Topical Cyclosporine in the Treatment of Ocular Surface Disorders

Abstract

Mounting evidence and studies suggests that inflammatory process is the key factor in the pathogenesis of different ocular surface diseases, with a complex interplay of genetic, environmental, and psychosocial factors. Management of these conditions is often challenging. Topical corticosteroids, with their associated side effects, are the mainstay of current treatments for patients with vision threatening disease. Cyclosporine A is an immuno-modulator that specifically inhibits T lymphocyte proliferation. Topical CsA preparation was approved by the US Food and Drug Administration for treatment of moderate to severe eye dryness. The topical CsA preparation proved its efficacy in controlling and treatment of many ocular surface disorders, which considered one of the leading cases of blindness worldwide, particularly the DED and chronic allergic keratoconjunctivitis. Topical CsA ophthalmic emulsion is the first treatment that targets an underlying pathological mechanism for chronic dry eye: the immune mediated process. CsA has been demonstrated to be safe and effective in clinical trials. It reduce signs and symptoms of dry eye syndrome, has a favorable pharmacokinetic profile, and is well tolerated, with few, mild and minor ocular adverse effects.