Assessment of the efficacy of 0.1% cyclosporine A cationic emulsion in the treatment of dry eye disease during COVID-19 pandemic

Objective: To assess the efficacy of 0.1% cyclosporine A (CsA) cationic emulsion (CE) in the treatment of dry eye disease (DED) in terms of ocular surface disease index (OSDI). Methods: DED patients with corneal fluorescein staining grade (CFS) ≤ 3 on the Oxford scale and Schirmer test score < 10 mm/ 5 min were enrolled for once-daily CsA use in this observational, prospective, one-center study. Efficacy of CE at 30, 60, and 90-day follow-up visit was evaluated using OSDI questionnaire. Both the overall OSDI score and the outcomes for all subscales - ocular symptoms (OS), vision-related function (VRF) and environmental triggers (ET) were considered. Results: Twelve patients (10 women and 2 men), whose baseline OSDI ranged between 27.08 and 70.03 mm (48.2 ± 11.8), were included. Their achieved mean scores for subscales such OS, VRF and ET were 66.6 ± 16.8, 42.2 ± 12.0 and 42.2 ± 12.5, respectively. Statistically significant results were obtained after 30 days for OSDI (45.5 ± 10.0; p=0.011), whereas after 90 days for both OSDI (35.4 ± 7.4; p=0.003) and OS (47.2 ± 10.9; p=0.005), VRF (30.5 ± 6.1; p=0.003) and ET (33.3 ± 11.2; p=0.008). Conclusions: CsA CE significantly reduced symptoms of patients with DED. Recovery was the most successful after 90 days of treatment and included OSDI, OS, VRF and ET. Abbreviations: CE = cationic emulsion, CFS = corneal fluorescein staining, CsA = cyclosporine A, DED = dry eye disease, ET = environmental triggers, OS = ocular symptoms, OSDI = ocular surface disease index, VRF = vision-related function