Antiinflammatory therapy for dry eye

Purpoe To preent evidence etablihing the relationhip between inflammation and dry eye and upporting the ue of antiinflammatory therapy for dry eye. Deign Analyi of literature. Method Reearch tudie that evaluated inflammation in dry eye pathogenei and clinical trial of antiinflammatory therapie for dry eye were reviewed. Reult There i increaing evidence that decreaed tear ecretion, decreaed tear turnover, and deiccation promote inflammation on the ocular urface. An increae in oluble mediator (cytokine and proteae) in the tear fluid, adheion molecule expreion by the conjunctival epithelium, and T-cell infiltration of the conjunctiva have been oberved in dry eye patient. Thi inflammation appear to have a role in the pathogenei of the ocular urface epithelial dieae, termed keratoconjunctiviti icca (KC), that develop in dry eye. Clinical improvement of KC ha been oberved after therapy with antiinflammatory agent including corticoteroid, cycloporin and doxycycline. Cycloporin A emulion wa approved by the Food and Drug Adminitration a therapy for dry eye. Randomized placebo-controlled FDA clinical trial howed that cycloporine A wa uperior to vehicle in timulating aqueou tear production, decreaing corneal punctuate fluorecein taining, reducing ymptom of blurred viion, and decreaing artificial tear ue in patient with KC. No ocular or ytemic toxicity wa oberved from thi medication. Concluion Ocular urface and lacrimal gland inflammation ha been identified in dry eye that play a role in the pathogenei of KC. Antiinflammatory therapy ha efficacy for treating KC. Cycloporin A i the firt FDA approved therapy for thi indication. It improved ign and ymptom of KC, and it i afe for long-term ue.