Postorino Elisa Imelde, Aragona Pasquale, Rania Laura, Spinella Rosaria, Puzzolo Domenico, Micali Antonio, Mazza Anna Maria Livia, Papa Vincenzo
Regional Referral Center for the Ocular Surface Diseases, Department of Biomedical Sciences, University of Messina, Messina, Italy.
Ophthalmology Unity, State Hospital of San Marino, Cailungo, Republic of San Marino.
Eur J Ophthalmol. 2020 May;30(3):439-445. doi: 10.1177/1120672119833278. Epub 2019 Mar 11.
To study the effects of xanthan gum eye drops on the ocular surface and conjunctival cytology of patients with mild-moderate dry eye.
This prospective, double-masked, controlled trial included 30 patients (age > 60 and Ocular Surface Disease Index score >12 and <33), divided into two groups of 15 subjects and treated with 0.2% xanthan gum eye drops (group 1) or 0.5% carboxymethylcellulose (group 2) qid. After a run-in period with saline qid, patients were evaluated by Ocular Surface Disease Index questionnaire, clinical assessment, and impression cytology at baseline (T0) and after 1 month (T1). For impression cytology, cellularity, cell-to-cell contacts, nucleus/cytoplasm ratio, chromatin aspect, goblet cells distribution, keratinization, and the presence of inflammatory cells were considered. Parameters were scored from 0 (no alterations) to 3 (evident alterations). For statistical analysis, Student's t-test, Wilcoxon rank-sum test, and Mann-Whitney U-test were used.
Clinically, after 1 month of treatment, group 1 showed an improvement of corneal stain (T0 = 1.1 ± 1.4; T1 = 0.5 ± 0.7; p = 0.03) and a reduction of Schirmer I test (T0 = 9.8 ± 6.1; T1 = 5.9 ± 4.1; p = 0.001). In group 2, no differences were found between T0 and T1 for all the clinical tests. For impression cytology, in group 1 cellularity (T0 = 0.6 ± 0.5; T1 = 0.3 ± 0.5; p = 0.05), chromatin aspect (T0 = 1.2 ± 0.4; T1 = 0.8 ± 0.5; p = 0.01), keratinization (T0 = 1 ± 0.7; T1 = 0.5 ± 0.5; p = 0.03), and total score (T0 = 5.8 ± 1.3; T1 = 3.6 ± 1.7; p = 0.003) were significantly ameliorated, while in group 2 only total score improved significantly (T0 = 5 ± 1.4; T1 = 4.3 ± 1.5; p = 0.01). The comparison between groups showed significant amelioration for keratinization in group 1 at T1 (p = 0.02).
The treatment with xanthan gum, a molecule with anti-oxidant and mucoadhesive properties, ameliorated conjunctival epithelium of mild-moderate dry eye patients better than carboxymethylcellulose.
研究黄原胶滴眼液对轻中度干眼症患者眼表及结膜细胞学的影响。
这项前瞻性、双盲、对照试验纳入了30例患者（年龄>60岁，眼表疾病指数评分>12且<33），分为两组，每组15名受试者，分别使用0.2%黄原胶滴眼液（第1组）或0.5%羧甲基纤维素（第2组），每日4次。在每日4次使用生理盐水的导入期后，患者在基线（T0）和1个月后（T1）通过眼表疾病指数问卷、临床评估和印片细胞学进行评估。对于印片细胞学，考虑细胞密度、细胞间接触、核质比、染色质形态、杯状细胞分布、角化以及炎症细胞的存在情况。参数评分从0（无改变）到3（明显改变）。对于统计分析，使用了学生t检验、Wilcoxon秩和检验和Mann-Whitney U检验。
临床上，治疗1个月后，第1组角膜染色有所改善（T0 = 1.1±1.4；T1 = 0.5±0.7；p = 0.03），泪液分泌试验Ⅰ（Schirmer I test）降低（T0 = 9.8±6.1；T1 = 5.9±4.1；p = 0.001）。在第2组中，所有临床检查在T0和T1之间均未发现差异。对于印片细胞学，第1组的细胞密度（T0 = 0.6±0.5；T1 = 0.3±0.5；p = 0.05）、染色质形态（T0 = 1.2±0.4；T1 = 0.8±0.5；p = 0.01）、角化（T0 = 1±0.7；T1 = 0.5±0.5；p = 0.03）和总分（T0 = 5.8±1.3；T1 = 3.6±1.7；p = 0.003）均有显著改善，而在第2组中只有总分有显著改善（T0 = 5±1.4；T1 = 4.3±1.5；p = 0.01）。两组之间的比较显示，第1组在T1时角化有显著改善（p = 0.02）。
黄原胶是一种具有抗氧化和黏膜黏附特性的分子，其治疗对轻中度干眼症患者结膜上皮的改善优于羧甲基纤维素。
