Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Wintersteller, P.
Effect of a topical Cyclosporine A therapy on the
meibomian glands in patients with Sjogren Syndrome
A retrospective data analysis
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2021. pp. 72
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- Autor*innen der Med Uni Graz:
- Wintersteller Paul
- Betreuer*innen:
- Berisha Bujar
- Horwath-Winter Jutta
- Altmetrics:
- Abstract:
- The Sjögren Syndrome is an autoimmune disease, which is primary associated with the damage of salivary and/or lacrimary glands. Typical symptoms are a dry mouth and dry eyes, as well as the reduction of the quality of life. Furthermore Sjögren Syndrome induced meibomian gland dysfunction is also diagnosed in many cases. The mainstay therapy are artificial tears, ointments, gels, regularly applied eye lid massage and the application of cyclosporine A. The evaluation of subjective discomfort is analyzed via patient-questionnaires, objective parameters are evaluated with the slit-lamp or other devices, like the Keratograph 5-M. A focus of this study was the evaluation and grading of the meibomian glands. This was achieved by the examination of their morphology with the meibography, and the evaluation of the quantity and quality of meibum secretion. In our retrospective design, Cyclosporine A was applied for minimum one year. 14 patients with primary or secondary Sjögren Syndrome of the dry eye unit of the Department of Ophthalmology, Medical University of Graz met the inclusion and exclusion criteria. Analyzed patient data showed a stabilization of objective and subjective patient/dry eye parameters. Furthermore, a significant improvement in the expression of meibum after the continuous application of Cyclosporine A (p=0,025) was observed. Our results suggest that a continuous longtime application of Cyclosporine A, in combination with artificial tears and regularly applied eye lid massage, can lead to a stabilization of the disease and a deceleration of the progression of Sjögren Syndrome induced meibomian gland dysfunction. This led to the recommendation that Cyclosporine A, complemented with the mentioned therapies, should be prescribed in moderate to severe cases of Sjögren Syndrome. Additionally, a meibography should be part of the follow up process to enable a better comparability of the patient history.