ETD

Digital archive of theses discussed at the University of Pisa

 

Thesis etd-12032021-061324


Thesis type
Tesi di specializzazione (4 anni)
Author
MENCHINI, MARTINA
URN
etd-12032021-061324
Thesis title
Short term results of a pulsed therapy with topical Hydrocortisone eye drops to treat moderate to severe Dry-eye in Sjogren Syndrome patients
Department
PATOLOGIA CHIRURGICA, MEDICA, MOLECOLARE E DELL'AREA CRITICA
Course of study
OFTALMOLOGIA
Supervisors
relatore Prof. Figus, Michele
relatore Dott.ssa Gabbriellini, Giovanna
Keywords
  • Sjögren syndrome
  • dry-eye
  • ocular surface
  • tear film osmolarity
  • corticosteroids
  • hydrocortisone
  • Schirmer test
Graduation session start date
10/01/2022
Availability
Withheld
Release date
10/01/2025
Summary
Dry-eye disease (DED) is a highly prevalent ocular condition in patients with Sjögren syndrome (SS) with a significant burden on affected patients. Regardless of the underlying aetiology, DED is associated with increased ocular surface inflammation and alterations in tear film osmolarity and composition. Retrospective data from 40 patients with moderate to severe SS, treated for at least six months with pulsed topical low dose hydrocortisone 0.335% (PFH), were collected. The safety and efficacy of PFH were tested. Clinical evaluation at each time point included best corrected visual acuity (BCVA), slit lamp biomicroscopy, assessment of conjunctival hyperaemia, non-invasive break-up time (NIBUT), corneal and conjunctival staining, Schirmer I test, Meibomian gland imaging, Goldmann application tonometry and funds examination. Data from 37 female and 3 males were collected. Mean age was 56.30 ± 13.91 years. Clinical signs and symptoms, including tear film osmolarity and Ocular Surface Index (OSDI) score, significantly improved (all p<0.001) after 3 and 6 months of treatment. IOP remained unchanged. No adverse events were recorded. This retrospective data review confirms that topical PFH with a pulsed posology, 6 days every month (three times a day for 2 days, twice daily for 2 days and then once daily for 2 days) for 3 months and then alternating, significantly improves clinical signs and symptoms in patients with moderate to severe SS-related DED with no safety issues.
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