Effects of topical loteprednol etabonate on tear cytokines and clinical outcomes in moderate and severe meibomian gland dysfunction: Randomized clinical trial

Hun Lee; Byunghoon Chung; Kyu Seo Kim; Kyoung Yul Seo; Bong Joon Choi; Tae Im Kim

doi:10.1016/j.ajo.2014.08.015

Effects of topical loteprednol etabonate on tear cytokines and clinical outcomes in moderate and severe meibomian gland dysfunction: Randomized clinical trial

Hun Lee, Byunghoon Chung, Kyu Seo Kim, Kyoung Yul Seo, Bong Joon Choi, Tae Im Kim

Department of Ophthalmology

Research output: Contribution to journal › Article › peer-review

40 Citations (Scopus)

Abstract

PURPOSE: To assess tear cytokine levels and clinical outcomes in moderate and severe meibomian gland dysfunction (MGD) after 2 months of treatment with topical loteprednol etabonate and eyelid scrubs with warm compresses vs eyelid scrubs with warm compresses alone.

DESIGN: Randomized controlled trial.

METHODS: Patients with moderate and severe MGD were randomized into 2 groups: topical loteprednol etabonate and eyelid scrubs with warm compresses (Group I, 34 eyes) or eyelid scrubs with warm compresses (Group II, 36 eyes). We evaluated cytokine levels, tear film break-up time (TBUT), corneal and conjunctival fluorescein staining, biomicroscopic examination of lid margins and meibomian glands, and the Ocular Surface Disease Index before initiating treatment and 1 month and 2 months after treatment.

RESULTS: There were significant decreases in the levels of interleukin (IL)-6, IL-8, and IL-1β in Group I, and IL-6 and IL-8 in Group II. Moreover, the observed decreases of these cytokines in Group I were attributed to a remarkable decrease between treatment and 1 month after treatment. In Group I, there were improvements in all of the clinical outcomes, with prominent improvement in TBUT, corneal and conjunctival fluorescein staining, and meibum quality after 1 month of treatment, compared with Group II. An improvement in meibomian gland expressibility and MGD stage reduction were more remarkable in Group I.

CONCLUSIONS: Topical loteprednol etabonate and eyelid scrubs with warm compresses were tolerated and efficacious for the treatment of moderate and severe MGD. We suggest that such beneficial effects could manifest after 1 month.

Original language	English
Pages (from-to)	1172-1183.e1
Journal	American Journal of Ophthalmology
Volume	158
Issue number	6
DOIs	https://doi.org/10.1016/j.ajo.2014.08.015
Publication status	Published - 2014 Dec 1

Bibliographical note

Funding Information:
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. This work was partially supported by the National Research Foundation of South Korea (NRF) grant funded by the South Korea government (MEST No. 2013R1A1A2058907 ) and by the Converging Research Center Program through the Ministry of Science, ICT and Future Planning, South Korea ( 2013K000365 ). The supporters had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors' contributions were as follows: involved in the design of the study (H.L., K.S.K., T.-I.K.); conduct of the study (H.L., K.S.K., B.H.C., T.-I.K.); collection, management, analysis, and interpretation of the data (H.L., K.S.K., K.Y.S., B.H.C., B.J.C., T.-I.K.); preparation of the manuscript (H.L., K.S.K., K.Y.S., T.-I.K.); and review or approval of the manuscript (H.L., K.S.K., K.Y.S., B.H.C., B.J.C., T.-I.K.). This study is registered at http://www.clinicaltrials.gov (identification no. NCT01692652).

All Science Journal Classification (ASJC) codes

Ophthalmology

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@article{3a7ab8b78cc54b6c9b980f2e7942b63f,

title = "Effects of topical loteprednol etabonate on tear cytokines and clinical outcomes in moderate and severe meibomian gland dysfunction: Randomized clinical trial",

abstract = "PURPOSE: To assess tear cytokine levels and clinical outcomes in moderate and severe meibomian gland dysfunction (MGD) after 2 months of treatment with topical loteprednol etabonate and eyelid scrubs with warm compresses vs eyelid scrubs with warm compresses alone.DESIGN: Randomized controlled trial.METHODS: Patients with moderate and severe MGD were randomized into 2 groups: topical loteprednol etabonate and eyelid scrubs with warm compresses (Group I, 34 eyes) or eyelid scrubs with warm compresses (Group II, 36 eyes). We evaluated cytokine levels, tear film break-up time (TBUT), corneal and conjunctival fluorescein staining, biomicroscopic examination of lid margins and meibomian glands, and the Ocular Surface Disease Index before initiating treatment and 1 month and 2 months after treatment.RESULTS: There were significant decreases in the levels of interleukin (IL)-6, IL-8, and IL-1β in Group I, and IL-6 and IL-8 in Group II. Moreover, the observed decreases of these cytokines in Group I were attributed to a remarkable decrease between treatment and 1 month after treatment. In Group I, there were improvements in all of the clinical outcomes, with prominent improvement in TBUT, corneal and conjunctival fluorescein staining, and meibum quality after 1 month of treatment, compared with Group II. An improvement in meibomian gland expressibility and MGD stage reduction were more remarkable in Group I.CONCLUSIONS: Topical loteprednol etabonate and eyelid scrubs with warm compresses were tolerated and efficacious for the treatment of moderate and severe MGD. We suggest that such beneficial effects could manifest after 1 month.",

author = "Hun Lee and Byunghoon Chung and Kim, {Kyu Seo} and Seo, {Kyoung Yul} and Choi, {Bong Joon} and Kim, {Tae Im}",

note = "Funding Information: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. This work was partially supported by the National Research Foundation of South Korea (NRF) grant funded by the South Korea government (MEST No. 2013R1A1A2058907 ) and by the Converging Research Center Program through the Ministry of Science, ICT and Future Planning, South Korea ( 2013K000365 ). The supporters had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors' contributions were as follows: involved in the design of the study (H.L., K.S.K., T.-I.K.); conduct of the study (H.L., K.S.K., B.H.C., T.-I.K.); collection, management, analysis, and interpretation of the data (H.L., K.S.K., K.Y.S., B.H.C., B.J.C., T.-I.K.); preparation of the manuscript (H.L., K.S.K., K.Y.S., T.-I.K.); and review or approval of the manuscript (H.L., K.S.K., K.Y.S., B.H.C., B.J.C., T.-I.K.). This study is registered at http://www.clinicaltrials.gov (identification no. NCT01692652). ",

