Topical 0.1% Prednisolone Lowers Nerve Growth Factor Expression in Keratoconjunctivitis Sicca Patients

doi:10.1016/j.ophtha.2005.09.033

Ophthalmology

Volume 113, Issue 2, February 2006, Pages 198-205

https://doi.org/10.1016/j.ophtha.2005.09.033 Get rights and content

Purpose

To compare nerve growth factor (NGF) levels in tears and on the ocular surfaces of normal control and non–Sjögren’s type keratoconjunctivitis sicca subjects, and to investigate the effect of 0.1% prednisolone eyedrops on NGF levels in keratoconjunctivitis sicca patients.

Design

Prospective, double-masked, randomized, comparative clinical trial.

Participants

Forty-one keratoconjunctivitis sicca patients and 23 age- and gender-matched healthy subjects.

Methods

Baseline tear NGF levels were measured in keratoconjunctivitis sicca patients and healthy control subjects using enzyme-linked immunosorbent assays. Keratoconjunctivitis sicca patients received 0.1% prednisolone drops in one eye and 0.1% hyaluronic acid drops in the other, 3 times a day for 28 days. Also, impression cytology (IC) and immunostaining for NGF on conjunctival epithelium were performed on both groups.

Main Outcome Measures

Tear NGF/total tear protein (TP) concentration ratio, IC and NGF immunocytologic staining, subjective symptom scale, tear breakup time, and Schirmer values.

Results

Keratoconjunctivitis sicca patients were found to have baseline tear NGF concentrations higher than those of age- and gender-matched healthy control subjects (65.9±14.5 vs. 122.1±45.3 pg/μg, P<0.0001). In keratoconjunctivitis sicca patients, prednisolone treatment for 28 days resulted in a decrease in tear NGF levels, symptom scores, and IC scores, whereas hyaluronic acid treatment had no such effect (68.2±25.0 pg/μg vs. 108.0±43.4 pg/μg, P<0.0001 for tear NGF/TP ratio; 2.16±1.01 vs. 3.39±1.50, P = 0.0014 for symptom scale; 1.05±0.67 vs. 1.61±0.86, P = 0.0317 for IC). Measurements taken at both 14 and 28 days indicated that neither prednisolone nor hyaluronic acid treatment affected breakup time or Schirmer values.

Conclusion

Keratoconjunctivitis sicca patients showed elevated levels of tear NGF, which were decreased by treatment with 0.1% prednisolone. These data suggest that ocular surface NGF may play an important role in ocular surface inflammation processes associated with dry eyes.

Section snippets

Subjects and Examinations

The study was commenced as a single-site, prospective, randomized, double-masked clinical trial conducted at the Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine. All procedures conformed to the tenets of the Declaration of Helsinki, and informed consent was obtained from all patients after the institutional review board gave its approval. A total of 41 non–Sjögren’s type keratoconjunctivitis sicca patients (11 male and 30 female) with a mean age of

Results

Of the 53 non–Sjögren’s type keratoconjunctivitis sicca patients initially enrolled, 12 did not complete the study. Six stopped visiting the clinic without giving a reason, 4 complained of severe adverse drug effects (e.g., stinging sensation, ocular pain), and 2 experienced an increase in IOP of 8 mmHg over the baseline value. Of those suffering side effects, 3 complained of pain in the prednisolone-treated eye and 1 complained of pain in the hyaluronic acid–treated eye. Both eyedrops

Discussion

The present study found that tear NGF levels were higher in dry eye patients than in normal subjects, and that antiinflammatory treatment with 0.1% prednisolone eyedrops lowered this elevated tear NGF concentration. In addition, prednisolone treatment decreased both symptom and IC grading scores, even though it did not alter clinical parameters such as breakup time and Schirmer values. Although the symptom score also improved after hyaluronic acid treatment, the improvement was greater with

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Manuscript no. 2005-288.

Drs Lee and Ryu contributed equally to the study.

The work was supported by the Korea Health 21 R&D Project, Ministry of Health and Welfare, Seoul, South Korea (grant no.: 02-PJ1-PG1-CH02-0003).

No author has any commercial or proprietary interests in any of the instruments or materials used in the study.

View full text

Original ArticleTopical 0.1% Prednisolone Lowers Nerve Growth Factor Expression in Keratoconjunctivitis Sicca Patients

Purpose

Design

Participants

Methods

Main Outcome Measures

Results

Conclusion

Section snippets

Subjects and Examinations

Results

Discussion

Surv Ophthalmol

Am J Ophthalmol

Ophthalmology

Ophthalmology

Cell

Ophthalmology

Surv Ophthalmol

Am J Ophthalmol

Ophthalmology

Ophthalmology

Brain Res Mol Brain Res

Brain Res Mol Brain Res

The pathology of dry eyethe interaction between the ocular surface and lacrimal glands

Cornea

The pathology of dry eye

Surv Ophthalmol

Report of the National Eye Institute/Industry Workshop on Clinical Trials in Dry Eyes

CLAO J

Tear fluid gelatinase B activity correlates with IL-1alpha concentration and fluorescein clearance in ocular rosacea

Invest Ophthalmol Vis Sci

Frequent association of delayed tear clearance in ocular irritation

Br J Ophthalmol

Altered cytokine balance in the tear fluid and conjunctiva of patients with Sjogren’s syndrome keratoconjunctivitis sicca

Curr Eye Res

Original Article
Topical 0.1% Prednisolone Lowers Nerve Growth Factor Expression in Keratoconjunctivitis Sicca Patients