Servicio de Oftalmología, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Hospital Clinico San Carlos, Madrid, Spain.
Departamento de Inmunología, Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.
Eur J Ophthalmol. 2024 May;34(3):719-725. doi: 10.1177/11206721231206790. Epub 2023 Oct 9.
To evaluate the efficacy of insulin eye drops for dry eye disease in reducing corneal staining and improving symptoms.
In this retrospective case series, patients with dry eye disease treated with off-label use of insulin eye drops were collected. The main inclusion criterion was diagnosis of dry eye disease with epithelial damage and acceptance of the off-label use of topical insulin. Age, sex, type of dry eye disease, time since diagnosis, previous ocular surgeries, concomitant treatment, best corrected visual acuity, symptoms, conjunctival hyperemia and corneal staining were recorded Data from the 1 and 3-month visit were included.
16 patients (32 eyes) were treated with insulin (14 females and 2 males; mean age 61.3 ± 16.8 years). 12 patients (71%) were also on autologous serum and 10 patients (63%) on cyclosporine. Symptoms were 3.4 ± 1.3 (range 2-5) when scaled from 0 to 5. Mean hyperemia was 1.0 ± 0.9 (range 0-3) and corneal staining was 2.5 ± 1.3 (range 0-5). After 3 months, 5 patients (31%) referred to be much better, 6 (38%) better, 3 (19%) slightly better and 2 patients (13%) were subjectively similar, mean symptoms being 2.3 ± 1.0 (range 1-4; = 0.001). Hyperemia was 0.3 ± 0.4 (range 0-1) and corneal staining was 1.1 ± 1.0 (range 0-3; both < 0.001). Topical insulin was well tolerated with no adverse events.
The excellent results presented in these case series illustrate topical insulin as a promising treatment in dry eye disease with refractory epithelial damage.
评估胰岛素滴眼剂治疗干眼症在减少角膜染色和改善症状方面的疗效。
在这项回顾性病例系列研究中，收集了使用胰岛素滴眼剂进行超适应证治疗的干眼症患者。主要纳入标准为诊断为干眼症合并上皮损伤，并接受局部使用胰岛素的超适应证治疗。记录患者的年龄、性别、干眼症类型、诊断后时间、既往眼部手术、合并治疗、最佳矫正视力、症状、结膜充血和角膜染色。纳入 1 个月和 3 个月访视的数据。
共治疗 16 例（32 只眼）患者，使用胰岛素（14 例女性，2 例男性；平均年龄 61.3±16.8 岁）。12 例（71%）患者还使用自体血清，10 例（63%）患者使用环孢素。症状按 0 至 5 分评分，平均评分为 3.4±1.3（范围 2-5）。平均充血评分为 1.0±0.9（范围 0-3），角膜染色评分为 2.5±1.3（范围 0-5）。3 个月后，5 例（31%）患者自述改善明显，6 例（38%）患者自述改善，3 例（19%）患者自述稍有改善，2 例（13%）患者自述无变化，平均症状评分为 2.3±1.0（范围 1-4； = 0.001）。充血评分为 0.3±0.4（范围 0-1），角膜染色评分为 1.1±1.0（范围 0-3；均 < 0.001）。局部使用胰岛素耐受性良好，无不良反应。
这些病例系列研究中的出色结果表明，胰岛素滴眼剂是治疗难治性上皮损伤干眼症的一种有前途的治疗方法。
