Hun Lee1, Byunghoon Chung1, Kyu Seo Kim2, Kyoung Yul Seo1, Bong Joon Choi3, Tae-Im Kim4. 1. Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea. 2. Emory University School of Medicine, Atlanta, Georgia. 3. Lee Eye Clinic, Busan, South Korea. 4. Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: tikim@yuhs.ac.
Abstract
PURPOSE: To assess tear cytokine levels and clinical outcomes in moderate and severe meibomian gland dysfunction (MGD) after 2 months of treatment with topical loteprednol etabonate and eyelid scrubs with warm compresses vs eyelid scrubs with warm compresses alone. DESIGN: Randomized controlled trial. METHODS:Patients with moderate and severe MGD were randomized into 2 groups: topical loteprednol etabonate and eyelid scrubs with warm compresses (Group I, 34 eyes) or eyelid scrubs with warm compresses (Group II, 36 eyes). We evaluated cytokine levels, tear film break-up time (TBUT), corneal and conjunctival fluorescein staining, biomicroscopic examination of lid margins and meibomian glands, and the Ocular Surface Disease Index before initiating treatment and 1 month and 2 months after treatment. RESULTS: There were significant decreases in the levels of interleukin (IL)-6, IL-8, and IL-1β in Group I, and IL-6 and IL-8 in Group II. Moreover, the observed decreases of these cytokines in Group I were attributed to a remarkable decrease between treatment and 1 month after treatment. In Group I, there were improvements in all of the clinical outcomes, with prominent improvement in TBUT, corneal and conjunctival fluorescein staining, and meibum quality after 1 month of treatment, compared with Group II. An improvement in meibomian gland expressibility and MGD stage reduction were more remarkable in Group I. CONCLUSIONS: Topical loteprednol etabonate and eyelid scrubs with warm compresses were tolerated and efficacious for the treatment of moderate and severe MGD. We suggest that such beneficial effects could manifest after 1 month.
RCT Entities:
PURPOSE: To assess tear cytokine levels and clinical outcomes in moderate and severe meibomian gland dysfunction (MGD) after 2 months of treatment with topical loteprednol etabonate and eyelid scrubs with warm compresses vs eyelid scrubs with warm compresses alone. DESIGN: Randomized controlled trial. METHODS:Patients with moderate and severe MGD were randomized into 2 groups: topical loteprednol etabonate and eyelid scrubs with warm compresses (Group I, 34 eyes) or eyelid scrubs with warm compresses (Group II, 36 eyes). We evaluated cytokine levels, tear film break-up time (TBUT), corneal and conjunctival fluorescein staining, biomicroscopic examination of lid margins and meibomian glands, and the Ocular Surface Disease Index before initiating treatment and 1 month and 2 months after treatment. RESULTS: There were significant decreases in the levels of interleukin (IL)-6, IL-8, and IL-1β in Group I, and IL-6 and IL-8 in Group II. Moreover, the observed decreases of these cytokines in Group I were attributed to a remarkable decrease between treatment and 1 month after treatment. In Group I, there were improvements in all of the clinical outcomes, with prominent improvement in TBUT, corneal and conjunctival fluorescein staining, and meibum quality after 1 month of treatment, compared with Group II. An improvement in meibomian gland expressibility and MGD stage reduction were more remarkable in Group I. CONCLUSIONS: Topical loteprednol etabonate and eyelid scrubs with warm compresses were tolerated and efficacious for the treatment of moderate and severe MGD. We suggest that such beneficial effects could manifest after 1 month.
Authors: Mark S Milner; Kenneth A Beckman; Jodi I Luchs; Quentin B Allen; Richard M Awdeh; John Berdahl; Thomas S Boland; Carlos Buznego; Joseph P Gira; Damien F Goldberg; David Goldman; Raj K Goyal; Mitchell A Jackson; James Katz; Terry Kim; Parag A Majmudar; Ranjan P Malhotra; Marguerite B McDonald; Rajesh K Rajpal; Tal Raviv; Sheri Rowen; Neda Shamie; Jonathan D Solomon; Karl Stonecipher; Shachar Tauber; William Trattler; Keith A Walter; George O Waring; Robert J Weinstock; William F Wiley; Elizabeth Yeu Journal: Curr Opin Ophthalmol Date: 2017-01 Impact factor: 3.761