的患者(3例男性,15例女性)进行回顾性评估,这些患者在试用Lacrimera滴眼液(仅在早晨滴1滴,共5天)后接受评估。所有患者在治疗前均使用其他人工泪液。停用所有润滑剂,改用Lacrimera。在治疗前以及治疗后1周和3周随访时进行裂隙灯检查并拍照。记录主观(眼表疾病指数,OSDI)和客观(牛津分级系统,OGS)评估结果。采用配对学生t检验分析数据。

结果

基线时,SPK分级为I至IV级(OGS),OSDI范围为25至71.4。15例患者在治疗后3周时OGS和OSDI有统计学显著改善(p < 0.0001)。3例患者无改善。

结论

连续5天单剂量滴注壳聚糖 - N - 乙酰半胱氨酸可改善多种原因引起的、对标准润滑剂治疗无效的DED患者的体征和症状。鉴于其用药剂量、无副作用以及所取得的结果,Lacrimera应被视为中度至重度DED患者的一种可行选择。

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