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Volume 113, Issue 2, Pages 198-205 (February 2006)


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Topical 0.1% Prednisolone Lowers Nerve Growth Factor Expression in Keratoconjunctivitis Sicca Patients

Hyung Keun Lee, MD1, Ik Hee Ryu, MD1, Kyoung Yul Seo, MD1, SoonWon Hong, MD, PhD2, Hyung Chang Kim, MD, PhD3, Eung Kweon Kim, MD14Corresponding Author Informationemail address

Received 1 April 2005; accepted 27 September 2005. published online 19 December 2005.

Purpose

To compare nerve growth factor (NGF) levels in tears and on the ocular surfaces of normal control and non–Sjögren’s type keratoconjunctivitis sicca subjects, and to investigate the effect of 0.1% prednisolone eyedrops on NGF levels in keratoconjunctivitis sicca patients.

Design

Prospective, double-masked, randomized, comparative clinical trial.

Participants

Forty-one keratoconjunctivitis sicca patients and 23 age- and gender-matched healthy subjects.

Methods

Baseline tear NGF levels were measured in keratoconjunctivitis sicca patients and healthy control subjects using enzyme-linked immunosorbent assays. Keratoconjunctivitis sicca patients received 0.1% prednisolone drops in one eye and 0.1% hyaluronic acid drops in the other, 3 times a day for 28 days. Also, impression cytology (IC) and immunostaining for NGF on conjunctival epithelium were performed on both groups.

Main Outcome Measures

Tear NGF/total tear protein (TP) concentration ratio, IC and NGF immunocytologic staining, subjective symptom scale, tear breakup time, and Schirmer values.

Results

Keratoconjunctivitis sicca patients were found to have baseline tear NGF concentrations higher than those of age- and gender-matched healthy control subjects (65.9±14.5 vs. 122.1±45.3 pg/μg, P<0.0001). In keratoconjunctivitis sicca patients, prednisolone treatment for 28 days resulted in a decrease in tear NGF levels, symptom scores, and IC scores, whereas hyaluronic acid treatment had no such effect (68.2±25.0 pg/μg vs. 108.0±43.4 pg/μg, P<0.0001 for tear NGF/TP ratio; 2.16±1.01 vs. 3.39±1.50, P = 0.0014 for symptom scale; 1.05±0.67 vs. 1.61±0.86, P = 0.0317 for IC). Measurements taken at both 14 and 28 days indicated that neither prednisolone nor hyaluronic acid treatment affected breakup time or Schirmer values.

Conclusion

Keratoconjunctivitis sicca patients showed elevated levels of tear NGF, which were decreased by treatment with 0.1% prednisolone. These data suggest that ocular surface NGF may play an important role in ocular surface inflammation processes associated with dry eyes.

1 Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea

2 Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea

3 Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, South Korea

4 BK21 Project for Medical Science, Yonsei University, Seoul, South Korea

Corresponding Author InformationCorrespondence and reprint requests to Eung Kweon Kim, MD, Institute of Vision Research, Department of Ophthalmology, Yonsei University, YongDong Severance Hospital, 146-92 Dokok-dong, Kangnam-Gu, Seoul 135-720, South Korea

 Manuscript no. 2005-288.

Drs Lee and Ryu contributed equally to the study.

The work was supported by the Korea Health 21 R&D Project, Ministry of Health and Welfare, Seoul, South Korea (grant no.: 02-PJ1-PG1-CH02-0003).

No author has any commercial or proprietary interests in any of the instruments or materials used in the study.

PII: S0161-6420(05)01151-6

doi:10.1016/j.ophtha.2005.09.033


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