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doi = "10.1016/j.ajo.2014.08.015",

language = "English",

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Effects of topical loteprednol etabonate on tear cytokines and clinical outcomes in moderate and severe meibomian gland dysfunction : Randomized clinical trial. / Lee, Hun; Chung, Byunghoon; Kim, Kyu Seo; Seo, Kyoung Yul; Choi, Bong Joon; Kim, Tae Im.

In: American Journal of Ophthalmology, Vol. 158, No. 6, 01.12.2014, p. 1172-1183.e1.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Effects of topical loteprednol etabonate on tear cytokines and clinical outcomes in moderate and severe meibomian gland dysfunction

T2 - Randomized clinical trial

AU - Lee, Hun

AU - Chung, Byunghoon

AU - Kim, Kyu Seo

AU - Seo, Kyoung Yul

AU - Choi, Bong Joon

AU - Kim, Tae Im

N1 - Funding Information: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. This work was partially supported by the National Research Foundation of South Korea (NRF) grant funded by the South Korea government (MEST No. 2013R1A1A2058907 ) and by the Converging Research Center Program through the Ministry of Science, ICT and Future Planning, South Korea ( 2013K000365 ). The supporters had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors' contributions were as follows: involved in the design of the study (H.L., K.S.K., T.-I.K.); conduct of the study (H.L., K.S.K., B.H.C., T.-I.K.); collection, management, analysis, and interpretation of the data (H.L., K.S.K., K.Y.S., B.H.C., B.J.C., T.-I.K.); preparation of the manuscript (H.L., K.S.K., K.Y.S., T.-I.K.); and review or approval of the manuscript (H.L., K.S.K., K.Y.S., B.H.C., B.J.C., T.-I.K.). This study is registered at http://www.clinicaltrials.gov (identification no. NCT01692652).

PY - 2014/12/1

Y1 - 2014/12/1

N2 - PURPOSE: To assess tear cytokine levels and clinical outcomes in moderate and severe meibomian gland dysfunction (MGD) after 2 months of treatment with topical loteprednol etabonate and eyelid scrubs with warm compresses vs eyelid scrubs with warm compresses alone.DESIGN: Randomized controlled trial.METHODS: Patients with moderate and severe MGD were randomized into 2 groups: topical loteprednol etabonate and eyelid scrubs with warm compresses (Group I, 34 eyes) or eyelid scrubs with warm compresses (Group II, 36 eyes). We evaluated cytokine levels, tear film break-up time (TBUT), corneal and conjunctival fluorescein staining, biomicroscopic examination of lid margins and meibomian glands, and the Ocular Surface Disease Index before initiating treatment and 1 month and 2 months after treatment.RESULTS: There were significant decreases in the levels of interleukin (IL)-6, IL-8, and IL-1β in Group I, and IL-6 and IL-8 in Group II. Moreover, the observed decreases of these cytokines in Group I were attributed to a remarkable decrease between treatment and 1 month after treatment. In Group I, there were improvements in all of the clinical outcomes, with prominent improvement in TBUT, corneal and conjunctival fluorescein staining, and meibum quality after 1 month of treatment, compared with Group II. An improvement in meibomian gland expressibility and MGD stage reduction were more remarkable in Group I.CONCLUSIONS: Topical loteprednol etabonate and eyelid scrubs with warm compresses were tolerated and efficacious for the treatment of moderate and severe MGD. We suggest that such beneficial effects could manifest after 1 month.

AB - PURPOSE: To assess tear cytokine levels and clinical outcomes in moderate and severe meibomian gland dysfunction (MGD) after 2 months of treatment with topical loteprednol etabonate and eyelid scrubs with warm compresses vs eyelid scrubs with warm compresses alone.DESIGN: Randomized controlled trial.METHODS: Patients with moderate and severe MGD were randomized into 2 groups: topical loteprednol etabonate and eyelid scrubs with warm compresses (Group I, 34 eyes) or eyelid scrubs with warm compresses (Group II, 36 eyes). We evaluated cytokine levels, tear film break-up time (TBUT), corneal and conjunctival fluorescein staining, biomicroscopic examination of lid margins and meibomian glands, and the Ocular Surface Disease Index before initiating treatment and 1 month and 2 months after treatment.RESULTS: There were significant decreases in the levels of interleukin (IL)-6, IL-8, and IL-1β in Group I, and IL-6 and IL-8 in Group II. Moreover, the observed decreases of these cytokines in Group I were attributed to a remarkable decrease between treatment and 1 month after treatment. In Group I, there were improvements in all of the clinical outcomes, with prominent improvement in TBUT, corneal and conjunctival fluorescein staining, and meibum quality after 1 month of treatment, compared with Group II. An improvement in meibomian gland expressibility and MGD stage reduction were more remarkable in Group I.CONCLUSIONS: Topical loteprednol etabonate and eyelid scrubs with warm compresses were tolerated and efficacious for the treatment of moderate and severe MGD. We suggest that such beneficial effects could manifest after 1 month.

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