Comparison between the Effectiveness of Topical Cyclosporine 0.05% and Artificial Tears eye drops in Treatment of Moderate Dry Eye in Egypt

Abstract

SUMMARY T he tear film overlays the ocular surface and provides the interface between the eye and the external environment. The tear film is essential for the nutrition and protection of the ocular surface and for clear vision as it is the first refractive surface of the eye. DED is a disorder of the tear film which occurs due to tear deficiency or excessive tear evaporation. It is one of the most frequently occurring ophthalmological health problems worldwide. Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear film instability, with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface. Even with only moderately severe dry eye, there is an inflammatory reaction of the ocular surface and the lacrimal gland. To break the vicious circle of surface damage and inflammation, anti-inflammatory treatment is required in patients with moderate to severe dry eye disease. CsA is an immunosuppressant that inhibits the calcineurin–phosphatase pathway by complex formation with cyclophilin, and thus reduces the transcription of T-cell-activating cytokines such as interleukin-2 (IL-2) . Topical application of CsA leads to increased production of tear fluid, possibly via local release of parasympathetic neuro transmitters.