Effects of Conventional Dry Eye Treatments on the Ocular Surface Response to Low Humidity Environment in Patients With Keratoconjunctivitis Sicca.
Overview
- Phase
- Phase 4
- Intervention
- Dexamethasone
- Conditions
- Keratoconjunctivitis Sicca
- Sponsor
- Baylor College of Medicine
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- Changes in Corneal Fluorescein Staining
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
The purpose of this study is to evaluate whether, in people with dry eye syndrome, over the counter artificial tears and the prescription eye drop, dexamethasone, change or effect the eyes response to a low humidity environment.
It is known that irritation from dry eye can be improved by over the counter artificial tears because they wet and lubricate the eyes. The prescription eye drop, dexamethasone, can also improve eye irritation by decreasing the inflammation that develops in dry eye. Thus, the investigators hypothesize that the use of these conventional dry eye treatments will improve the eyes' response to a low humidity environment.
Detailed Description
This study evaluated the effects of the corticosteroid dexamethasone on suppressing development of eye irritation, cornea epithelial disease and increased production of inflammatory mediators in subjects who were subjected to an experimental low humidity drafty environment.
Investigators
Steven Pflugfelder
Professor of Ophthalmology
Baylor College of Medicine
Eligibility Criteria
Inclusion Criteria
- •Signature on the written informed consent form
- •Patient motivation and willingness to cooperate with the investigator by following the required medication regimen
- •Patient willingness and ability to return for all visits during the study
- •Rapid tear film break up time of seven seconds or less in at least one eye AND
- •Both cornea fluorescein staining score 3 or greater and conjunctival lissamine green staining 3 or greater in at least one eye
- •Ocular Surface Disease Index Symptom Severity score of twenty or greater
- •Tear meniscus height less than or equal to 200um
- •Intact corneal sensitivity
- •Willingness to discontinue use of any current dry eye treatment (except artificial tears) for four weeks prior to enrollment, and during the course of the study
Exclusion Criteria
- •Compromised cognitive ability which may be expected to interfere with study compliance
- •Uncontrolled or poorly controlled diabetes or heart or pulmonary disease that could, in the judgment of the investigator, jeopardize subject safety or interfere with the interpretation of the results of the study
- •Known hypersensitivity to any components of the artificial tears or dexamethasone eye drops
- •Anticipated contact lens wear during the study
- •History of corneal transplant
- •Active ocular infection, uveitis or non-Keratoconjunctivitis sicca related inflammation
- •History of cataract surgery within 3 months prior to enrollment
- •History of pterygium removal within 6 months prior to enrollment
- •Reduced corneal sensitivity
- •Initiation, discontinuation or change in dosage of hormone replacement therapy, fish oil, evening primrose, flaxseed, or black current seed oil supplements, antihistamines, cholinergic agents, beta-blocking agents, tricyclic or selective serotonin reuptake inhibitors, antidepressants, phenothiazines, or topical or systemic acne rosacea medications in two months prior to enrollment, or anticipated change in dosage during course of study
Arms & Interventions
Artificial tears first, then Dexamethasone
Artificial tears four times a day both eyes for two weeks, then Dexamethasone 0.01% four times a day both eyes for two weeks
Intervention: Dexamethasone
Artificial tears first, then Dexamethasone
Artificial tears four times a day both eyes for two weeks, then Dexamethasone 0.01% four times a day both eyes for two weeks
Intervention: Artificial tear
Outcomes
Primary Outcomes
Changes in Corneal Fluorescein Staining
Time Frame: Two weeks after treatment and exposure to a low humidity environment
Subjects will be treated with preservative-free artificial tears for 2 weeks then exposed to a low humidity environment for 90 minutes, then treated with preservative-free dexamethasone 0.1% for 2 weeks and exposed to a low humidity environment again. The change in corneal fluorescein staining before and after the low humidity exposure was measured after each treatment. Fluorescein staining was graded using the CCLR scale (0-100) in 5 zones on the cornea for a maximum score of 500 (range 0-500). A lower change in staining indicates less severe disease in response to the low humidity stress. Negative number indicates staining after exposure was lower than pre.