Ophthalmic rosacea – etiology, pathogenesis, new approaches to the therapy

• Main Authors: T. A. Chekhova, V. V. Chernykh
• Format: Article
• Language: Russian
• Published: Publishing house "Ophthalmology" 2016-07-01
• Series: Офтальмохирургия
• Subjects: ophthalmic rosacea; dry eye syndrome (des); 0.05% cyclosporine a
• Online Access: https://www.ophthalmosurgery.ru/jour/article/view/255
• ISSN: 0235-4160; 2312-4970

Purpose. To analyze results of a complex treatment of ocular manifestations of rosacea using a 0.05% solution of cyclosporine for a topical application according to a scheme.Material and methods. The monitoring group consisted of 9 persons (18eyes) with a diagnosis of ophthalmic rosacea complicated by the dry eye syndrome (DES). The best corrected visual acuity (BCVA) in the group varied from 0.04 to 0.85 and averaged at 0.42. All patients underwent a complete ophthalmic examination, as well as Schirmer’s test, Norn’s test, meibomian glands disfunction (MGD) test, questionnaire. A previous topical treatment was canceled in patients of the monitoring group.Cyclosporine A (0.05%) drops were prescribed in combination with the lacrima substitutional therapy.Results. Clinical improvement occurred in 100% of cases in the form of reduced corneal syndrome, improvement of meibomian conjunctivitis, blepharitis, of secondary DES. In all cases there was a significant decrease in corneal vascularization and corneal subepithelial infiltrates. As a result of performed treatment there was an increase in visual acuity from 0.02 to 0.3 of the initial one. The mean BCVA after the treatment was 0.54. There was also a statistically significant improvement according to functional methods.Conclusions. 1. Ophthalmic rosacea is considered as a poly-etiologic disease with a complex and incompletely studied pathogenesis. 2. The above-mentioned group of patients is necessary to treat together with dermatologist to use both general and local therapy. 3. Cyclosporine A 0.05% drops usage is an effective method of local therapy in patients with ophthalmic rosacea, as it acts directly on the inflammation and the secondary DES. The main advantage of this medicine is an instillation nature of its application. 4. All patients have the objective positive results of treatment in all patients combined with subjective improvement, decrease in complaints. Patients reported an improved quality of life, that confirmes the questionnaire data.