Clinical and immunological results of the complex therapy of postadenoviral corneal infiltrates

Session Details

Session Title: Cornea - Medical

Session Date/Time: Monday 07/09/2015 | 08:00-10:30

Paper Time: 08:27

Venue: Room 17

First Author: : D.Maychuk RUSSIA

Co Author(s): :    O. Vasilyeva                    

Abstract Details

Purpose:

The problem of postadenoviral infiltrative corneal lesions is a significant and persistent reducing in visual functions of patients. The use of monotherapy with corticosteroids brings only temporary positive results. The purpose of this study is to evaluate the results of treatment of postadenoviral corneal infiltrates (PCI) with topical corticosteroids and 0.05% cyclosporin A (Restasis®), based on clinical data and the local cytokine status.

Setting:

S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia

Methods:

The study included 42 eyes (24 patients) with PCI in cases of 3 month and more after acute period. Therapy included Dexamethasone 0,1%, 0,05%, 0,01% eye drops for 12 weeks; corneal protectors; artificial tears; Cyclosporine 0,05% twice a day for 6 months. Except clinical methods patients were carried out the studying of cytokine gene expression (IFN-α, IFN-β, IFN-γ, IFN-λ1, IFN-λ2, IFN-λ3, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-17, IL-18, TNF-α) in cultured cells of conjunctival scrapings and determining the content of cytokines (IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α) in the supernatant before treatment and 4 months after beginning.

Results:

. Maximum corrected visual acuity before treatment: 0.6±0.15, in 3 months period: 0.95±0.05, in 6 months period: 0.9±0.1. IOP data was always in normal range. Corneal condition before treatment: 4 points – 6 eyes, 3 – 20 eyes, 2 – 11 eyes, 1 – 5 eyes; at 3 and 6 months: 1 point –2 eyes, 0 – 40 eyes. Cytokine gene expression before treatment: IFN-α –71%; IFN-β, IL-8 –42%; IFN-γ, IFN-λ2 and IL-18 –14%. The content of cytokines: IFN-α –3,43±9,07pg/ml, IL-2 – 2,03±4,96pg/ml, IL-4 – 3,69±1,72pg/ml, IL-6 –2,57±5,59pg/ml, IL-8 – 24,00±13,30pg/ml. Cytokine gene expression in 3 months: IFN-α–60%; IL-6, IL-10–40%; IFN-β–30%; IFN-λ2, IL-18 –20%; IFN-γ, IL-1β,-2,-4,-8,-17, TNF-α –10%. The content of cytokines: IL-4 – 5,01±4,95pg/ml, IL-6 – 2,02±1,28pg/ml, IL-8 –20,02±11,97pg/ml.

Conclusions:

Long-term use of combined anti-inflammatory therapy with corticosteroids and 0.05% Cyclosporine A showed a positive clinical result. This was reflected in a persistent increase of visual acuity and in resorption of corneal opacities. On the background of this therapy, the complete suppression of residual antiviral activity (suppression of IFN-α) was marked. The increasing in IL-4 level, as well as its growth during the therapy showed the local activation of humoral immunity. Inhibition of the production of IL-2 during treatment indicates the suppression of Th-1-type immune responses. That was clinically manifested in the form of suppressing of the corneal immune inflammation.

Financial Interest:

NONE