The Efficacy Of Different Frequencies Of 0.05% Cyclosporine Eye Drops In The Treatment Of Dry Eye Disease Associated With Sj(?)gren’s Syndrome

Objective: To investigate the tear secretion(Schirmer I test,Sit),tear film break-up time(BUT),corneal fluorescein staining(FL),morphology of the lid gland acinus(MGA),and the lid gland acinus(MGA)in patients with Dry eye associated with Sj(?)gren’s syndrome(SS-DED)treated with Cyclosporine(CsA)eye drops at different frequencies.(Schirmer I test,SIt),Tear break-up time(BUT),Corneal fluorescein staining(FL),Meibomian gland acinus(MGA),Corneal nerve fiber density and diameter(CNF),The corneal epithelium and the number of Langerhans cells(LGs)in the corneal epithelium.Methods: A prospective non-randomized controlled experimental method was applied in this study.Forty-eight patients with SS-DED(SSDAI score <5)attending the ophthalmology clinic of the People’s Hospital of Xinjiang Uygur Autonomous Region from December 2021 to December 2022 were selected,and patients were numbered sequentially by the order in which they were seen,with patients with odd numbers as the control group and patients with even numbers as the experimental group,24 cases in each group.The relevant examinations were completed including: three dry eye tests,OSDI scale,Keratograph 5M ocular surface comprehensive analyzer(K5M),in vivo confocal microscopy(IVCM),etc.The patients were treated with the expected test,and the above examinations were reviewed at 1,4,and 12 weeks after the end of treatment,and changes in SIt,BUT,FL,MGA,CNF,and LGs were observed by treating SS-DED with 0.05%CsA twice a day and three times a day.Results: Before treatment,patients in both groups had changes in visual acuity,IOP,SIt,BUT,FL,tear meniscus height(TMH),first-noninvasive tear breakup time(BUTf),mean tear film breakup time(BUT-average.BUTav),lacrimal gland missing area,lacrimal gland vesicle morphology,nerve fiber diameter and number,and LGs were not statistically different(P>0.05).After 4 weeks of treatment,there was a statistical difference in TMH in the experimental group compared with the control group(P<0.05).After 12 weeks of treatment,SIt,BUT,BUTf and BUTav were found to be significantly higher and LGs were significantly lower in the experimental group compared to the control group,all of which were significantly different(P<0.05),and OSDI scores were all lower but not statistically different(P>0.05).There were no statistically significant differences in blepharoplasty morphology,upper and lower blepharoplasty gland loss area,crepuscular mite infection rate,nerve fiber diameter and number compared to the control group(P>0.05).Conclusion: In patients with moderate-to-severe SS-DED,treatment with CsA three times a day resulted in significantly better discomfort such as dry eyes and photophobia,increased SIt,and significant improvement in defective corneal epithelium and regression of inflammatory cells compared with treatment with CsA twice a day.