This paper is interesting given that there is an ongoing clinical trial to look at restasis and treating ocular rosacea.
Current Treatment of Ocular Rosacea, Topical cyclosporine proves to be effective in treating rosacea. BY BARRY A. SCHECHTER, M.D.
Topical cyclosporine provided statistically significantly greater improvements in Schirmer scores (Graph 1), TBUT (Graph 2), corneal staining and ocular surface disease index (OSDI) scores (Graph 3) compared to artificial tears solution after 3 months of treatment.
The finding that cyclosporine is an effective treatment for the signs and symptoms of ocular rosacea is consistent with another recent evaluation. Perry and associates reported that topical cyclosporine was effective in treating ocular rosacea patients unresponsive to standard therapy.
Moreover, most patients in that cohort (71%) were able to discontinue all other medications. These authors also found that topical cyclosporine was safe and well tolerated in patients with ocular rosacea.
In another study by Wittpenn, which evaluated topical cyclosporine 0.05% in treating chronic active ocular rosacea, 55 patients placed on topical cyclosporine were followed an average of 5.2 months (range 2 to 119 patients).
Nine patients (16%) did not respond and withdrew. Twenty-one patients (38%) reported mild-to-moderate relief of symptoms with improvement in clinical exam. Twenty-five patients (46%) had significant improvement or complete resolution.
At long-term follow-up, 18 (39%) required no additional medications and 30 (65%) were still taking low-dose tetracycline. Wittpenn concluded that topical cyclosporine is efficacious in treating ocular rosacea.
Given the excellent side effect profile of topical cyclosporine and its lack of systemic absorption, ophthalmologists should consider utilizing topical cyclosporine in the treatment of patients with ocular rosacea.
. Perry HD, Wittpenn JR, D’Aversa G, Donnenfeld ED. Topical cyclosporine 0.05% for the treatment of chronic, active ocular rosacea. Presented at: the Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO); May 1-5, 2005; Fort Lauderdale, Fla.
Also some more comments from Cyclosporine Offers First-line Therapy Benefits for Ocular Rosacea :
When standard therapy fails ocular rosacea patients, topical cyclosporine 0.05%, either alone or in conjunction with a low-dose tetracycline, may prove to be the answer. In a preliminary study, more than 80% (46 of 55) of patients obtained partial or complete cessation of signs and symptoms.
Equally impressive was that a year later 76% (42 of 55) of patients were still taking the drug, either by itself or with a tetracycline.
A subsequent randomized, prospective, placebo-controlled study found cyclosporine significantly more effective than an artificial tear in reducing the signs and symptoms of ocular rosacea.
Because it is potentially safer than long-term therapy with members of the tetracycline family, topical cyclosporine may become a first-line agent for the treatment of ocular rosacea.