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Recurrence after Topical Nonpreserved Methylprednisolone Therapy for Keratoconjunctivitis Sicca in Sjögren's Syndrome

Authors
 Samin Hong  ;  Terry Kim  ;  Kyoung Yul Seo  ;  Eung Kweon Kim  ;  So-Hyang Chung 
Citation
 JOURNAL OF OCULAR PHARMACOLOGY AND THERAPEUTICS, Vol.23(1) : 78-82, 2007 
Journal Title
 JOURNAL OF OCULAR PHARMACOLOGY AND THERAPEUTICS 
ISSN
 1080-7683 
Issue Date
2007
MeSH
Administration, Topical ; Female ; Glucocorticoids/administration & dosage* ; Humans ; Keratoconjunctivitis Sicca/drug therapy* ; Keratoconjunctivitis Sicca/etiology ; Male ; Methylprednisolone/administration & dosage* ; Middle Aged ; Ophthalmic Solutions/administration & dosage ; Preservatives, Pharmaceutical ; Pulse Therapy, Drug ; Recurrence ; Sjogren's Syndrome/complications ; Sjogren's Syndrome/drug therapy* ; Tears/metabolism ; Treatment Outcome
Abstract
BACKGROUND: The aim of this study was to evaluate the prevalence of long-term recurrence after topical nonpreserved methylprednisolone pulse therapy for the treatment of keratoconjunctivitis sicca (KCS) with Sjögren's syndrome. METHODS: A total of 106 eyes of 53 Sjögren's syndrome patients were included in the study. All patients were treated with topical nonpreserved 1% methylprednisolone solution. Initial therapy consisted of eyedrops 4 times a day for 2 weeks, and then patients were reevaluated and tapered off the medication every 2 weeks until discontinuation. Tear film breakup time (TBUT), Schirmer test, corneal fluorescein staining, and subjective symptom scores were measured. Additionally, impression cytology of the bulbar conjunctiva was performed. The over-all success rates and success period were determined using the Kaplan-Meier survival curve. RESULTS: A reduction in subjective symptoms and fluorescein staining, and an improvement in TBUT and Schirmer test results, was observed after treatment (P<0.001). Impression cytology specimens revealed a significantly increased number of periodic acid-Schiff-positive cells after treatment. After the first pulse therapy, mean survival was 56.6 weeks and 11 (20.8%) patients recurred. After the second pulse therapy, mean survival was 72.4 weeks and only 1 patient recurred. No serious complications, including intraocular pressure elevation and cataract formation, were encountered during the entire follow-up period. CONCLUSIONS: Topical nonpreserved methylprednisolone pulse therapy proved to be a safe, effective long-term treatment of improving subjective and objective dry eye factors in KCS patients with Sjögren's syndrome.
Full Text
http://online.liebertpub.com/doi/abs/10.1089/jop.2006.0091
DOI
10.1089/jop.2006.0091
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Eung Kweon(김응권) ORCID logo https://orcid.org/0000-0002-1453-8042
Seo, Kyuong Yul(서경률) ORCID logo https://orcid.org/0000-0002-9855-1980
Chung, So Hyang(정소향)
Hong, Sa Min(홍사민)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/96498
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