Effect of a combination of 0.001% hydrocortisone and 0.2% hyaluronic acid on conjunctival cytology in patients with dysregulatory inflammatory changes of the conjunctiva in type 2 diabetes
DOI:
https://doi.org/10.31288/oftalmolzh202441822Keywords:
hydrocortisone 0.001%, hyaluronic acid, type 2 diabetes, dry eye disease, impression cytology, inflammatory infiltration, ocular surfaceAbstract
Purpose. To assess and evaluate cytological changes of conjunctival epithelial cells collected by CIC and relative expression of CD15 before and after 2-month treatment with sodium hyaluronate 0.2% and 0.001% hydrocortisone among patients with dysregulatory inflammatory changes of the conjunctiva in type 2 diabetes mellitus.
Methods. We prospectively enrolled 38 T2DM patients (76 eyes). All patients were further divided into two groups: Group I - study group (n=23; 46 eyes); Group II - controls (n=15; 30 eyes). Group I received one drop of sodium hyaluronate 0.2% and 0.001% hydrocortisone (HA/Hydrocortisone); group II – one drop of sodium hyaluronate two times daily for two months, respectively.
Results. Relative expression of epithelial CD15 was significantly reduced after the treatment in Group I (p˂0,001) in contrast to Group II (p=0,8726). Absence of CD 15 expression was found in five cases (11%) before treatment and seven cases (15%) after HA/Hydrocortisone administration (p=0,7582). Macrophage infiltration was observed in 28% of participants upon baseline examination and it completely disappeared after treatment with HA/Hydrocortisone. These findings show that HA/hydrocortisone drops should be considered as an effective treatment for patients with dysregulated parainflammation of the conjunctiva.
Conclusions. Treatment with hyaluronate/hydrocortisone eye drops showed a statistically significant improvement of conjunctival cytology and functional tests: lipid layer thickness (LLT), tear breakup time (TBUT), meibomian gland loss (MGL) along with reduction of relative expression of epithelial CD15 among T2DM patients.
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