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长期应用低浓度皮质醇人工泪液治疗干眼的疗效和安全性观察。

Long-Term Activity and Safety of a Low-Dose Hydrocortisone Tear Substitute in Patients with Dry Eye Disease.

机构信息

Ocular Surface Center, IS.Pre Oftalmica, Genoa, Italy.

Department of Ophthalmology, ASST Fatebenefratelli SACCO-Università di Milano, Milan, Italy.

出版信息

Curr Eye Res. 2023 Sep;48(9):799-804. doi: 10.1080/02713683.2023.2214948. Epub 2023 Jun 19.

Abstract

PURPOSE

A clinical trial was conducted to evaluate the activity of a new artificial tear containing hyaluronic acid (HA) and low-dose hydrocortisone to control dry-eye disease (DED) symptoms.

METHODS

a randomized, controlled, double-masked study was carried out at the Ocular Surface and Dry Eye Center, "Luigi Sacco" University Hospital (Milan, Italy), between June 2020 and June 2021. The study involved patients with DED for at least 6 months. After an initial 7-day treatment with corticosteroid, the treatment with the new artificial tear (four-times a day for 6 months) was compared with a control HA solution.

RESULTS

A total of 40 patients were considered. We observed a significant improvement in the frequency and intensity of DED symptoms in both groups. After corticosteroid discontinuation, the maintenance of the therapeutic advantage was observed only in the treatment group, which also showed a significant improvement of the tear film break-up time ( ≤ 0.05) and infiltrated macrophages ( < 0.05). A significant reduction in fluorescein and Lissamine staining ( < 0.05) was observed in the treatment group, suggesting damage reduction at both corneal and conjunctival levels. Intraocular pressure did not change at the end of the treatment period and was maintained within the normal range, sustaining the product's safety.

CONCLUSIONS

Our findings support the prolonged use of the new eye drop with low-dose hydrocortisone, also in the DED initial stages, to prevent the degenerating towards a chronic condition (http://www.isrctn.com/ISRCTN16288419).

摘要

目的

一项临床试验评估了含有透明质酸(HA)和低剂量氢化可的松的新型人工泪液控制干眼疾病(DED)症状的活性。

方法

这项在意大利米兰 Luigi Sacco 大学医院的眼表面和干眼中心进行的随机、对照、双盲研究于 2020 年 6 月至 2021 年 6 月间开展,共纳入 DED 至少 6 个月的患者。在接受皮质类固醇初始 7 天治疗后,将新型人工泪液(每日 4 次,持续 6 个月)与 HA 溶液进行对照治疗。

结果

共纳入 40 例患者。两组 DED 症状的频率和强度均显著改善。停用皮质类固醇后,仅治疗组维持治疗优势,且泪膜破裂时间( ≤ 0.05)和浸润性巨噬细胞( < 0.05)显著改善。治疗组的荧光素和丽丝胺染色( < 0.05)显著减少,提示角膜和结膜水平的损伤减少。治疗结束时眼压无变化,且保持在正常范围内,提示该产品安全。

结论

我们的研究结果支持在 DED 初始阶段延长使用含有低剂量氢化可的松的新型滴眼液,以预防向慢性疾病发展(http://www.isrctn.com/ISRCTN16288419)。

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